A Mixed-Methods Evaluation of a Wellbeing Programme Designed for Undergraduate Students: Exploring Participants’ Experiences Using Interpretative Phenomenological Analysis

Abstract

The mental health struggles of university students have been the focus of a substantial amount of research worldwide. To tackle this, universities have developed initiatives to promote student wellbeing. Here, we highlight Time to Thrive (TTT), a co-designed online programme based on positive and coaching psychology and neuroscience literacy to support undergraduate students to thrive at university. This study examines the effectiveness of TTT on undergraduate student wellbeing and explores students’ subjective experiences as participants in TTT. A mixed-methods randomised controlled trial was conducted with an intervention group (n = 18) and a later access control group (n = 26) to verify the impact of TTT on psychological wellbeing, mental wellbeing, and resilience. Participants completed the Short Warwick-Edinburgh Mental Wellbeing Scale (SWEMWBS), the Flourishing Scale (FS), and the Brief Resilience Scale (BRS) pre-post intervention. Following programme completion, intervention group participants were interviewed about their experience with TTT (n = 5), and their reflections were analysed using Interpretative Phenomenological Analysis (IPA). Participation in TTT significantly improved psychological wellbeing in the intervention group, controlling for pre-TTT scores. Three themes were developed through IPA: the differing functions of TTT, the personal impact of TTT, and placing students who need it the most at the heart of TTT. These findings suggest that university-delivered initiatives can effectively foster undergraduates‘ wellbeing. Embedding TTT and relevant programmes within the curriculum may facilitate engagement and impact. Moreover, evidence sustaining their effectiveness may inform policy for broader application in higher education.

1. Introduction

University students’ mental health and wellbeing have gradually attracted substantial attention from policymakers and researchers (Brown, 2018), particularly with a considerable rise in the number of students requiring support (Lipson et al., 2019; McManus & Gunnell, 2020). Depression and anxiety are the two most prominent mental health conditions reported in this population (Auerbach et al., 2018). Moreover, the recent public health crisis of the COVID-19 pandemic has adversely impacted their levels of anxiety, distress, and flourishing (Allen et al., 2023). Developmentally, the onset of most long-term mental health conditions occurs by the mid-twenties (Kessler et al., 2007). Therefore, university studies often coincide with a high-risk window for young people’s mental health. Importantly, dealing with a mental health issue during university years has been related to lower academic performance, increased drop-out chances, and future unemployment (Bruffaerts et al., 2018; Eisenberg et al., 2009; Hjorth et al., 2016).

Furthermore, although mental health issues represent a crucial factor for the student experience, mental wellbeing also deserves attention. Distinguishing between mental health and wellbeing is often complex, with various definitions and contradictions surrounding these concepts. For instance, according to the World Health Organization, mental health is defined as “a state of mental wellbeing that enables people to cope with the stresses of life, realise their abilities, learn well and work well, and contribute to their community”, which emphasises that it incorporates more than just the absence of mental disorders (World Health Organization, 2022). Meanwhile, the University Mental Health Charter (Hughes & Spanner, 2019) described mental health as existing along a continuum of experiences, where mental health stands at one end and mental illness at the other, while wellbeing serves as a broader umbrella framework, encompassing mental health as one of its integral components besides physical and social wellbeing.

In contrast, some suggest that mental illness and wellbeing represent two distinct but related dimensions, where one can experience symptoms of mental ill-health while simultaneously maintaining a strong sense of wellbeing (Iasiello et al., 2020; Keyes, 2014). Regardless of these perspectives, it remains crucial that we recognise that mental health and wellbeing, though closely intertwined, represent different concepts (A. Dodd et al., 2022). In this context, mental health in the present study is approached as the multi-faceted concept of mental wellbeing described in the WHO definition.

Additionally, several frameworks of wellbeing led to the development of various measures assessing related but distinct aspects of this layered construct. For example, subjective wellbeing refers to positive emotions and life satisfaction (Diener, 1984), whereas psychological wellbeing is considered a broader concept, moving beyond the subjective experience by capturing aspects such as autonomy, mastery, self-acceptance, positive relationships, life purpose, and personal growth (Ryff, 1989).

Given this understanding of mental health and wellbeing, promoting university students’ wellbeing can be valuable both in terms of reducing the risk of future mental illness (Schotanus-Dijkstra et al., 2017) and relating to higher academic performance (Schrader, 2023) and greater social engagement (Antaramian, 2015). However, the multitude of definitions and measuring approaches hinder the measurement of student wellbeing (A. L. Dodd et al., 2021), which, in turn, complicates data comparison and the ability to draw clear conclusions regarding its prevalence among students (A. Dodd et al., 2022). Nonetheless, findings from the Healthy Minds Network, based on a population-level survey using the Flourishing Scale (Diener et al., 2010), showed that just 36% of university students in the US experienced high psychological wellbeing and were considered to be flourishing (The Health Minds Network, 2023). Likewise, nearly a decade of data from the Student Academic Experience Survey in the UK (2016–2024) have consistently shown that university students’ wellbeing, measured through happiness, life satisfaction, life being worthwhile, and stress levels, remains low, with a slight improvement over time, and is often lower than that of young adults in the general population (Neves et al., 2024; Neves & Hewitt, 2020).

