Stress Interventions in STEM and Non-STEM
Condition: MBSR-STEM; PMR-STEM; MBSR-NON-STEM; PMR -NON-STEM
Study type: Interventional
Phase: Phase 1

Summary: 
      The purpose of this study is to determine if (1) stress management intervention response
      depends on college major and (2) if there is a difference in effectiveness between
      Mindfulness Based Stress Reduction (MBSR) and Progressive Muscle Relaxation (PMR).

      A. Objectives The goal of this study is to determine if STEM and non-STEM students respond
      differently to stress management interventions (SMIs) and to measure if MBSR and PMR are
      effective for reducing stress and improving sleep, mood, anxiety and depression symptoms.

      B. Research Question(s) Aim #1: Determine if the type of SMI (PMR or MBSR) has different
      efficacies on STEM vs nonSTEM students for reducing stress and improving sleep, mood, anxiety
      and depression in university students.

      Aim #2: Determine if administration of a SMI improves self-reported stress, sleep quality,
      mood, anxiety and depression in university students.
    

Detailed description: 
      Stress is a common response throughout all populations but has been associated with a 20%
      increase in the last thirty years. There are positive aspects to stress but high levels of
      consistent stress can be detrimental on the individual. In 2014, 77% of all Americans
      reported regularly experiencing physical symptoms of stress and 73% reported regularly
      experiencing the psychological effects caused by stress, with 33% feeling that they are
      dealing with extreme stress. When stress levels remain high for prolonged periods of time,
      individuals can experience the risk of development or worsening of sleep issues. There is
      abundant evidence that stress can cause changes in sleep time, fragmented sleep patterns,
      time taken to fall asleep, etc. Dysregulation of sleep is associated with worsening and
      development of mental health disorders like anxiety and depression. Stress can also adversely
      impact health due to its effect on suppressing the immune system and has a major impact on
      the severity of negative moods in individuals.

      College students are a subset of the population that are vulnerable to experiencing extreme
      and prolonged stress, and in turn, poor sleep quality and depressive and anxiety symptoms.
      College students are a unique population as they are living in a critical period experiencing
      major environmental and psychological challenges and adaptations. Nearly 60% of all college
      students are reporting facing higher than average stress which is at an all-time high.
      College students already report poor sleep hygiene and quality which makes the impact of
      stress more profound on their health. Depressive symptoms across universities worldwide show
      that up to 50% of college students are facing depressive symptoms regularly. In a separate
      study, it was found that 3 out of 4 American college students in 2017 have experienced a
      sense of overwhelming anxiety. There is also a strong association with self-reported low
      sleep quality and experience of depression or depressive symptoms and anxiety symptoms,
      indicating the high levels of stress in college students are indirectly responsible for
      mental health concerns.

      Stress in college students has become more prevalent in the past year due to the COVID-19
      pandemic which resulted in many students living at home and having a virtual education. In
      2020, individuals aged 18-23 (Gen Z adults) were reported as having the highest stress levels
      compared to other age groups. 87% of Gen Z adults in college reported that education and
      uncertainty about academics due to the COVID-19 pandemic were the reason for the higher
      stress levels. Gen Z adults were also most likely to report depressive symptoms with 34%
      saying that their mental health was worse than the prior year. In a separate study, sleep
      patterns in 86% of college students during the pandemic were shown to have been severely
      disrupted. Increased stress as a consequence of the pandemic has had direct effects on stress
      which has in turn deteriorated sleep quality and the mental health of college age kids.

      Efforts to reduce stress in college age kids have been studied in the past. One such study
      looks at the efficacy of using a mindfulness meditation mobile app which was shown to reduce
      stress and improve sleep disturbances. Mindfulness, cognitive, and behavioral intervention
      programs have also been administered with evidence that they can be effective in stress
      reduction in college students. Prior studies have tested the effects of stress reduction
      interventions on a general college student population without taking into account differences
      within the types of stress that college students face. A major contributor to stress for
      college students is the major they choose- specifically whether the student chooses a STEM
      major or a non-STEM major. STEM majors consist of the most stressful fields of study
      according to Indiana University's National 2016 Study of Student Engagement. Self-reported
      scores of stress were the highest among STEM students and STEM students were also more likely
      to pull more all-nighters, have more homework, and less sleep compared to humanities majors.
      STEM majors also report studying and preparing the most number of hours compared to other
      majors.

      STEM students also differ from non-STEM students with regards to engagement with their
      institution. Non-STEM college students displayed higher integrative and learning skills and
      scored higher on Higher Order Thinking surveys compared to STEM students. These differences
      in cognitive behaviors could result in stress interventions that require deeper reflection
      like Mental Imagery and Mindfulness Interventions to be more effective in non-STEM students
      than in STEM students. Understanding these differences in how STEM and non-STEM students
      respond to different stress interventions can allow students and universities to help
      alleviate the adverse effects of stress.
    

Intervention name(s): Stress Reduction: MBSR; Stress Reduction : PMR
Intervention type(s): Behavioral; Behavioral
Intervention description(s): Four activities, one each week - raising body awareness, sitting meditation, mindful yoga, expanding awareness meditation.; Progressively tensing and releasing each muscle group from head to toe in a specific order.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: stress; sleep; STEM; non-STEM; students; stress interventions; PMR; MBSR