title: Interventions to reduce stress in university students: a review and meta-analysis.
abstract: BACKGROUND
  Recent research has revealed concerning rates of anxiety and depression among university students. Nevertheless, only a small percentage of these students receive treatment from university health services. Universities are thus challenged with instituting preventative programs that address student stress and reduce resultant anxiety and depression.
  
  
  METHODS
  A systematic review of the literature and meta-analysis was conducted to examine the effectiveness of interventions aimed at reducing stress in university students. Studies were eligible for inclusion if the assignment of study participants to experimental or control groups was by random allocation or parallel cohort design.
  
  
  RESULTS
  Retrieved studies represented a variety of intervention approaches with students in a broad range of programs and disciplines. Twenty-four studies, involving 1431 students were included in the meta-analysis. Cognitive, behavioral and mindfulness interventions were associated with decreased symptoms of anxiety. Secondary outcomes included lower levels of depression and cortisol.
  
  
  CONCLUSIONS
  Included studies were limited to those published in peer reviewed journals. These studies over-represent interventions with female students in Western countries. Studies on some types of interventions such as psycho-educational and arts based interventions did not have sufficient data for inclusion in the meta-analysis.
  
  
  CONCLUSIONS
  This review provides evidence that cognitive, behavioral, and mindfulness interventions are effective in reducing stress in university students. Universities are encouraged to make such programs widely available to students. In addition however, future work should focus on developing stress reduction programs that attract male students and address their needs.
authors.affiliation: Factor-Inwentash Faculty of Social Work Vice-Provost, Academic Programs, University of Toronto, 27 King's College Circle, Toronto, Canada M5S 1A1. Cheryl.regehr@utoronto.ca
authors.forename: Cheryl
authors.initials: C
authors.lastname: Regehr
authors.forename: Dylan
authors.initials: D
authors.lastname: Glancy
authors.forename: Annabel
authors.initials: A
authors.lastname: Pitts
mesh_terms: D001007:Anxiety / Q000517:prevention & control*; D003863:Depression / Q000517:prevention & control*; D006801:Humans; D015397:Program Evaluation; D016032:Randomized Controlled Trials as Topic; D013315:Stress, Psychological / Q000517:prevention & control*; D013334:Students / Q000523:psychology*; D014495:Universities