From Health Information to Health Decisions Integrating Mindfulness Into Digital Learning and Daily Life

Official title

Effects of Mindfulness Practice and E-health Information Push on E-health Literacy, Media Literacy, Food Literacy, and Mindfulness Skills Among University Students in Macau

Overview

This research project aims to explore how combining e-health literacy with mindfulness practices can help university students navigate the complex landscape of e-health information and make more informed, healthier choices. Specifically, the study will assess the current levels of e-health literacy, food literacy, and media literacy among university students, and examine how these factors are related to critical thinking, decision-making confidence, and overall well-being. The project will involve a 4-arm design, including: (1) a mindfulness group, (2) an e-health group, (3) a mindfulness + e-health Group, and (4) a Control Group. Participants in the intervention groups will engage in short mindfulness exercises focused on mindful eating and movement during break times and cool-down sessions of their Physical Education (PE) classes. Additionally, digital health content (e.g., videos and articles) will be provided to enhance e-health literacy. This could lead to better-informed, more confident students who are able to make healthier choices in their daily lives, both during their university years and into the future. Study Aim To evaluate the effectiveness of an 8-week intervention delivered during PE classes, comparing the effects of: 1\. Mindfulness Group 2. E-health Group 3. Mindfulness + E-health Group 4. Control Group The intervention will assess changes in students' e-health literacy, food literacy, media literacy, critical thinking, self-compassion and decision-making self-efficacy over time, with assessments at pre-test, post-test, and 4-week follow-up. Study Hypotheses: 1. Students in the mindfulness group, e-health group, and combined group will show significantly greater improvements in all outcome measures from pre-test to post-test compared to the control group. 2. The combined group will demonstrate the greatest gains in literacy and cognitive outcomes, due to the additive effect of both interventions. 3. Improvements will be maintained at the 4-week follow-up, particularly in the combined group.

Detailed description

This study aims to explore the effects of mindfulness practice and e-health interventions on e-health literacy, media literacy, food literacy, critical thinking, and decision-making abilities among university students.

Research Objectives: To investigate the impact of mindfulness practice and e-health interventions on university students' e-health literacy, media literacy, food literacy, critical thinking, and decision-making abilities, and to evaluate their short-term effectiveness.

Participants: 268 university students aged between 18 and 25 who are willing to participate in mindfulness activities during and after class and receive e-health-related information.

Study Procedure:

1. Baseline Assessment: Includes questionnaires on e-health literacy, media literacy, critical thinking, and food literacy, as well as tests conducted using E-Prime software. 2. Intervention: Participants will take part in an 8-week program during their physical education classes and leisure time. They will be randomly assigned to one of four groups:

Mindfulness Group: Engage in mindful eating and mindful movement exercises during each physical education class (approximately 20 minutes).

E-health Group: Read or listen to two push notifications of e-health information per week, covering topics such as health management, stress and sleep, nutrition, and behavior change.

Combined Group: Participate in both mindfulness practice and receive e-health information.

Control Group: Receive no additional intervention and participate only in regular physical education classes. 3. Post-Intervention Assessment: Immediately after the 8-week intervention, participants will complete the same questionnaires and E-Prime tests as at baseline to assess immediate effects. 4. Follow-Up Assessment: Four weeks after the intervention ends, the same set of measurements will be conducted again to evaluate the sustainability of the intervention effects. 5. Interviews (Optional): With your consent, semi-structured or unstructured interviews may be conducted during and after the intervention to gain in-depth insights into your experiences and perceptions.

Statistical Analysis: A mixed-design analysis of variance (ANOVA) or analysis of covariance (ANCOVA) will be used to compare the effects across different time points. Post-hoc tests will be conducted to identify specific differences between the various groups and across different time points. The significance level will be set at a p-value of less than 0.05.

Interventions

• Behavioral Mindfulness
  Structured over 8 weeks (twice weekly) with dual modules (dietary + movement), this group employs Mindfulness-Based Eating Awareness Training (MB-EAT) to improve mind-body awareness. Week 1 establishes foundational practices through mindful eating concepts and introductory yoga; Weeks 2-4 systematically train awareness of hunger/satiety cues using partner breathing techniques, postural alignment, and group-assisted stretching; Week 5 analyzes emotional eating triggers while integrating therapeut
• Behavioral e-Health Literacy
  This 8-week program (twice weekly) aims to enhance participants' ability to access, evaluate, and apply digital health information. It progresses through sequential modules: Week 1 introduces e-Health literacy fundamentals and physical activity principles; Weeks 2-3 focus on nutritional assessment and personalized planning; Week 4 addresses sleep health; Weeks 5-7 train health information retrieval skills, including database navigation and source reliability verification; the final week hones cr

