Interviews were completed within 2 months of intervention completion during April and May 2020 at the onset of the COVID-19 pandemic. The window to interview was initially 1-month post program however, the pandemic and adjusting to social distances measures presented scheduling difficulties (e.g., course shifts, childcare/family responsibilities, etc.) which limited the availability of participants. There was a 94% participation rate (n = 15) with one participant electing not to complete the post-intervention interview despite three contact attempts by research staff. The racial and ethnic composition of the group is shown in Table 1. Six (42%) of the participants indicated that they were first generation college students. Over half the sample was female (n = 12; 75%) and identified their sexual orientation as “straight”. Most students attended more than 5 class sessions. However, completion rates in the second group (n = 12) averaged 6 sessions with several decreasing class attendance after the shift to online delivery. In addition, students were not restricted to a program, so the sample was mixed with students concentrating in various departments including educational studies (e.g., special education, health and physical education, nursing, arts and sciences (e.g., biology, music, etc.), and business. Of the 15 participants, one elected not to complete the demographic questionnaire as such baseline characteristics are based on 14 participants.
In reviewing the FGCS transcripts (n = 6) compared with the non-FGCS (n = 7), we found no notable differences thematically when reviewing participants’ descriptions of their experiences while in the mindfulness program. In addition, we reviewed the proportions of coding frequencies across all themes between those who were FGCS and non-FGCS. We found no proportional differences in coding that might indicate FGCS status affected uptake of mindfulness training and application of the mindfulness learned in the program. It should be noted this lack of differences in coding and experiences could be a limitation of the interview guide and has been addressed below in the limitations.
Themes derived from all participants experiences are presented under their associated research aim (1) exploring the application of mindfulness practices in daily life; (2) understanding how participants believe mindfulness training affected their health and well-being; (3) learn participants’ recommendations and suggested changes for future mindfulness interventions. For aims, resulting themes and example quotations for each theme, please see Table 2.
Exploring the application of mindfulness practices in students’ daily lives
Theme 1. The most used practices are those that could be integrated into daily life
Although students were taught formal meditation practices (e.g., sitting meditations, body scans, etc.) during class, these were not the most used mindfulness trainings. The practices that they applied the most were mindfulness activities that could be easily incorporated into their daily routines.
Mindfulness of eating was introduced formally at the beginning of the intervention and was one of the most incorporated practices mentioned by students (n = 9). Participants described that eating mindfully allowed them to settle into the moment, fully experience the taste and sensations of the food, and choose to make healthier choices because they were becoming aware of the impact of diet on health.
I’m not used to just like to stop and be mindful while I’m eating. I just like go through and eat it as quick as possible to eat something. So, I can now acknowledge that I can, like, take the time enjoy the food. (P756, male).
Also, eight of the 15 participants discussed how the introduction to mindfulness of physical activity, both low intensity and higher aerobic activity, was a practice they had regularly incorporated. The most common application was mindful walking throughout the day. For example, going from class to class on campus as well as walking in their homes, neighborhoods, or local community when classes were shifted during the pandemic.
I feel like most days you just walk, to walk, you have to get to one place or you’re going somewhere you’re talking so you don’t really like think about the actual movement and break it down. So, kind of just like taking yourself…like to slow down. I think that that was really cool and just something that like I guess I’ve never really focused on before. (P540, female).
Several participants (n = 4) said that they added mindfulness to exercise routines they had prior to starting the course. They were applying the instruction offered during the class on mindfulness and aerobic activity as a component of their existing exercise routine and noticing that these activities can be enhanced with mindfulness.
I found the physical part very helpful because I even discovered on my own, you know recently that working out and exercising can really play a big role in mindfulness. (P533, female).
For one participant the class allowed her to modify her existing excise routine not only to incorporate mindfulness but to accommodate the restriction that resulted from the pandemic.
Physical activity and, and just now with this whole COVID thing and like not being able to go to the gym and the lack of exercising I focused on physical activity. Because I have not been able to do it so often as I would like to because of not being able to go to the gym. So just finding different methods, like going around my neighborhood, and going for a jog, you know, or either like walking my dog or you know those aspects to just try to like motivate me to like keep going you know keep focusing on physical activity. (P176, Female).
