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Depression and anxiety are growing issues for college students, with both aerobic resistance training and mindfulness yoga exercises known to be effective in reducing symptoms and severity. However, no known research is available comparing these 2 depression and anxiety interventions simultaneously and in a web-based environment.
This study aims to determine the effects of a web-based aerobic resistance exercise intervention (WeActive) and a web-based yoga mindfulness exercise intervention (WeMindful) on depression and anxiety symptoms in college students.
The participants were 77 college students who anonymously completed a Qualtrics survey, including the Generalized Anxiety Disorder Scale and the Major Depression Inventory at baseline and after the intervention. Participants were randomly assigned to either the WeActive or WeMindful group and underwent two 30-minute web-based aerobic resistance exercise lessons or yoga mindfulness lessons per week for 8 weeks.
The results of analysis of covariance with repeated measures indicated that although not statistically significant, both groups showed a notable decrease in anxiety with a marginally significant main effect of time (
College students in both WeActive and WeMindful groups experienced a significant decrease in depression symptoms and a decrease, although not significant, in anxiety as well. The study suggests that web-based WeActive and WeMindful interventions are effective approaches to managing US college students’ depression and anxiety during a pandemic.
It has been well-documented that mental health issues are increasing within a college student population [
The 2018 Physical Activity Guidelines for Americans recommends that adults participate in 150 minutes of moderate-intensity aerobic activity per week or 75 minutes of vigorous-intensity aerobic activity per week or a combination of the 2 intensities [
Web-based physical activity interventions have also been shown to be associated with reductions in depression and anxiety symptoms in a collegiate population [
College students’ mental health has also been found to improve with the practice of mindfulness activities, which are designed to allow participants to practice self-awareness of sensation and feeling [
In a web-based setting, the use of mindfulness-based interventions to reduce anxiety and depression symptoms in college students has demonstrated similar results to those of in-person interventions [
Overall, there is clear and repeated evidence showing that practicing mindfulness activities or physical activities can positively affect mental health problems. One study compared the influence of mindfulness exercises with that of physical activity on stress, anxiety, and depression in the adult population and found significant reductions in the severity of mental health symptoms across both interventions [
Therefore, this study aims to compare the effects of a web-based aerobic resistance exercise intervention (WeActive) and a web-based yoga mindfulness intervention (WeMindful) on depression and anxiety in college students during the winter semester of 2021. It was hypothesized that both intervention groups would produce improvements in depression and anxiety but that the fitness intervention would show slightly higher positive improvements in both measures. As fitness and mindful exercise interventions have been shown to assist with depression and anxiety improvement, the significance of this study is in determining the effectiveness of web-based fitness exercise and mindfulness exercise interventions on improving student mental health in the midst of a pandemic.
We recruited college students from a large public university in the Midwestern region of the United States to participate in a randomized quasi-experimental study during the spring semester of 2021. We used several recruiting strategies, including the targeted email response system, the university’s canvas learning management platform, undergraduate and graduate bulletins, and university social media pages. The eligibility criteria included being at least 18 years of age, having current status as a student at the university, and having consistent access to the internet and to the web-based conferencing app Zoom (Zoom Video Communications). Participant enrollment information is available in
CONSORT (Consolidated Standards of Reporting Trials) recruitment and study design diagram.
As seen in
Both intervention groups were asked to attend two 30-minute group exercise classes via Zoom twice per week. Participants opted to attend 1 synchronized Zoom exercise lesson and 1 asynchronized lesson or 2 asynchronized lessons that were Zoom-recorded and uploaded to the University Canvas study-related website. The asynchronous recording contained the same lesson content from the synchronous live session, meaning content was repeated for the second session each week. In addition, all participants were asked to attend synchronous, researcher-led peer coaching sessions that took place once every 2 weeks for 30 minutes.
The intervention lasted for 8 weeks over the course of the winter 2021 semester. Before the intervention started, participants were given 1 week to complete a preintervention Qualtrics survey that included anxiety and depression measures. Immediately after the intervention period, the participants were again given 1 week to complete a postintervention Qualtrics survey that included the same anxiety and depression measures used in the preintervention survey.
