title: Enhancing Web-based mindfulness training for mental health promotion with the health action process approach: randomized controlled trial.
abstract: BACKGROUND
  With increasing evidence demonstrating the effectiveness of Web-based interventions and mindfulness-based training in improving health, delivering mindfulness training online is an attractive proposition.
  
  
  OBJECTIVE
  The aim of this study was to evaluate the efficacy of two Internet-based interventions (basic mindfulness and Health Action Process Approach enhanced mindfulness) with waitlist control. Health Action Process Approach (HAPA) principles were used to enhance participants' efficacy and planning.
  
  
  METHODS
  Participants were recruited online and offline among local universities; 321 university students and staff were randomly assigned to three conditions. The basic and HAPA-enhanced groups completed the 8-week fully automated mindfulness training online. All participants (including control) were asked to complete an online questionnaire pre-program, post-program, and at 3-month follow-up.
  
  
  RESULTS
  Significant group by time interaction effect was found. The HAPA-enhanced group showed significantly higher levels of mindfulness from pre-intervention to post-intervention, and such improvement was sustained at follow-up. Both the basic and HAPA-enhanced mindfulness groups showed better mental well-being from pre-intervention to post-intervention, and improvement was sustained at 3-month follow-up.
  
  
  CONCLUSIONS
  Online mindfulness training can improve mental health. An online platform is a viable medium to implement and disseminate evidence-based interventions and is a highly scalable approach to reach the general public.
  
  
  BACKGROUND
  Chinese Clinical Trial Registry (ChiCTR): ChiCTR-TRC-12002954; http://www.chictr.org/en/proj/show.aspx?proj=3904 (Archived by WebCite at http://www.webcitation.org/6VCdG09pA).
authors.affiliation: Diversity & Well-Being Laboratory, Department of Psychology, The Chinese University of Hong Kong, Shatin, NT, Hong Kong, China (Hong Kong). wwsmak@psy.cuhk.edu.hk.
authors.forename: Winnie W S
authors.identifier: http://orcid.org/0000-0002-9714-7847
authors.initials: WW
authors.lastname: Mak
authors.forename: Amy T Y
authors.identifier: http://orcid.org/0000-0002-5816-1451
authors.initials: AT
authors.lastname: Chan
authors.forename: Eliza Y L
authors.identifier: http://orcid.org/0000-0002-2844-862X
authors.initials: EY
authors.lastname: Cheung
authors.forename: Cherry L Y
authors.identifier: http://orcid.org/0000-0002-2923-6725
authors.initials: CL
authors.lastname: Lin
authors.forename: Karin C S
authors.identifier: http://orcid.org/0000-0002-5747-6857
authors.initials: KC
authors.lastname: Ngai
mesh_terms: D005500:Follow-Up Studies; D006293:Health Promotion; D006801:Humans; D057194:Intention to Treat Analysis; D020407:Internet; D008603:Mental Health; D064866:Mindfulness; D011788:Quality of Life; D011795:Surveys and Questionnaires; D014495:Universities
keywords: Health Action Process Approach (HAPA); Internet-based intervention; mental health promotion; mindfulness; online intervention