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.
Methods: 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
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.