Theme 2. Students often applied mindfulness to existing behaviors and activities
In addition to adding new practices introduced during class to their lives students also described applying mindfulness to existing parts of their daily routine that were not formally discussed in class, transforming these activities into informal mindfulness practices. There was substantial variety in the behaviors that mindfulness was incorporated into, but studying was one of the more consistently mentioned. Three students explained how they had applied mindfulness during studying. As a result, they stayed more focused for longer periods of time, noticed earlier on when distracted, and were able to refocus when engaging with difficult material.
If I’m doing a reading for like one of my other like normal classes and it’s some research paper and it’s not super exciting like just reading that and focusing on the actual like words as well as sort of the bigger picture like content, like, what has this paper said so far, like in the last three pages. And then just sort of notice when my mind drifts off for like one sentence brings up something it makes me think of something else, just like notice that, and then come back to the reading. (P433, male).
In addition, individual students reported transforming a variety of other routine activities. Showering, goal setting, and listening to music were behaviors they began to engage in mindfully. These students indicated incorporating mindfulness into aspects of their hygiene routines (e.g., brushing their teeth, shaving), or taking short pauses in routine moments on campus (e.g., drinking coffee, sitting in the sun), enable them become more present in their moment-by-moment experiences.
It [the program] made me realize that you can mindfully do things, even when you’re working and I found that very calming. And it helped me not to be so stressed, so like mindfully brushing my teeth every morning and every night. It helps me realize and be grateful for the things around me as well. (P213, female).
Theme 3. Mindfulness increased students’ engagement in activities motivated by self-care
Over half (n = 10) of students mentioned that they shifted to intentionally engaging in behaviors that were motivated by self-care. For some students this meant choosing to eat healthier food to be kind to themselves (n = 4), engaging in physical activity to improve their health (n = 3), or pausing to take a break during busy days. Some described taking breaks from academic stress to rest with the intention of taking care of themselves, which then allowed them to study more effectively.
Being a college student and then going through all those new environmental changes and adaptations that you have to make regarding academic work. I think that implementing meditation and just deep breathing and taking time out of your week and I tried to actually do it daily, once I started doing this class. I tried to do at least just some like deep breathing and have some time for like quiet time just for myself, to kind of distress and like break up my weekend and reset. (P540, female).
One student described a significant shift in her perspective about self-care as a result of taking MBC. Prior to the course, she believed that mental health was not a component of well-being and prioritized only physical health. After taking the course she shifted her perspective and started attending to both her mental and physical health.
It really emphasized or made me realize that like I actually need to take care of my mental well-being. Because, like, a few months ago, or like last year coming into this year I had that mentality that mental health does not exist if I’m physically well then I’m good. But taking this course and made me realize that in order for me to be even more productive I need to be mentally well as well and I need to set boundaries. (P213, female).
Understanding how students believe mindfulness training affected their health and well-being
Theme 1. Mindfulness was used most often to cope with an array of stressors
All of the students indicated that they used the mindfulness skills they’d learned to manage some type of life stress however, the specific stressors varied somewhat by student. Not surprisingly, academic stress was the most prevalent (n = 6). Students described how they became aware that they were stressed, for example studying or taking an exam, and tried to apply practices taught in class.
Like to just be able to be in the present has enabled me to you know stop looking at the past, stop worrying about the future, stop stressing out. Just to be more focus oriented. I had some exams coming up and like being able to only focus on studying and doing it mindfully has enabled me to improve my GPA and to be also able to have more control over my emotions. (P004, female).
I use it during the exam actually…final exams. You know, it’s a stressful time and me personally, I’m the kind of person to study. A lot. And then when the test comes, I forget things, but before one of my exams I just did like a deep breathing exercise and it kind of helped me to just boost my confidence and just relax. (P203, female).
Others (n = 4) explained that they were balancing academics as well as job-related stress. Mindfulness helped them become more aware of a difficult situation and take moments of self-care. For some participants, this involved taking a quick moment to breathe, away from sources of stress. For other participants, mindfulness practice allowed them to recognize when they needed to take more sustained action (e.g., set work boundaries). One student found that she was overworking herself responding to emails far past the point of when was healthy for her, even beyond expected working hours. The course allowed her to see the need to set boundaries and act to protect her health and well-being.
