Article Text

Mindfulness online: a preliminary evaluation of the feasibility of a web-based mindfulness course and the impact on stress
  1. Adele Krusche1,
  2. Eva Cyhlarova2,
  3. Scott King3,
  4. J Mark G Williams1
  1. 1Department of Psychiatry, University of Oxford, Oxford, UK
  2. 2Mental Health Foundation, London, UK
  3. 3Wellmind Media Ltd, Brighton, UK
  1. Correspondence to Adele Krusche; adele.krusche{at}


Objectives Stress has been shown to have a number of negative effects on health over time. Mindfulness interventions have been shown to decrease perceived stress but access to interventions is limited. Therefore, the effectiveness of an online mindfulness course for perceived stress was investigated.

Design A preliminary evaluation of an online mindfulness course.

Participants This sample consisted of 100 self-referrals to the online course. The average age of participants was 48 years and 74% were women.

Interventions The online programme consisted of modules taken from Mindfulness Based Stress Reduction and Mindfulness Based Cognitive Therapy and lasted for approximately 6 weeks.

Primary and secondary outcome measures Participants completed the Perceived Stress Scale (PSS) before the course, after the course and at 1-month follow-up. Completion of formal (eg, body scan, mindful movement) and informal (eg, mindful meal, noticing) mindfulness activities was self-reported each week.

Results Participation in the online mindfulness course significantly reduced perceived stress upon completion and remained stable at follow-up. The pre-post effect size was equivalent to levels found in other class-based mindfulness programmes. Furthermore, people who had higher PSS scores before the course reported engaging in significantly more mindfulness practice, which was in turn associated with greater decreases in PSS.

Conclusions Because perceived stress significantly decreased with such limited exposure to mindfulness, there are implications for the accessibility of mindfulness therapies online. Future research needs to evaluate other health outcomes for which face-to-face mindfulness therapies have been shown to help, such as anxiety and depressive symptoms.

This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See:

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  • Correction notice The license of this article has also changed since publication to CC BY 4.0.

  • Acknowledgements The authors would like to thank Richard Latham of Wellmind Media Ltd, for his help in developing the online intervention, and Paul Bristow of the Mental Health Foundation, for his continued support.

  • To cite: Krusche A, Cyhlarova E, King S, et al. Mindfulness online: a preliminary evaluation of the feasibility of a web-based mindfulness course and the impact on stress. BMJ Open 2012;2:e000803. doi:10.1136/bmjopen-2011-000803

  • Contributors All authors planned the paper and EC and JMGW contributed to the first draft, which was written by AK. The intervention was developed by JMGW, SK and RL. AK, EC, SK and MW designed the analysis plan, and AK analysed the data. All authors critically revised the manuscript and approved the final version. AK is the guarantor.

  • Funding This project was collaboration between Oxford University, the Mental Health Foundation and Wellmind Media Ltd. The development of the intervention was supported by Wellmind Media Ltd and the Mental Health Foundation.

  • Competing interests Wellmind Media Ltd and the Mental Health Foundation received a fee from the intervention. None of the authors receive any payment personally; there are no other relationships or activities that could appear to have influenced the submitted work. The data were handled and analysed securely and confidentially by AK at the University of Oxford.

  • Consent This investigation was conducted as an initial audit of the online mindfulness course for its usefulness. Consent was taken upon registering for the course.

  • Patient consent Obtained.

  • Ethics approval This paper is an initial evaluation of the site and no one particular person is identifiable in the paper. The data are taken as a survey, obtained by an opt-in system (where ‘implied consent’ is relevant). Confirmation was obtained from the Research and Development Ethics Clinical Audit and Effectiveness Department, Oxford, that no formal ethics approval was needed.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement The original anonymous data files (which include the PSS scores, practice responses and date of birth of participants) are held securely at the University of Oxford. Access to these files is held by the first author.

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