The objectives of the WeActive intervention were to help the participants engage in at least 150 minutes of moderate to vigorous physical activity per week and improve their abilities to achieve the recommended amount of weekly moderate to vigorous physical activity minutes throughout the intervention. The participants were instructed to attend two 30-minute exercise classes via Zoom per week for 8 weeks. The class duration was set to 30 minutes to maximize participant retention while still allowing participants to achieve an amount of exercise that has been shown to be beneficial [
The WeMindful group was instructed to participate in two 30-minute web-based yoga mindfulness classes per week for 8 weeks. The use of yoga, which incorporates movement with breathing and self-awareness, as a primary mindfulness exercise has been supported by previous research [
To facilitate the participants to attend the WeActive or WeMindful exercise lessons and to provide ongoing emotional, informational, and appraisal support for them, we offered all participants in both groups with four 30-minute peer coaching sessions conducted via Zoom, with 1 session every 2 weeks. Each peer coaching session included experience and feedback sharing from participants, barrier or challenge reflections, and participant suggestions for class content. The focus of the first peer coaching session was on orienting and introducing participants to the session formatting, which included goal-setting prompts, self-regulation prompts, self-monitoring reflection, and time for social support. The second, third, and fourth peer coaching sessions delved deeper into obtaining participant feedback on any challenges or preferences they had during the main intervention group components, along with continued goal-setting, self-regulation, and self-monitoring exercises. The peer coaching sessions were led by 1 doctoral student and 1 other undergraduate student of the research team. In addition to peer coaching sessions, all participants were instructed to complete weekly journals that asked participants to provide their weekly attendance for both synchronous and asynchronous classes. In addition, participants received encouraging messages on the web from the research team every Thursday, with content including praise and motivational phrasing.
This study used the 7-item Generalized Anxiety Disorder (GAD-7) scale by Spitzer et al [
This study used the 10-item Major Depression Inventory (MDI) developed and validated by Bech et al [
Of the 77 participants who completed the preintervention and postintervention surveys, 3 were excluded from the final data analysis because of poor participation. The final data set included 46 participants from the WeActive intervention and 28 participants from the WeMindful intervention, for a total of 74 participants.
The preintervention and postintervention data were analyzed using SPSS 26 software (IBM Corporation), with statistical significance set at
This study was reviewed and approved by the University Institutional Review Board-Health Sciences and Behavioral Sciences (IRB-HSBS) (HUM00189120). We conducted this study in accordance with the principles of the Declaration of Helsinki. All participants in the study have provided written informed consent to participate in the study.
The results showed significant decreases in depression symptoms in both intervention groups as a main effect of time. Anxiety symptoms decreased marginally in both groups. There were no significant effects of group or of time and group in affecting anxiety or depression symptoms.
The final WeActive group consisted of 48 participants, with a mean age of 23.02 (SD 4.83) years. The final WeMindful group consisted of 29 participants, with a mean age of 24.31 (SD 7.48) years. Both groups had similar educational and racial distributions. A summary of the descriptive statistics is presented in
Descriptive statistics of baseline characteristics of all participants.
Characteristics | Values | ||
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Female | 63 (85.1) | |
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Male | 7 (9.5) | |
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Nonbinary | 4 (5.4) | |
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Freshman | 8 (10.7) | |
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Sophomore | 9 (12) | |
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Junior | 15 (20) | |
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Senior | 14 (18.7) | |
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Masters | 13 (17.3) | |
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Doctoral | 14 (18.7) | |
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Professional | 2 (2.7) | |
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African American | 4 (5.4) | |
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Asian | 15 (20.3) | |
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White | 48 (64.9) | |
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White, Asian | 3 (4.1) | |
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White, native | 1 (1.4) | |
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White, other | 1 (1.4) | |
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Other | 2 (2.7) | |
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WeActive (n=46) | 23.02 (4.833; 0.713) | |
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WeMindful (n=29) | 24.31 (7.479; 1.389) | |
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WeActive (n=46) | 0.47 (0.504; 0.072) | |
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WeMindful (n=29) | 0.38 (0.494; 0.092) | |
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WeActive (n=46) | 0.16 (0.373; 0.053) | |
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WeMindful (n=29) | 0.24 (0.435; 0.081) | |
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WeActive (n=46) | 0.20 (0.407; 0.058) | |
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WeMindful (n=29) | 0.48 (0.509; 0.094) |
aX3month_exercise: number of exercise sessions in the previous 3 months.bX3month_yoga: number of yoga sessions in the previous 3 months.cX3month_therapist: number of therapist visits in the previous 3 months.
Independent t tests of baseline difference between the WeActive and the WeMindful groups.
Equal variances assumed | ||
Age (years) | −0.908 (73) | .37 |
Race | −1.077 (72) | .29 |
Education | 0.299 (73) | .77 |
X3month_exercisea | 0.768 (76) | .45 |
X3month_yogab | −0.839 (76) | .40 |
X3month_therapistc | −2.660 (76) | .01d |
Health_rating | −0.610 (76) | .54 |
PreGADtotale | −0.941 (76) | .35 |
PreMDItotalf | −0.509 (76) | .61 |
aX3month_exercise=number of exercise sessions in the previous 3 months.
bX3month_yoga=number of yoga sessions in the previous 3 months.
cX3month_therapist=number of therapist visits in the previous 3 months.
d
ePreGADtotal=baseline total Generalized Anxiety Disorder.
fPreMDItotal=baseline total Major Depression Inventory.
