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Interventions incorporating mindfulness meditation are increasingly popular and have been reported to reduce stress, improve certain mental health conditions (e.g., depression and anxiety), and produce beneficial health effects (e.g., alleviate pain, possibly lower blood pressure). In this provocative randomized clinical trial of a mindfulness-meditation stress management program delivered via the internet [1], over 500 volunteers were randomized to the stress management program (with or without an online message board) or a wait-list control. Reductions in perceived stress (and improvement in other measures) were similar to those observed for in-person mindfulness programs and persisted after 4 weeks. The authors called this a feasibility trial, recognizing that the point was to show that delivering the intervention using the internet can work—if participants persist in the mindfulness training. The successful demonstration of improved self-report outcomes supports the obvious implications that this modality can greatly extend the reach and lower the cost of mindfulness interventions. The authors estimated a cost of only US$50 per participant for the fully automated online version (with minimal moderation of the discussion forum), compared to US$400–600 for an in-person group intervention. This means of delivery untethers the intervention from space and time, reducing the need for skilled providers and allowing participation for people who prefer a self-paced approach or who experience barriers to traditional classes such as transportation problems, busy work or school schedules, lack of child care, or living a long distance from the class location or a trained mindfulness teacher. In our view, this clinical trial also raises questions and suggests new opportunities beyond the scope of this particular trial.

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