Impact of Online Versus In-Person Delivery of Mindfulness-Based Stress Reduction on Psychological Distress

Context: Management of psychological distress is a major challenge in healthcare settings. Mindfulness Based Stress Reduction (MBSR) has documented benefits for psychological distress and has been increasingly offered in health centers across the U.S. The COVID-19 pandemic has necessitated changes to many services, favoring remote delivery. Prior research has focused primarily on in-person delivery of MBSR. To date, the relative benefits of remote versus in-person delivery of MBSR remain to be elucidated.

Objective: To evaluate relative changes in psychological distress (stress, anxiety, and depression) among online and in-person MBSR participants.

Study Design: Retrospective cohort study.

Setting: Large academic health center in Central Pennsylvania.

Population Studied: Adult members of the general public enrolled in MBSR courses.

Intervention: Standard eight-week MBSR curriculum was delivered live online or in-person by trained instructors.

Outcome Measures: Psychological distress was assessed with measures of stress (Perceived Stress Scale-10), anxiety (Generalized Anxiety Disorder-7) and depression (Patient Health Questionnaire-9). Assessments were administered to MBSR participants before and after course completion.

Results: Among MBSR participants (N=95), 25 completed MBSR training in-person (pre-pandemic) and 70 completed training remotely via video conferencing. The majority identified as white (77.9%), non-Hispanic (91.6%), female (76.8%), >40 years of age (62.1%), with an annual household income <$100,000 USD (45.3%), without between-group differences noted in demographic characteristics. Each group had significantly reduced their mean stress, anxiety and depression scores (all p<0.05) from baseline to post course; these pre-post changes did not differ statistically between the in-person and remote cohorts.

Conclusions: The results of this pragmatic study leveraging real-life services and their impact evaluation, suggest that live, remotely delivered MBSR can be an effective, viable alternative to conventional in-person delivery.