A randomized controlled trial found that an LMS-based self-guided online resilience intervention produced significant improvements in mental distress and self-compassion under per-protocol conditions, but low adherence meant intention-to-treat analyses revealed no significant effects.
Key Findings
Results
Per-protocol analyses revealed significant improvements in mental distress at post-test for the intervention group compared to waitlist controls.
Per-protocol sample included n=150 university students out of 216 randomized participants.
Mental distress was the primary outcome measure.
Significant improvement was found at post-test but results were evaluated across three measurement points: pre, post, and follow-up.
No significant effects were found in intention-to-treat (ITT) analyses, which included all randomized participants.
Results
Per-protocol analyses revealed significant improvements in self-compassion at post-test.
Self-compassion was assessed as a secondary outcome (resilience factor).
Significant improvement was found at the post-test measurement point.
No favourable effects were found for overall self-reported resilience or other resilience factors.
ITT analyses did not confirm this finding.
Results
Significant improvement in acceptance was found at follow-up in per-protocol analyses.
Acceptance was measured as a resilience factor and secondary outcome.
The effect emerged at the follow-up measurement point rather than post-test.
This was among the few secondary outcomes showing a significant effect under per-protocol conditions.
ITT analyses did not reveal significant effects for this outcome.
Results
No favourable effects were found for self-reported resilience and most resilience factors in either analysis.
Self-reported resilience was a secondary outcome alongside individual resilience factors.
Neither per-protocol nor ITT analyses showed significant improvements in overall resilience.
Only self-compassion and acceptance showed selective improvements under per-protocol conditions.
Results suggest the intervention's impact was narrow rather than broad across resilience constructs.
Results
Adherence to the intervention was low among participants.
Low adherence was identified as a key limitation of the trial.
The discrepancy between per-protocol (n=150) and full randomized sample (n=216) reflects dropout and non-adherence.
ITT analyses, which account for all randomized participants regardless of adherence, revealed no significant effects.
The authors noted that 'further research into determinants of adherence is needed to improve intervention reach.'
Results
Satisfaction with the LMS-based self-guided online resilience intervention was high among participants.
Satisfaction was explored as one of several process-related outcomes alongside attitudes towards online interventions and possible negative effects.
High satisfaction was reported despite low adherence rates.
Attitudes towards online interventions and possible negative effects were also explored as secondary process measures.
The combination of high satisfaction but low adherence suggests engagement barriers unrelated to perceived value of the program.
Methods
The study enrolled 216 university students in a randomized controlled trial with intervention and waitlist control groups.
The trial included three measurement points: pre, post, and follow-up.
Both per-protocol (PP, n=150) and intention-to-treat (ITT) analyses were conducted.
The intervention was delivered via a Learning Management System (LMS) in a self-guided format.
University students were identified as an at-risk population for the development of mental disorders.
Conclusions
The study provides only preliminary evidence for the LMS-based intervention as a potentially valuable tool under optimal adherence conditions.
Authors characterized the findings as 'preliminary evidence' given the adherence limitations.
The intervention was described as 'a potentially valuable tool for university mental health services under optimal adherence conditions.'
Online interventions are framed as promising for 'reducing barriers to treatment and establishing easily accessible health-care services.'
The authors call for further research into adherence determinants to improve intervention reach.
What This Means
This research suggests that a self-guided online program designed to build resilience and improve mental health in university students can produce meaningful benefits, but only when students actually complete it. In a study of 216 university students randomly assigned to either the online program or a waiting list, students who adequately engaged with the program showed improvements in mental distress and self-compassion after completing it, and in a skill called 'acceptance' at a later follow-up assessment. Participants also reported high satisfaction with the program. However, many students did not fully engage with the intervention, and when all randomized students were included in the analysis regardless of how much they participated, no significant benefits were detected.
The gap between the 'per-protocol' results (those who adhered) and the 'intention-to-treat' results (everyone randomized) highlights a common challenge with self-guided digital health tools: getting people to actually use them consistently. This research suggests that the program itself may be effective in principle, but that low adherence limits its real-world impact. Notably, the intervention did not produce broad improvements across all resilience-related measures — only self-compassion and acceptance showed selective gains.
For university mental health services considering digital solutions, this research suggests that self-guided online resilience programs delivered through a learning management system may be a useful and accessible option, particularly given that students reported high satisfaction. However, the findings highlight that simply making a program available is not enough — understanding why students disengage and developing strategies to support sustained participation will be critical to realizing the program's potential benefits at a population level.
Bartelt S, Werner T, von Boros L, Schäfer S, Koehler F, Wirth B, et al.. (2026). Efficacy of a self-guided online resilience intervention for improving mental health among university students: A randomized controlled trial.. Scientific reports. https://doi.org/10.1038/s41598-026-67088-7