Impact of a Yoga and Meditation Intervention on Students' Stress Impact of a Yoga and Meditation Intervention on Students' Stress and Anxiety Levels and Anxiety Levels

Objective . To evaluate the impact of a 6-week yoga and meditation intervention on college students’ stress perception, anxiety levels and mindfulness skills. Methods . College students participated in a 6-week pilot program consisting of a 60-minute vinyasa yoga class followed by guided meditation once weekly, delivered by trained faculty at the University of Rhode Island College of Pharmacy. Students completed pre- and post-questionnaires to evaluate changes in the following outcomes: stress levels, anxiety levels, and mindfulness skills. The questionnaire was comprised of three self reporting tools: Beck Anxiety Inventory (BAI), Perceived Stress Scale (PSS), and Five Facet Mindfulness Questionnaire (FFMQ). Changes from baseline were assessed using numerical and categorical scales (low, medium, and high). Results . Seventeen participants (ages 19-23) completed the study. Thirteen participants were female, and four were male. Nine of the students were enrolled in the PharmD program and eight from other majors. Anxiety and stress scores decreased while total mindfulness increased, with all changes statistically significant. Categorical pre-post data from BAI and PSS were statistically significant with no students reported being in the “high” category of both stress and anxiety post intervention. Conclusion . Students demonstrated a reduction in stress and anxiety levels after completing a 6-week yoga and meditation program preceding final exams. Results suggest adopting a mindfulness practice for as little as once per week may reduce stress and anxiety in college students. Higher education may consider the inclusion of nonpharmacologic methods, such as yoga and meditation, to support student self-care. (not at all) to 3 (severely) with a total score of 63 points. Scores ranging from 0-21 were categorized as “Low” anxiety, 22-35 as “Moderate” anxiety, and 36 or higher as “High” anxiety. The BAI demonstrates internal consistency, convergence with other anxiety measurements, and has been tested in many populations including college students. 19-21 The PSS reports an individual’s experience of stress. The tool measures psychological manifestations of stress, designed to assess “the degree to which individuals appraise situations in their lives as stressful. ” Responses are collected using a 5-point Likert scale from 0 (never) to 5 (very often). Scores ranging from 0-13 were categorized as “Low” stress, 14-26 as “Moderate” stress, and 27-40 as “High” stress. This research utilized the 10 item inventory, also known as the PSS-10. 22,23 Last, the FFMQ, developed at the University of Kentucky by Dr. Ruth Baer, was utilized to assess student mindfulness which included Observing (FFMQ-O), Describing (FFMQ-D), Acting with Awareness (FFMQ-AwA), Non Judging of Inner Experience (FFMQ-NJ), and Nonreactivity to Inner Experience (FFMQ-NR). 24 Responses are collected using a 5-point Likert scale from 1 (never or very rarely true) to 5 (very often or always true). The three self-reporting inventories were administered electronically via Google Forms to all participants pre and post intervention. Several studies have demonstrated benefit utilizing yoga or meditation, predominantly in medical, psychology, and nursing students; however, none have incorporated a dual intervention on pharmacy students specifically. O’Driscoll and colleagues conducted a systematic review on the benefits of Mindfulness Based Stress Reduction and Mindfulness Based Cognitive Therapy for undergraduate health and social care college students. Eleven studies met the inclusion criteria demonstrating benefits in student stress, anxiety, and mindfulness. Limitations included lack of long-term follow-up, potential risk of bias, and failure to cite the qualifications of those delivering the mindfulness intervention. 18 Another study demonstrating a reduction in stress and increase in self-compassion was conducted by Erogul and colleagues on 59 first-year medical students in Brooklyn, NY, utilizing an 8-week dual intervention of didactic, classroom instruction with a home meditation requirement. A major limitation included poor adherence with the home meditation component yielding a mean number of minutes per meditation session of 14.6. 11 In contrast, our study incorporated the meditative practice within our intervention sessions ensuring a higher minimum number of minutes. Though our study did not require a home meditation component, practice was encouraged. Last, Warnecke and colleagues conducted a multicenter, single-blinded, randomized control trial consisting of sole, home-based guided meditation practice utilizing a 30-minute audio compact disc for final year medical students in Australia. Students documented adherence to daily, 8-week intervention in a written diary. Results demonstrated a reduction in stress and anxiety. Similar to our study, the PSS was used as the outcome measure. A reduction from baseline of -3.44 was observed as compared to our findings of -7.9, demonstrating a face-to-face, dual yoga and meditation practice, as opposed to home study, may yield a greater reduction in student stress. 17 As the literature, our pilot study demonstrated many strengths, including a high quality, dual yoga and meditation intervention in addition to well-qualified, experienced practitioners leading the sessions. Limitations to our pilot study included a small sample size and short duration of follow-up. Our study was limited by potential self-reported outcomes which may have led to reporting bias by participants. Further limitations included a lack of randomization