000099075 001__ 99075
000099075 005__ 20230519145518.0
000099075 0247_ $$2doi$$a10.1371/journal.pmed.1003481
000099075 0248_ $$2sideral$$a122243
000099075 037__ $$aART-2021-122243
000099075 041__ $$aeng
000099075 100__ $$aGalante, J.
000099075 245__ $$aMindfulness-based programmes for mental health promotion in adults in nonclinical settings: A systematic review and meta-analysis of randomised controlled trials
000099075 260__ $$c2021
000099075 5060_ $$aAccess copy available to the general public$$fUnrestricted
000099075 5203_ $$aBackground
There is an urgent need for mental health promotion in nonclinical settings. Mindfulness–based programmes (MBPs) are being widely implemented to reduce stress, but a comprehensive evidence synthesis is lacking. We reviewed trials to assess whether MBPs promote mental health relative to no intervention or comparator interventions.
Methods and findings
Following a detailed preregistered protocol (PROSPERO CRD42018105213) developed with public and professional stakeholders, 13 databases were searched to August 2020 for randomised controlled trials (RCTs) examining in–person, expert–defined MBPs in nonclinical settings. Two researchers independently selected, extracted, and appraised trials using the Cochrane Risk–of–Bias Tool 2.0. Primary outcomes were psychometrically validated anxiety, depression, psychological distress, and mental well–being questionnaires at 1 to 6 months after programme completion. Multiple testing was performed using p < 0.0125 (Bonferroni) for statistical significance. Secondary outcomes, meta–regression and sensitivity analyses were prespecified. Pairwise random–effects multivariate meta–analyses and prediction intervals (PIs) were calculated. A total of 11, 605 participants in 136 trials were included (29 countries, 77% women, age range 18 to 73 years). Compared with no intervention, in most but not all scenarios MBPs improved average anxiety (8 trials; standardised mean difference (SMD) = -0.56; 95% confidence interval (CI) -0.80 to -0.33; p–value < 0.001; 95% PI -1.19 to 0.06), depression (14 trials; SMD = -0.53; 95% CI -0.72 to -0.34; p–value < 0.001; 95% PI -1.14 to 0.07), distress (27 trials; SMD = -0.45; 95% CI -0.58 to -0.31; p–value < 0.001; 95% PI -1.04 to 0.14), and well–being (9 trials; SMD = 0.33; 95% CI 0.11 to 0.54; p–value = 0.003; 95% PI -0.29 to 0.94). Compared with nonspecific active control conditions, in most but not all scenarios MBPs improved average depression (6 trials; SMD = -0.46; 95% CI -0.81 to -0.10; p–value = 0.012, 95% PI -1.57 to 0.66), with no statistically significant evidence for improving anxiety or distress and no reliable data on well–being. Compared with specific active control conditions, there is no statistically significant evidence of MBPs’ superiority. Only effects on distress remained when higher–risk trials were excluded. USA–based trials reported smaller effects. MBPs targeted at higher–risk populations had larger effects than universal MBPs. The main limitation of this review is that confidence according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach is moderate to very low, mainly due to inconsistency and high risk of bias in many trials.
Conclusions
Compared with taking no action, MBPs of the included studies promote mental health in nonclinical settings, but given the heterogeneity between studies, the findings do not support generalisation of MBP effects across every setting. MBPs may have specific effects on some common mental health symptoms. Other preventative interventions may be equally effective. Implementation of MBPs in nonclinical settings should be partnered with thorough research to confirm findings and learn which settings are most likely to benefit.
000099075 536__ $$9info:eu-repo/grantAgreement/ES/MECD/FPU15-00598$$9info:eu-repo/grantAgreement/ES/MECD/FPU16-03565
000099075 540__ $$9info:eu-repo/semantics/openAccess$$aby$$uhttp://creativecommons.org/licenses/by/3.0/es/
000099075 590__ $$a11.613$$b2021
000099075 592__ $$a4.18$$b2021
000099075 594__ $$a15.0$$b2021
000099075 591__ $$aMEDICINE, GENERAL & INTERNAL$$b22 / 172 = 0.128$$c2021$$dQ1$$eT1
000099075 593__ $$aBiochemistry$$c2021$$dQ1
000099075 593__ $$aMolecular Biology$$c2021$$dQ1
000099075 593__ $$aMedicine (miscellaneous)$$c2021$$dQ1
000099075 593__ $$aBiotechnology$$c2021$$dQ1
000099075 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/publishedVersion
000099075 700__ $$aFriedrich, C.
000099075 700__ $$aDawson, A.F.
000099075 700__ $$0(orcid)0000-0003-1575-7738$$aModrego-Alarcón, M.$$uUniversidad de Zaragoza
000099075 700__ $$aGebbing, P.
000099075 700__ $$aDelgado-Suárez, I.
000099075 700__ $$aGupta, R.
000099075 700__ $$aDean, L.
000099075 700__ $$aDalgleish, T.
000099075 700__ $$aWhite, I.R.
000099075 700__ $$aJones, P.B.
000099075 7102_ $$14009$$2735$$aUniversidad de Zaragoza$$bDpto. Psicología y Sociología$$cÁrea Psicolog.Evolut.Educac
000099075 773__ $$g18, 1 (2021), e1003481[40 pp]$$pPLos Med.$$tPLOS MEDICINE$$x1549-1277
000099075 8564_ $$s795656$$uhttps://zaguan.unizar.es/record/99075/files/texto_completo.pdf$$yVersión publicada
000099075 8564_ $$s2416039$$uhttps://zaguan.unizar.es/record/99075/files/texto_completo.jpg?subformat=icon$$xicon$$yVersión publicada
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000099075 951__ $$a2023-05-18-15:20:07
000099075 980__ $$aARTICLE