Date of Award

2024

Degree Type

Dissertation

Degree Name

Doctor of Philosophy in Psychology

Specialization

2024

Department

Psychology

First Advisor

Joseph S. Rossi

Abstract

Introduction: Stress negatively impacts health, well-being, and productivity. Mindfulness-based stress reduction (MBSR) interventions are a promising strategy to reduce stress, but they are not covered by most health insurance policies in the United States (US). A recent Delphi process gathered feedback from key stakeholders, such as clinicians, MBSR instructors and students, policymakers, healthcare administrators, and health insurance company leaders. The results indicated synthesizing the existing evidence of the impact of MBSR interventions on stress was the 2nd highest priority out of 43 options evaluated. Past research has indicated MBSR interventions may be as effective as active controls at reducing stress, with both being significantly more effective than inactive controls.

Methodology: Screening of 103 existing systematic reviews and meta-analyses of MBSR and other mindfulness-based interventions found 1,579 potentially relevant reports. Full-text review of those reports identified MBSR randomized controlled trial (RCT) interventions in the US whose results contained pre- and post-intervention measures of self-reported perceived stress. A meta-analytic review (k = 30) was completed of studies that met inclusion criteria.

Results: MBSR interventions were found to be significantly more effective than both active controls and inactive controls in reducing perceived stress. MBSR and active control arms with higher percentages of females experienced greater decreases in perceived stress than samples with lower percentages of females. Mean age was found to moderate effects in MBSR groups, with samples with an older mean age having less perceived stress than samples with a younger mean age. Treatment effects were largely maintained through follow-up assessments up to 12 months post-intervention.

Discussion: This meta-analytic review is the first to focus on the impact of MBSR RCTs on self-reported perceived stress in the US without restrictions on the types of participants included. The results provide support for MBSR interventions to be utilized to reduce stress. Because increased levels of stress are associated with disadvantageous outcomes across a range of domains, the use of strategies to decrease stress can enhance healthy lifestyles and increase productivity in a variety of heterogeneous populations. Stakeholders determining whether health insurance should cover MBSR interventions will be interested to learn MBSR was found to be more effective than both active and inactive controls - and the effects of MBSR were maintained for an extended amount of time.

Available for download on Saturday, September 12, 2026

Share

COinS