Okay, let's break down the components of your systematic review on mindfulness-based interventions for anxiety in college students.

1. Comprehensive Search Strategy for PubMed and PsycINFO

The goal is to capture as many relevant studies as possible while minimizing irrelevant results. Here's a strategy, keeping in mind the databases have slightly different syntax:

Core Concepts:

• Mindfulness: (Mindfulness OR Mindfulness-Based OR "Mindfulness Meditation" OR MBSR OR MBCT OR "Acceptance and Commitment Therapy" OR ACT OR "Dialectical Behavior Therapy" OR DBT OR "Meditation"[Mesh] OR "mindful awareness" OR "attention regulation" OR "present moment awareness")


• Anxiety: (Anxiety OR "Anxiety Disorders"[Mesh] OR "Stress, Psychological"[Mesh] OR Worry OR "Generalized Anxiety Disorder" OR "Social Anxiety Disorder" OR "Panic Disorder" OR "Test Anxiety" OR "Performance Anxiety")


• College Students: ("College Students"[Mesh] OR "Students"[Mesh] OR Student OR University Student OR Higher Education OR Undergraduate OR Post-graduate OR "Young Adult*")


• Intervention: (Intervention OR Treatment OR Program OR Therapy OR Therapies OR Trial OR RCT OR "Randomized Controlled Trial"[Publication Type] OR "Controlled Clinical Trial"[Publication Type])

(("Mindfulness" OR "Mindfulness-Based" OR "Mindfulness Meditation" OR "MBSR" OR "MBCT" OR "Acceptance and Commitment Therapy" OR "ACT" OR "Dialectical Behavior Therapy" OR "DBT" OR "Meditation"[Mesh] OR "mindful awareness" OR "attention regulation" OR "present moment awareness")) AND ((Anxiety OR "Anxiety Disorders"[Mesh] OR "Stress, Psychological"[Mesh] OR Worry OR "Generalized Anxiety Disorder" OR "Social Anxiety Disorder" OR "Panic Disorder" OR "Test Anxiety" OR "Performance Anxiety")) AND (("College Students"[Mesh] OR "Students"[Mesh] OR Student* OR "University Student*" OR "Higher Education" OR "Undergraduate*" OR "Post-graduate*" OR "Young Adult*")) AND ((Intervention* OR Treatment* OR Program* OR Therapy OR Therapies OR Trial* OR RCT OR "Randomized Controlled Trial"[Publication Type] OR "Controlled Clinical Trial"[Publication Type]))

PsycINFO Search Strategy:

(("Mindfulness" OR "Mindfulness-Based" OR "Mindfulness Meditation" OR "MBSR" OR "MBCT" OR "Acceptance and Commitment Therapy" OR "ACT" OR "Dialectical Behavior Therapy" OR "DBT" OR "mindful awareness" OR "attention regulation" OR "present moment awareness")) AND ((Anxiety OR "Anxiety Disorders" OR "Stress, Psychological" OR Worry OR "Generalized Anxiety Disorder" OR "Social Anxiety Disorder" OR "Panic Disorder" OR "Test Anxiety" OR "Performance Anxiety")) AND (("College Students" OR "Students" OR Student* OR "University Student*" OR "Higher Education" OR "Undergraduate*" OR "Post-graduate*" OR "Young Adult*")) AND ((Intervention* OR Treatment* OR Program* OR Therapy OR Therapies OR Trial* OR RCT))
Limiters: *Peer Reviewed* and *English Language*

Explanation and Refinements:

• Boolean Operators (AND, OR): AND narrows the search (all terms must be present). OR broadens the search (any of the terms can be present).


• **Truncation (*):** Allows for variations in word endings (e.g., Student* retrieves Student, Students, Student's).


• Phrase Searching (" "): Keeps words together as a phrase (e.g., "Mindfulness Meditation").


• MeSH Terms (PubMed) and Thesaurus Terms (PsycINFO): These are controlled vocabulary terms that help retrieve relevant articles even if the authors used different keywords. Use the database's thesaurus/MeSH browser to find the most relevant terms and explode/narrow them as necessary.


• Publication Type: Including "Randomized Controlled Trial" and "Controlled Clinical Trial" increases the likelihood of finding intervention studies.


• Adaptations: Experiment with different combinations of terms. For example, if you are only interested in RCTs, remove the Intervention OR Treatment OR Program OR Therapy OR Therapies OR Trial terms and keep only the RCT-related terms.


• Iteration: After an initial search, review the relevant articles retrieved and identify additional keywords or MeSH terms that you may have missed. Refine the search strategy based on these findings.

• Date Range: Specify a start date (e.g., 2010) depending on the scope of your review.


• Grey Literature: Consider searching grey literature sources (e.g., ProQuest Dissertations & Theses, OpenGrey) for unpublished studies. This can help reduce publication bias.


• Hand Searching: Manually reviewing the reference lists of included studies is crucial to identify articles missed by database searches.

Clearly defined criteria are vital for consistency and replicability.

Inclusion Criteria:

• Population: College/university students (18-25 years old; adjust as needed). Studies including older students will be reviewed based on a percentage of the sample.


• Intervention: Mindfulness-based interventions (MBIs) defined as programs incorporating core mindfulness practices such as meditation, body scan, mindful movement, or elements of ACT, DBT, MBSR, or MBCT.


• Comparison: Control group (waitlist, active control, usual care, or no intervention).


• Outcome: Studies that measured anxiety as a primary or secondary outcome using validated anxiety scales (e.g., GAD-7, BAI, STAI).


• Study Design: Randomized controlled trials (RCTs) or quasi-experimental designs.