Primary outcome measures

• eHealth Literacy Scale (eHEALS) [Time frame: From enrollment to the end of intervention at 8 weeks, and a 4-week follow up]
• Media Health Literacy Scale (MeHLit) [Time frame: From enrollment to the end of intervention at 8 weeks, and a 4-week follow up]
• Food Literacy Evaluation Questionnaire (Chinese version, FLEQ-Ch) [Time frame: From enrollment to the end of intervention at 8 weeks, and a 4-week follow up]
• Assessment Tools for Critical Thinking and Decision-Making Abilities [Time frame: From enrollment to the end of intervention at 8 weeks, and a 4-week follow up]

Secondary outcome measures (7)

• New Media Literacy Scale (NMLS) [Time frame: From enrollment to the end of intervention at 8 weeks, and a 4-week follow up]
• Self-compassion short form (SCS-SF) [Time frame: From enrollment to the end of intervention at 8 weeks, and a 4-week follow up]
• Decision Self-Efficacy Scale [Time frame: From enrollment to the end of intervention at 8 weeks, and a 4-week follow up]
• Decisional Conflict Scale [Time frame: From enrollment to the end of intervention at 8 weeks, and a 4-week follow up]
• Five Facet Mindfulness Questionnaire (FFMQ-C-SF) [Time frame: From enrollment to the end of intervention at 8 weeks, and a 4-week follow up]
• International Fitness Scale (IFIS) [Time frame: From enrollment to the end of intervention at 8 weeks, and a 4-week follow up]
• Critical Thinking Self-assessment Scale (CTSAS) [Time frame: From enrollment to the end of intervention at 8 weeks, and a 4-week follow up]

Eligibility criteria

Inclusion criteria

Mindfulness Group

• Currently enrolled in a Physical Education (PE) class.
• Aged between 18 and 25 years.
• Willing to participate in the 8-week intervention and provide informed consent.
• Generally healthy and able to engage in physical activity.
• Proficient in Chinese.

E-health Group

• Currently enrolled in a Physical Education (PE) class.
• Aged between 18 and 25 years.
• Willing to participate in the 8-week intervention and provide informed consent.
• Generally healthy and able to engage in physical activity.
• Proficient in Chinese.

Mindfulness + E-health Group

• Currently enrolled in a Physical Education (PE) class.
• Aged between 18 and 25 years.
• Willing to participate in the 8-week intervention and provide informed consent.
• Generally healthy and able to engage in physical activity.
• Proficient in Chinese.

Control Group

• Currently enrolled in a Physical Education (PE) class.
• Aged between 18 and 25 years.
• Willing to participate in the 8-week intervention and provide informed consent.
• Generally healthy and able to engage in physical activity.
• Proficient in Chinese.

Exclusion criteria

Mindfulness Group

• Currently studying in medical, nutrition, or health-related fields.
• Pregnant or lactating.
• Severe mental health conditions or cognitive impairments affecting participation.
• Currently participating in other mindfulness or digital health programs.
• Involved in competitive sports (e.g., varsity athletes).
• Recent major life events (e.g., trauma or major illness) within the last 6 months.
• Unable to participate in PE classes due to medical or personal reasons.

E-health Group

• Currently studying in medical, nutrition, or health-related fields.
• Pregnant or lactating.
• Severe mental health conditions or cognitive impairments affecting participation.
• Currently participating in other mindfulness or digital health programs.
• Involved in competitive sports (e.g., varsity athletes).
• Recent major life events (e.g., trauma or major illness) within the last 6 months.
• Unable to participate in PE classes due to medical or personal reasons.

Mindfulness + E-health Group

• Currently studying in medical, nutrition, or health-related fields.
• Pregnant or lactating.
• Severe mental health conditions or cognitive impairments affecting participation.
• Currently participating in other mindfulness or digital health programs.
• Involved in competitive sports (e.g., varsity athletes).
• Recent major life events (e.g., trauma or major illness) within the last 6 months.
• Unable to participate in PE classes due to medical or personal reasons.

Control Group

• Currently studying in medical, nutrition, or health-related fields.
• Pregnant or lactating.
• Severe mental health conditions or cognitive impairments affecting participation.
• Currently participating in other mindfulness or digital health programs.
• Involved in competitive sports (e.g., varsity athletes).
• Recent major life events (e.g., trauma or major illness) within the last 6 months.
• Unable to participate in PE classes due to medical or personal reasons.

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: Yes

Study design

Allocation

Randomized

Model

Parallel assignment

Masking

Open label

Primary purpose

Prevention

Study locations

Macau · 2 centers

• UM Sports Complex (N8) , Avenida da Universidade Taipa, Macau, China — Macao
• University of Macau — Macao

Identifiers

NCT: NCT07157566 · HE-0947-2025

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