MINDSTRONG Cognitive Behavioral Skills Building Initiative to Enhance Wellness in Nursing Students at a Big 10 University: Lessons Learned

Introduction: Nursing students experience higher rates of anxiety, depression, stress, and burnout. Providing MINDSTRONG, an evidence-based cognitive behavioral skills-building program, to nursing students may enhance resiliency and decrease feelings of anxiety, depression, stress, and burnout. Methods: Implemented program using virtual and in-person delivery methods. Participants completed online demographic information, end-of-program evaluation, and four validated tools including the Patient Health Questionnaire–8 (PHQ-8), Generalized Anxiety Disorder–7 (GAD-7), Perceived Stress Scale–4 (PSS-4), and a Single-Item Burnout Measure. Results: Participants included 431 undergraduate nursing students. Students reported substantial levels of depression, anxiety, stress, and burnout at baseline. Overall, average stress (PSS-4) and burnout (Single-Item Burnout) scores showed a statistically significant increase from baseline. Depression (PHQ-8) and anxiety (GAD-7) scores showed no statistically significant change pre-to post. Students who reported the highest levels at baseline had a significant reduction in burnout, depression, and anxiety after completing the MINDSTRONG program and had less of an increase in stress post-training than students who started with lower scores overall. Conclusions: This quality improvement initiative supports ongoing efforts to integrate and strengthen wellness content into the curriculum and other college-related student support, outreach, and faculty/staff professional development initiatives.