• Language: English.


• Publication Status: Published or pre-prints.


• Setting: University or community setting.

• Population: Non-student populations, or studies where college students are not the primary focus (e.g., studies targeting general adult populations where college students are a small subset). Studies where the majority of the sample is not college students.


• Intervention: Interventions not primarily focused on mindfulness (e.g., pure exercise interventions without a mindfulness component). Interventions using mindfulness as an add-on to another intervention.


• Comparison: Studies without a control/comparison group.


• Outcome: Studies not reporting anxiety outcomes.


• Study Design: Case studies, qualitative studies, reviews, meta-analyses, or opinion pieces.


• Language: Non-English.


• Full Text Unavailable: Unable to access the full text of the article after reasonable attempts.


• Non-empirical Studies: Studies not providing original research data.


• Co-morbid anxiety and depression cannot be disaggregated.

• Operational Definitions: Be precise in defining key terms like "mindfulness-based intervention." Provide examples.


• Pilot Testing: Test your inclusion/exclusion criteria on a sample of articles to ensure clarity and feasibility. Revise as needed.


• Inter-rater Reliability: Have two reviewers independently screen articles and assess agreement. Resolve discrepancies through discussion. Report the inter-rater reliability (e.g., Cohen's Kappa).

A well-designed form ensures you collect all necessary data in a consistent manner. Consider using a spreadsheet program (e.g., Excel) or a data extraction software.

Sections of the Form:

• Study Identification:


• Article Title


• Authors


• Journal


• Year of Publication


• DOI/URL


• Study Design:


• Type of Study (RCT, Quasi-experimental)


• Randomization Method (if applicable)


• Blinding (if applicable)


• Allocation Concealment (if applicable)


• Participants:


• Sample Size (Intervention Group, Control Group)


• Age (Mean, SD)


• Gender (%)


• Ethnicity (%)


• Inclusion/Exclusion Criteria (for participants)


• Baseline Anxiety Levels (Mean, SD)


• Intervention:


• Type of Mindfulness Intervention (MBSR, MBCT, ACT, etc.)


• Description of Intervention (Content, Format, Duration, Frequency, Delivery Method)


• Intervention Provider (e.g., trained therapist, self-guided)


• Intervention Fidelity (How was it assessed?)


• Control/Comparison Group:


• Type of Control Group (Waitlist, Active Control, Usual Care)


• Description of Control Group


• Outcome Measures:


• Anxiety Measure(s) Used (e.g., GAD-7, BAI, STAI)


• Time Points of Assessment (Pre-intervention, Post-intervention, Follow-up)


• Results:


• Means and Standard Deviations (or other relevant statistics) for anxiety outcomes at each time point for both groups.


• Effect Size (if reported, e.g., Cohen's d, Hedges' g)


• P-values and Confidence Intervals


• Attrition Rates (Intervention Group, Control Group)


• Adverse Events (if reported)


• Risk of Bias Assessment: (Record your assessment using the chosen quality assessment tool; see below)


• Notes: Any other relevant information or comments about the study.

• Pilot Testing: Pilot test the data extraction form on a few articles to identify any missing elements or areas for improvement.


• Inter-rater Reliability: Have two reviewers independently extract data from a subset of articles and assess agreement. Resolve discrepancies through discussion. Report the inter-rater reliability (e.g., Cohen's Kappa or Intra-class Correlation Coefficient - ICC).


• Detailed Manual: Develop a detailed manual to accompany the data extraction form, providing clear instructions on how to extract specific data elements.

Assessing the methodological quality of included studies is essential to evaluate the strength of the evidence.

Suggested Tools:

• Cochrane Risk of Bias 2 (RoB 2) Tool: This is a widely used tool for assessing the risk of bias in RCTs. It evaluates five domains:


• Bias arising from the randomization process


• Bias due to deviations from intended interventions


• Bias due to missing outcome data


• Bias in measurement of the outcome


• Bias in selection of the reported result


• Overall Risk of Bias: Low, Some Concerns, High


• Risk Of Bias In Non-randomised Studies - of Interventions (ROBINS-I): For quasi-experimental studies. This tool is used to assess the risk of bias in non-randomized studies of interventions.


• PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses): While not a quality assessment tool in the strict sense, PRISMA is a guideline for reporting systematic reviews and meta-analyses. Following PRISMA ensures that your review is transparent and comprehensive. You will use the PRISMA checklist and flow diagram to document your search and selection process.


• MINORS Methodological Index for Non-Randomized Studies: Is a good choice for assessing non-randomized studies (Quasi-experimental studies).

• Training: Familiarize yourself with the chosen tools and their scoring criteria. The Cochrane Handbook for Systematic Reviews of Interventions provides detailed guidance on using RoB 2. The ROBINS-I tool also has a detailed user manual.


• Independent Assessment: Have two reviewers independently assess the risk of bias for each study.


• Resolution of Discrepancies: Resolve any disagreements through discussion or consultation with a third reviewer.


• Reporting: Report the results of the quality assessment in your systematic review, including a summary of the risk of bias across studies and how it might affect the overall conclusions.


• Sensitivity Analysis (Optional): Conduct a sensitivity analysis to examine the impact of excluding studies with a high risk of bias on the overall findings.

• RCTs: RoB 2 is the standard and highly recommended for RCTs.


• Quasi-experimental Studies: ROBINS-I or MINORS are appropriate.

• Transparency: Clearly document your quality assessment process and the rationale for your judgments.


• Impact on Synthesis: Consider how the quality assessment results will influence your synthesis of the evidence (e.g., weighting studies based on quality, excluding low-quality studies).