I’m supposed to work from a certain time period. But if people are emailing me at like 11 PM before I would like respond right away. But I realized that “No, I don’t think that’s healthy” working till like 11 or 12 and I can respond the next day, and that’s why: because that time is for me and I need to restore and reset. […] So this course it made me realize that you can mindfully do things, even when you’re working and I found that very calming. (213, female).
For a few (n = 2), commuting to class was stressful. Using the practices from class they recognized the stress and either modified their commute for less driving or took other actions. In one example a student described how it was her first year living off campus and commuting was a difficult experience. The course helped her recognize her situation and take action, mindfully making plans to modify her living arrangements in the future.
This was my first time commuting from school so that was a really hard experience for me just because I don’t have the best home life and for a while I kind of just tried to push that in the back of my mind. But through these meditations I actually kind of reached a point where I acknowledged just how unstable I felt living at home. And that was something that through the mindfulness courses I just kind of acknowledged and I realized that I needed to take mindful action. (001, female).
Theme 2. Mindfulness practices help to handle COVID-19 specific stress
Eleven of the 15 students interviewed participated in MBC during the onset of the COVID-19 pandemic. Of those, 6 students described that the course helped them to work with pandemic-related stress. For two students who were working in healthcare, the practices provided a space of relief in highly stressful situations.
I work in healthcare. So work is really stressful overall, there’s just probably not a day I don’t feel stressed after work and tense because there’s just so much going on and everything is so chaotic. So that [mindfulness practices] would be like a way I just try to use those techniques to help deal with stress and anxiety from like after work or from, like, a fight with like a friend or like a significant partner or like a breakup, like it’s just it’s good to learn about these things to help you… your own self deal with things. (P832).
For others (n = 3) the shift to online delivery of all classes was a difficult transition. They explained that staring at a computer screen for hours as well as being back home, away from social support, while taking classes was challenging. The meditations provided some relief helping them get through the day.
It’s been like really hard doing everything online. But just knowing that I can use this [mindfulness] practice as a way to help cope has really helped me get through day-to-day tasks and anything pertaining to schoolwork. (P533, female).
One student was working from home as a peer mentor as well as taking classes. Not only did she use the practices to help manage the stress, but she also became aware when being online was too much for her. Instead of trying to work through this she took appropriate action and, because of insight gained from the course, was able to recognize her limitations responding effectively.
I’ve had a lot of concussions in my life. So, looking at a computer screen constantly was becoming a severe issue for me. So, where I was looking at the computer from probably nine o’clock in the morning till nine o’clock at night and getting maybe a half hour break in between and it’s something that I couldn’t really control at that point. That’s what life had done. I contacted like Disability Services and explained and was able to modify some of my assignments where my professors would have to send me hard copies, rather than taking the quiz online. I would have to take the quiz; they would send me the hard copy and things like that. So that allowed me to like kind of take the step back. (P344, female).
Theme 3. Mindfulness enhanced stress coping by increasing the ability to acceptance of the present moment and let go of the experience to move forward
Ten students detailed how important mentally ‘letting go’ was especially when confronted with difficulty. More specifically, narratives from students describe a process of becoming willing to engage with difficulty, using grounding practices to steady themselves in the moment and choosing to let go when they recognized that situations were beyond their control. This process seemed to involve letting go of their attempts at controlling their experiences, specifically thoughts of anxiety and rumination (n = 7), as well as social challenges (n = 4), circumstances surrounding COVID (n = 4), and work stress (n = 2).
I used to just like “oh my gosh” and just shut down and cry or have an anxiety attack and now I’m like genuinely “it’s out of my control” I’m going to do what I can do and… like… I don’t even freak out anymore which is amazing. So, my anxiety levels have definitely gone down. (002, female).