As seen in
The independent sample
Baseline and posttest scores of anxiety and depression.
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Values, mean (SD) | ||
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WeActive | 7.152 (5.517) | |
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WeMindful | 7.786 (4.475) | |
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WeActive | 6.652 (5.225) | |
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WeMindful | 6.429 (4.710) | |
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WeActive | 16.89 (12.97) | |
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WeMindful | 17.75 (10.77) | |
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WeActive | 13.57 (10.98) | |
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WeMindful | 16.89 (12.61) |
Results of analyses of variance with repeated measures for anxiety and depression.
Effects | Anxiety | Depression | |||||
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Time | 0.485(1) | .07 | 0.047 | 0.892 (1) | .05a | 0.052 | |
Time×group | 0.989 (1) | .32 | 0.014 | 0.914 (1) | .34 | 0.013 | |
Group | 0.423 (1) | .52 | 0.006 | 0.001 (1) | .98 | 0.000 | |
X3_month_therapist | 8.63 (1) | .004b | 0.108 | 7.007 (1) | .01b | 0.090 |
a
b
For the anxiety measure, while controlling for the past 3-month therapist visit, the results of ANCOVA with repeated measures indicated no significant main effect of time and group and no significant interaction between time and group. However, the main effect of time was close to a significant level (
With regard to the depression measure, the results of ANCOVA with repeated measures yielded a significant main effect of time (
This study aims to examine the effects of a web-based aerobic resistance exercise (WeActive) intervention and web-based yoga mindfulness (WeMindful) intervention on college students’ anxiety and depression levels. Both the 8-week interventions were hypothesized to have positive effects on anxiety and depression, with greater positive effects predicted in the WeActive group. As expected, the participants in the 2 groups experienced a significant decrease in depression scores over the 8-week period. Although not statistically significant, the participants experienced a decrease in anxiety scores as well. Contrary to our second hypothesis, there were no significant interactions between group and time, indicating that the WeActive group did not experience greater improvements in mental health scores than the WeMindful group over time.
The decrease in depression scores across both intervention groups in our study aligns with results from previous mindfulness interventions [
It is important to note that the participants in both groups experienced a marginally significant decrease in anxiety, a result that mostly supported our original hypothesis. Previous research that has examined the relationship between anxiety and either mindfulness or aerobic resistance exercise has displayed mixed results. Although most studies reveal a significant positive relationship [
Contrary to our expectations, there was no statistical significance in the group and time interactions, meaning neither the WeActive nor WeMindful group showed significant differences in depression or anxiety changes over time. Of the few studies that have compared the mental health effects of mindfulness exercises with aerobic or resistance exercises, only van der Zwan et al [
This study has several limitations. First, although initial participant interest was high, most interested potential participants decided not to proceed with the study. This limitation was likely caused by the completely web-based nature of this study, which prevented opportunities to connect more directly with participants and by the increasingly busy period of the school semester during which this study was conducted. The stressful nature of college classes, where stress often builds as the semester goes on, may have greatly hindered some of the students’ participation, as higher levels of stress related to schoolwork could have reduced the free time these participants had to complete the study. Second, the demographics of participants may have interfered with obtaining widely applicable findings, as most participants identified as female. Previous research has shown that females tend to report higher rates and severity of anxiety and depression symptoms than males [
Our study showed that the participants in both the WeActive and WeMindful groups experienced significantly decreased depression symptoms over time. This decrease in depression occurred despite the stressors of upcoming final examinations for all participants. Anxiety symptoms decreased but did not reach a statistically significant level. Both web-based aerobic resistance training and web-based yoga mindfulness exercises seem to be effective in buffering mental health distress, especially with depression. Future research should focus on examining the effects of web-based environments against in-person environments for reducing mental health disorder severity or symptoms in college students. In addition, as this study used multiple modalities in both aerobic resistance training and yoga mindfulness exercise interventions, future research could benefit from exploring single modality interventions, such as aerobic exercise compared with resistance training or yoga compared with meditation. This study suggests that both the combination of aerobic resistance training and the combination of yoga mindfulness exercises are associated with a reduction in college student depression scores over an 8-week period. As the findings from our study indicate the potential efficacy of WeActive and WeMindful interventions in improving student mental health measures, this study design could be a useful resource for colleges and mental health treatment providers.
CONSORT eHealth Checklist (V 1.6.1).
analysis of covariance
Consolidated Standards of Reporting Trials
Major Depression Inventory
mindfulness virtual community
The authors would like to thank the students who participated in this study and the entire research team for their hard work during this unpredictable year.
None declared.