Background: Mindfulness-Based Interventions (MBIs) can improve mental health and well-being in adolescents with chronic illnesses. However, there are many barriers such as reduced mobility and distance which compromise accessibility to MBIs. Objective: The aim of this study was to determine the effectiveness of the Mindful Awareness and Resilience Skills for Adolescents (MARS-A) program in youth with chronic illnesses delivered in person or via eHealth. Method: In this mixed method randomized controlled trial, participants received weekly 90- minute long MARS-A sessions for 8 weeks, either in person or via a secure eHealth audiovisual platform allowing group interactions in real time. Data was collected at baseline, immediately after and two months post-MBI through saliva analyses, electronic participant logs and validated questionnaires assessing mindfulness skills and mental health outcomes. Results: Seven participants per group completed the intervention (total n=14, completion rate 77.8%). Paired t-test analyses revealed a significant reduction in depression/anxiety scores immediately post-intervention (p=0.048, Cohen’s d=0.934) and a significant reduction in pre-post mindfulness cortisol levels at week 8 (p=0.022, Cohen’s d=0.534) in the eHealth group. Frequency and duration of weekly individual home practice (eHealth: 6.5 times; 28.8 minutes; in-person: 6.0 times; 30.6 minutes) were similar in both groups and maintained at follow-up. Conclusion: This is the first study comparing in-person and eHealth delivery of an 8-week MBI for adolescents with chronic illnesses. Although the study was limited by the small size of the sample, our results suggest that eHealth delivery of MBIs may represent a promising avenue for increasing availability in this population.

Mindfulness-based interventions (MBIs) have been shown to improve health and well-being in adolescents with chronic illnesses. Because they are most often delivered in person in a group setting, there are several barriers that limit access to MBIs for youth with limited mobility or who cannot access in-person MBIs in their communities. The objective of this study was to determine if eHealth is a viable platform to increase accessibility to MBIs for teens with chronic illnesses. This study reports the qualitative results of a mixed method randomized trial describing the experience of the Mindful Awareness and Resilience Skills for Adolescents (MARS-A) program, an 8-week MBI, delivered either in person or via eHealth. Participants were adolescents between the ages of 13 and 18 with a chronic illness recruited at a tertiary pediatric hospital in Toronto, Canada. Individual semi-structured post-participation audio-video interviews were conducted by a research assistant. A multiple-pass inductive process was used to review interview transcripts and interpret emergent themes from the participants’ lived experiences. Fifteen participants completed post-participation interviews. Four distinct themes emerged from participants in both the in-person and eHealth groups: creation of a safe space, fostering peer support and connection, integration of mindfulness skills into daily life and improved well-being through the application of mindfulness. Results from this study suggest that eHealth may be an acceptable and feasible mode of delivery for MBIs in adolescents with chronic illnesses. EHealth should be considered in future studies as a promising avenue to increase access to MBIs in this population.

Mindfulness practice and protocols—often referred to as mindfulness-based interventions (MBIs)—have become increasingly popular in every sector of society, including healthcare, education, business, and government. Due to this exponential growth, thoughtful reflection is needed to understand the implications of, and interactions between, the historical context of mindfulness (insights and traditions that have been cultivated over the past 25 centuries) and its recent history (the adaptation and applications within healthcare, therapeutic and modern culture, primarily since the 1980s). Research has shown that MBIs have significant health benefits including decreased stress, insomnia, anxiety, and panic, along with enhancing personal well-being, perceptual sensitivity, processing speed, empathy, concentration, reaction time, motor skills, and cognitive performance including short- and long-term memory recall and academic performance. As with any adaptation, skillful decisions have to be made about what is included and excluded. Concerns and critiques have been raised by clinicians, researchers, and Buddhist scholars about the potential impact that the decontextualization of mindfulness from its original roots may have on the efficacy, content, focus, and delivery of MBIs. By honoring and reflecting on the insights, intentions, and work from both historical and contemporary perspectives of mindfulness, the field can support the continued development of effective, applicable, and accessible interventions and programs.

Research on the physiological and emotional health benefits of meditative practices has grown exponentially over the last two decades, influencing both scientific literature and popular media. Research has highlighted three distinct components or pillars at the core of meditative practices and mind training. They are, focused attention, open awareness, and