Virtual Reality (VR) Based Mindfulness Practice in Relieving Stress in Postgraduate Students

Study Overview
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Brief Summary
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University students, especially graduate students, are constantly striving to achieve their goals, and their performance is constantly being evaluated, which creates a plethora of stressors, such as tests, a large amount of content to be learnt, lack of time, getting poor marks, and living up to their expectations. Mindfulness has been demonstrated to benefit one's emotions in a 'non-judgement' way. Evidence suggests that VR-based mindfulness practice may help individuals maintain present-moment awareness and block out distractions and may be more effective than conventional mindfulness approaches. The current pilot study aims to test the feasibility and acceptability of VR-based mindfulness practices in graduate students.

Detailed Description
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A three-arm, assessor-blinded pilot randomised controlled trial (RCT) will be implemented. Participants will be randomly assigned to either mindfulness group, VR mindfulness group and control group. Participants will be randomised at a 1:1:1 ratio to the intervention groups or control group. Block randomization will be conducted by an independent research assistant using randomly varying block sizes of 4 and 6 to avoid selection bias. This study aims to test the feasibility, acceptability, and preliminary effects of the VR-based mindfulness practice in improving stress for graduate students. Specific objectives are as follows: To investigate the feasibility and acceptability of the VR-based mindfulness practice in improving stress for graduate students To investigate the preliminary effects of VR-based mindfulness practice in improving stress for graduate students To understand the user experience of mindfulness practice in VR

Official Title
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Virtual Reality-supported Mindfulness Practice in Relieving Stress in Postgraduate Students: a Pilot Randomised Controlled Trial

Conditions
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Student, Stress, Virtual Reality, Mindfulness

Intervention / Treatment
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* Other: Virtual reality-supported mindfulness
* Other: Mindfulness


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: aged 18 or over; enrolled in graduate programme at the Chinese University of Hong Kong; experienced stress: the score of perceived stress scale more than 13; able to speak and write in English Exclusion Criteria: diagnosed with psychiatric disorders; currently taking psychotropic medication; have history of photosensitive epilepsy or previous experience of severe simulator sickness; receiving or have just completed other psychological interventions (e.g. stress management, mental health support, peer support, etc) within the last six months will be excluded; or history of seizures and motion sickness.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Participants are assigned to three groups in parallel for the duration of the study. Participants in Group A receive Virtual reality-based mindfulness. Participants in Group B receive general mindfulness exercises. Participants in Group C receive no intervention as control.
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: VR-supported mindfulness group<br>Participants in the intervention group will receive VR mindfulness intervention, consisting of four face-to-face sessions (twice a week for two weeks). During the first week, the interventionist will teach and guide the participant face-to-face. During the second week, participants will be required to practice VR on their own for self-help. | Other: Virtual reality-supported mindfulness<br>* A single mindful stretching exercise provides a conscious stretch of VR scenario. The implementation of VR exercises will be performed by the interventionist who have received training in the application of VR scenarios and have extensive experience in VR research.<br>|
| Active Comparator: Mindfulness group<br>Participants in this group will receive a mindfulness exercise guided by the interventionist twice a week for two weeks. | Other: Mindfulness<br>* The interventionist will guide the participant to do a mindful stretching exercise in the first week. During the second week, the interventionist will send participants an audio recording on how to do mindful stretching exercise via WeChat/WhatsApp.<br>|
| No Intervention: Control group<br>Participants in the control group will not receive mindfulness or mindfulness plus VR. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Eligibility rate | The eligibility rate is defined as the percentage of participants fulfilling the inclusion criteria amongst the participants screened for the eligibility | Baseline | 
| Recruitment rate | The recruitment rate is defined as the percentage of participants who consented to participate in the study amongst the participants eligible for the study | Baseline | 
| Attrition rate | The attrition rate is defined as the percentage of participants who withdrew from the study before completion | Week 2 | 
| Adherence rate | The adherence rate is defined as the frequency of the practice of mindfulness and session attendance | Week 2 | 
| Change from baseline in the score of perceived stress assessed by The Perceived Stress Scale to immediately after the intervention | A 10-item self-report instrument that measures the degree to which events are appraised as stressful and the frequency of perceived stressful situations. Students will be instructed to report the frequency of perceived stress over the past month from 0 (Never) to 4 (Very Often). Total scores on the PSS can range from 0 to 40. Higher total scores indicate higher levels of perceived stress. | Baseline and Week 2 (post-intervention) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change from baseline in the score of mindfulness assessed by The Five Facet Mindfulness Questionnaire to immediately after the intervention | A 39-item self-report instrument that measures levels of mindfulness, including five facets: observing, describing, acting with awareness, non-judging of inner experience and non-reactivity to inner experience. Students will be invited to indicate on a 5-point Likert scale the degree to which each item is generally true for them, ranging from 1 to 5. Higher scores indicate higher levels of mindfulness. | Baseline and Week 2 (post-intervention) | 
| Change from baseline in the level of mood states by The abbreviated Profile of Mood States to immediately after the intervention | A 40-item self-report instrument that measures seven different subscales of transient mood states. Each question is score from 0 to 4. High scores indicate great mood disturbance. | Baseline and Week 2 (post-intervention) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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graduate student, stress, mental health, mindfulness, virtual reality