title: Loving-Kindness Meditation Effects on Well-Being and Altruism: A Mixed-Methods Online RCT.
abstract: BACKGROUND
  Evidence suggests that facilitating empathy could improve individuals' well-being. Loving-kindness meditation (LKM) could be a facilitator, and online delivery a cost-effective format.
  
  
  METHODS
  We conducted an internet-based randomised controlled trial recruiting 809 adults to test whether an LKM course improves well-being through evoking pleasant emotions, psychological resources, and altruism compared to a light physical exercise course (LE). Participants in both arms followed video-based instructions, completed post-intervention questionnaires, and used online diaries and forums. To measure altruism £10/$10 were offered to participants with a choice of donating all/half to charity. Thematic analysis was applied to diary/forum entries.
  
  
  RESULTS
  Both courses increased well-being without significant differences. LKM participants were less anxious than LE participants (ß = -0.22, 95% confidence interval (CI) [-0.43, -0.02], p = .03), and more likely to donate £5/$5 (Relative Risk = 3.57, 95%CI [0.82, 15.50], p = .09). Attrition was high (82%). Participants engaged in diary/forum usage. LKM was an emotionally intense experience, generating deep reflections and increased connectedness but difficult for some to process. LE led to gentle increases in relaxation, generating a sense of achievement.
  
  
  CONCLUSIONS
  Future research needs to confirm findings and devise ways of delivering online LKM effectively to diverse populations.
authors.affiliation: Cochrane Institute of Primary Care and Public Health, Cardiff University, UK. mjg231@cam.ac.uk.|Department of Psychiatry, University of Cambridge, UK. mjg231@cam.ac.uk.
authors.forename: Julieta
authors.identifier: http://orcid.org/0000-0002-4108-5341
authors.initials: J
authors.lastname: Galante
authors.affiliation: Centre for Trials Research, Cardiff University, UK.
authors.forename: Marie-Jet
authors.initials: MJ
authors.lastname: Bekkers
authors.affiliation: Cochrane Institute of Primary Care and Public Health, Cardiff University, UK.
authors.forename: Clive
authors.initials: C
authors.lastname: Mitchell
authors.affiliation: Cochrane Institute of Primary Care and Public Health, Cardiff University, UK.
authors.forename: John
authors.initials: J
authors.lastname: Gallacher
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000533:Altruism; D004644:Emotions; D004645:Empathy; D005260:Female; D006801:Humans; D008149:Love; D008297:Male; D019122:Meditation / Q000379:methods* / Q000523:psychology*; D008875:Middle Aged; D055815:Young Adult
keywords: Internet; loving-kindness meditation; mixed methods; physical exercise; randomised controlled trial; well-being