Evaluating the Feasibility of a Guided Culturally Adapted Internet-Delivered Mindfulness Intervention for Indonesian University Students Experiencing Psychological Distress

Objectives Psychological distress is common among university students globally. A culturally relevant internet-based mindfulness intervention could be a potential solution for addressing students' distress in low- and middle-income countries (LMICs), including Indonesia. However, internet-based mindfulness interventions are new in Indonesia. In this study, we evaluated the feasibility, acceptability, and mental health outcomes of a counsellor-guided, culturally adapted, internet-delivered mindfulness intervention for Indonesian university students experiencing psychological distress.Method This open pilot trial used a single-arm pre-post-test design. Indonesian university students with elevated distress (n = 40) enrolled in a 4-week counsellor-guided internet-delivered mindfulness intervention. Participants completed the Indonesian adaptation of the Depression Anxiety Stress Scales (DASS-21) at screening, baseline, and post-treatment. They also completed the Indonesian version of Kessler's Psychological Distress Scale (K-10) prior to each lesson, Five Facet Mindfulness Questionnaire (FFMQ) and Indonesian Well-Being Scale (IWBS) at baseline and post-treatment, and questionnaires to evaluate the feasibility, acceptability, and treatment satisfaction.Results Results showed the feasibility and acceptability of our guided culturally adapted Indonesian internet-delivered mindfulness intervention, with good completion rates (70%). We also found large and significant improvements in distress, mindfulness, and well-being (Hedges' g = 0.85-1.68) from pre- to post-treatment. Participants reported that the program was satisfactory.Conclusions This study suggested that a counsellor-guided culturally adapted internet-based mindfulness intervention was feasible, acceptable, and associated with improvements in psychological distress, well-being, and mindfulness among university students in Indonesia. A randomized controlled trial with follow-up is needed to evaluate the intervention's effectiveness.Preregistration This trial was preregistered on the Australian New Zealand Clinical Trial Registry (ACTRN12620000135910).