Some students detailed letting go as an immediate action once they became aware of the difficulties but for eight students, acceptance of their circumstances was suggested as an important step before they were able to let go. Mindfulness practices allowed them to more objectively look at difficulties, and instead of resisting, they began to understand and accept both pleasant and difficult experiences will occur in life, thereby making it easier to let go. Some participants explained how they accepted their emotional experiences, others detailed accepting a difficult job situation and moving on, and others accepted past choices, thereby reducing judgment of themselves.
That was one situation where I realized that I need to accept what is. And I need to take mindful action in order to you know, feel more secure with myself. And there were multiple instances where I had certain things arise where I realized that I just need to think upon and rather than just feel like anxiety I decided to take more of a mindful approach to it. In my situation. (001, female).
Theme 4. Students also believe mindfulness enhanced resilience, especially for those with existing mental health conditions
Several (n = 9) students described a process of adapting to adverse circumstances over time coded as ‘resilience’. They described a series of adverse circumstances from difficult housing situations, COVID-19 isolation and academic difficulties, interpersonal stress, and job-related stress. They understood that these situations would continue to be sources of stress over time and that, through mindfulness practice, they could acknowledge the situation, take action to limit the effects of the stress (e.g., mindful action, breathing meditation), and manage the difficulty more effectively the next time they were confronted with this challenge. Importantly, students were able to be more objective using mindfulness to look clearly at a situation knowing that difficulties will eventually end which made the life circumstances easier to work with. Other students explained that they let go of sources of constant stress more easily knowing that the situation was out of their control and would continue for the time being.
It was one of those things where I acknowledged that I would have to go through this for longer. And sometimes it’s hard especially when you acknowledge something that doesn’t feel comfortable because then you still have to kind of live through it. And sometimes it’s just easier to not think about it. But because I was mindful because I was aware that I had to live on campus for the rest of the semester, but I did take the action knowing that my future can be changed. And that it doesn’t have to be permanent. (P001, female).
Three students in treatment with clinically diagnosed mental health conditions (anxiety, depression, and anorexia), described how mindfulness also enhanced their recovery and increased their resilience for managing adversity. All three students indicated that they came to the intervention hoping to enhance their ongoing treatment. Through the class they were able to recognize their thoughts and emotions regarding triggering situations, continue to engage instead of avoiding, and experienced the fading of difficult thoughts and emotions.
And just breathing and like even stopping to think back and like meditating to get through it has helped me a lot. Like before I would just freak out. I would shut down and I would just feel so defeated and have no confidence in myself. And now I kind of just allow myself to be here and be present and it’s ok to feel all of those things but like there are ways that I have now. (P002, female).
I had a depression like screening and conference call with my primary care. And I’ve had the past two anti-depressants that I’ve been on I’ve been allergic to, and even with that she’s even like she even noticed today. She’s like, you see much more chipper and things like that. So I feel like I have like a more positive outlook on things and I don’t let everything else going on around me that I can’t really control, control me anymore. I kind of take a step back and look at things from a different perspective and just try to stay in the moment and breathe and like I said, like if I can’t control it there’s no use really and stressing about it. (P344, female).
Theme 5. Mindfulness was critical for grounding themselves during difficult experiences as well as enhancing the value of positive experiences
Every student described the importance of becoming more aware of their thoughts, emotions, and physical sensations. Present moment awareness reportedly offered two primary functions: as an initial step in working with difficult life experiences and decreasing distractions increasing enjoyment of pleasant experiences.
Grounding during difficulty was the most common application for present moment awareness (n = 15). Multiple accounts explain that stress management was facilitated by becoming aware of thoughts, feelings and emotions in the moment which then allowed a choice of how to engage. Most (n = 11) reported that they chose to focus on their breathing or body sensation staying present with an unwanted experience and choosing how they would like to respond. Some (n = 2) described grounding by looking at objects in their immediate vicinity during a difficult experience, and one indicated that she would write down her thoughts and experiences instead of being “controlled by my thoughts or by the environment” (004, female).
I’m learning to recognize, you know, like maybe anxiousness or overwhelmed-ness but being able to channel into deep breathing or focusing on the moment, the present moment, whether that be, you know, noticing or looking around and seeing five things you see or things you hear, you know, using your senses to get in touch with where you are at that time, that’s been really helpful to me to calm my anxiousness. (206, female).
