# A pilot randomized controlled trial of an online mindfulness-based intervention to reduce patient anxiety before a first-time screening colonoscopy

## TL;DR

A pilot study tested an online mindfulness program to reduce anxiety before first-time colonoscopies, finding it acceptable and potentially effective.

## Contribution

This study introduces a novel online mindfulness-based intervention to address anxiety before colonoscopies, showing preliminary acceptability and potential efficacy.

## Key findings

- The MBI had high participant satisfaction and was associated with lower anxiety scores in those not lost to follow-up.
- Logistical issues limited full feasibility, but results suggest the MBI could reduce pre-colonoscopy anxiety.
- A larger trial is needed to confirm the intervention's efficacy.

## Abstract

Anxiety before a first-time screening colonoscopy is a commonly reported patient-level barrier to completing colorectal cancer (CRC) screening. This pilot study evaluated the feasibility, acceptability, and preliminary efficacy of “For peace of mind. Get Screened,” a brief online mindfulness-based intervention (MBI) to reduce anxiety before a first-time screening colonoscopy.

Participants (n = 100) were randomized (October 2023—July 2024) to usual care or the MBI (daily CRC screening infographics guided by the Protection Motivation Theory, mindfulness infographics, and brief mindfulness meditations based on Monitor and Acceptance Theory) starting five days before their scheduled colonoscopy. Anxiety was assessed using the State-Trait Anxiety Inventory—State Subscale (STAI-S) in the endoscopy suite’s waiting room.

Participant retention was 83% due to patient and health system issues. Participant satisfaction with the MBI was high (mean: 6.40 out of 7). The MBI group had an average STAI-S score 2.54 points lower than the usual care group, though this difference was not statistically significant (32.24 vs. 34.78; p = 0.21). However, among participants not lost to follow up (n = 83), the MBI group had significantly lower waiting room STAI-S scores compared to the usual care group (31.52 vs. 35.21; p = 0.02). Clinical outcomes did not differ between groups.

Feasibility of the MBI was partially limited due to logistical issues. Findings support MBI acceptability and suggest that a brief MBI has the potential to decrease anxiety prior to a first-time colonoscopy. A larger randomized controlled trial is needed to further examine the efficacy of this intervention.

ClinicalTrials.gov NCT06233253.