In other descriptions, students (n = 6) explained that by becoming more aware of the present moment they could engage more actively in positive health behaviors without being distracted, which increased the perceived value of the experiences. Some reported that they were able to focus more on academic tasks and performed better. For others, increased attention to the present moment made activities like eating, looking at something pleasant, or walking on a beautiful day, become more enjoyable.
Things are more enjoyable when I focus on them. And I also do them better. (P466, male).
Being aware of the small things in life. We usually don’t pay attention. So even sensations or sounds there’s something there we can be aware of. So, they’re like really important. So now when I go outside and it’s sunny, I stop for a moment and just look at the sun and just feel the warmth on my skin and just try to take a deep breath and engage in the moment, within nature, just to feel alive. (P756, male).
Recommendations for future mindfulness interventions
Theme 1. Social support is generated during in-person meetings so in-person was the more preferred method of delivery
All of the students preferred in-person delivery of the course. Among the students who only took the class in-person (n = 4, Cohort 1) they felt as though the course would lose the supportive community by moving online; which was an important component for them.
To be able to go to a community where I can like get other insights and opinions and like share the experience with other people. So, I don’t think that the, I don’t think that doing it online would be very effective. Just because you don’t really get that personal like interaction you know? Like you don’t get that sense of community. (003, female).
Students (n = 11, Cohort 2) who, at week 5, were moved to online learning due to the coronavirus pandemic confirmed that this was their perception. They explained that the social support and sense of community they’d had in person was lost or reduced in their mind when the class was moved to digital delivery.
When you’re in the presence of others and you’re able to see everyone’s faces more clearly and assess how they’re breathing, how they’re acting if they’re fidgeting stuff like that. In person, you can see a lot more about someone’s body language and understand how they’re feeling and be able to empathize with them and the response of the instructor is a little bit better. It’s a little less, less poised when you’re in-person. And I think when you have that atmosphere being in-person, the just the raw body language that you get out of everything. Everyone gets a better experience. (223, female).
The class was also a safe physical space more conducive to practice for students and this seemed to be lost in digital delivery. One student (P001) from Cohort 1 explained that they believed it would be difficult for students to find protected space (e.g., quiet area, alone for two hours) to practice meditation and students (n = 3) that took the class digitally explained that they did find it difficult take the class in a space conducive to practice.
It would probably take away from the program if it was completely digital. And I just really value like having the like in-person type setting. I think that’s kind of what grounded me throughout this program and that’s what motivated me to continue with it in like setting goals. (P001, female).
Online is more difficult, especially like if you’re using zoom at home just finding a comfortable spot and I feel like you can’t really connect with everybody around you on webcam versus in-person. (P540, female).
Theme 2. A split class format would fit into schedules more effectively but could be difficult for those who commute
The majority (n = 13) preferred a split class approach. Students believed that if the class was delivered twice a week they would have more opportunities to have a space set aside for self-care each week even though they would be shorter sessions and that this would increase their frequency of practice because there would be less time between classes (e.g. 3 days instead of 1 week).
It just allows for people to attend rather than say we have a 2.5 hour class where that may cut into someone’s time elsewhere or like another class or like an appointment or just different things that people can have going on in a two and a half hour gap, rather than a one and a half hour gap. (P206, female).
Some indicated it would be easier to attend two shorter classes while others acknowledged that, for busy commuter students, meeting twice a week could be difficult. In fact, one student (P540) indicated that many of the students that signed up during recruitment but didn’t attend class chose to do so because the length of time (i.e., 2.5 hours) later in the day was a barrier. In addition, they suggested holding the class earlier in the day so that it could be incorporated into a free period rather than holding it at 6:00 PM after most classes were completed would make it easier to attend.
Having two classes a week might be a little, or two classes that are shorter and time might be a little bit easier and I think that also when you presented this course to some of the other people in my first year seminar class. I know a lot of people signed up for it on like the clipboard. But no, not a lot of people actually ended up going because some people knew that two and a half hours that they weren’t gonna be able to fit that into their schedules. (P540, male).