Moreover, resilience, conceptualised as the ability to recover from stress-inducing circumstances and setbacks and adjust to the environment (B. W. Smith et al., 2008), represents a skill university students can use to navigate throughout their studies. Interestingly, resilience training and cognitive therapy showed similar effects in decreasing depressive symptoms among university students in Iran (Zamirinejad et al., 2014). Furthermore, resilience positively correlates with academic engagement and achievement (Martin et al., 2015). Additionally, research indicates that resilience not only promotes academic performance but also facilitates students’ overall university experience by enabling them to better manage the stressors commonly associated with higher education (Walters & James, 2020).

Although counselling remains the most consistently offered support by higher education institutions, services often struggle to meet growing demands (Brown, 2018). Consequently, universities are exploring scalable, accessible, and student-friendly alternatives (Worsley et al., 2022). Mindfulness-based interventions, cognitive–behavioural therapy, and technology-delivered interventions effectively address depression, anxiety, and stress (Worsley et al., 2022), though in-person delivery yields better results (Farrer et al., 2013). Coaching interventions also provide academic, emotional, and psychological support (Shorey et al., 2022). Moreover, recreation programmes and peer support have shown promising results in reducing depression and anxiety (Huang et al., 2018). Lastly, positive psychology-based interventions (PPIs) have produced mixed results, highlighting the need for further research (Cheung et al., 2021; Hobbs et al., 2022a, 2022b; Hood et al., 2021; Kounenou et al., 2022; Lambert et al., 2023).

Nevertheless, by focusing mainly on supporting students who already face mental health challenges, higher education institutions frequently overlook the promotion of wellbeing within the broader student body (Conley et al., 2013). Moreover, because university years represent a period of increased vulnerability, they can equally be seen as a unique chance to aid students in developing resources to cope with and to recognise and treat problems right at their start or prevent their occurrence (Duffy, 2023). Importantly, universities have begun developing new mental wellbeing initiatives which prioritise prevention in a community-wide context, targeting all students, regardless of their existing or past difficulties (Hobbs et al., 2022a).

A systematic review of the effectiveness of university positive psychology courses revealed that, while such studies often report benefits for psychological wellbeing, they often present a moderate to serious risk of bias (Hobbs et al., 2022a). Other studies showed that some wellbeing outcomes like positive emotions can be improved through PPIs but others like resilience (Kounenou et al., 2022) or life satisfaction (Lambert et al., 2023) cannot. Additionally, from a theoretical perspective, university-positive-psychology-based programmes often remain rooted in more traditional positive psychology principles and techniques (e.g., positive emotions, gratitude, and signature strengths, as seen in Cheung et al., 2021; Kounenou et al., 2022; and Lambert et al., 2023), with fewer adopting a more holistic approach to wellbeing, encompassing neuroscientific perspectives and the importance of lifestyle factors for wellbeing (Hobbs et al., 2022b; Hood et al., 2021).

In this light, the Time to Flourish (TTF) programme, a pilot face-to-face positive coaching psychology-based programme, was designed at King’s College London (KCL), to support postgraduate students in the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) in promoting their wellbeing, finding their voice, and building on their sense of agency (Dias et al., 2019). The programme was based on the integrative cognitive–behavioural coaching (ICBC) model (Dias et al., 2017). Namely, while ICBC is mainly based on a cognitive–behavioural approach, it actively draws on positive psychology coaching, e.g., by guiding students in identifying their core strengths and values (Peterson & Seligman, 2004), and the solution-focused approach (Greene & Grant, 2003), e.g., by helping students become aware of strategies that already work for them and encouraging their more consistent implementation (Dias et al., 2017).

Moreover, TTF is structured around the PERMA model where positive emotions, engagement, relationships, meaning, and accomplishment are considered fundamental components of wellbeing (Seligman, 2011). Designed as a PPI, it includes reflective activities to nurture positive emotions, behaviours, and thoughts. Students who participated in TTF found it helpful in providing them with skills to build a more satisfying life within and beyond university (Dias et al., 2019), suggesting that this integration of positive psychology and coaching psychology may be a promising avenue to support postgraduate students.

In 2020, in response to the unprecedented adversities posed to students by the COVID-19 pandemic, the programme was adapted for online delivery to support postgraduate students at the IoPPN, KCL, and renamed to Time to Thrive (TTT), following students’ recommendation (Vourda et al., in press). The programme was based on an expansion of the ICBC model, with the inclusion of neuroscience literacy as another potential facilitator of wellbeing (R. Miller, 2016), addressing inquiries to explore whether learning about neuroplasticity and the neurobiology of stress and happiness could promote a better understanding and management of emotional responses among students (Martin & Ochsner, 2016). Importantly, promising findings from this evaluation highlighted that, in its adapted format, TTT (version 2020) could serve as a valuable university-led initiative to enhance wellbeing and empower postgraduate students to be more resilient (Vourda et al., in press).

Furthermore, it is also worth mentioning that, initially, TTF and TTT (version 2020) were designed for postgraduate students. Focusing on this sub-group of students was an attempt to reduce the gap in the literature, showing that, while postgraduate students present greater vulnerability to anxiety and depression compared with the general population (Evans et al., 2018), most student wellbeing research focuses on undergraduate students (Nolan et al., 2024).

Nevertheless, fuelled by the encouraging results mentioned above and the need to extend the programme’s offering to undergraduate students across all faculties at KCL, another version of the programme was designed (TTT version 2022), this time co-developed with undergraduate students (Dias et al., 2023), recognising the value of involving students in the design of wellbeing programmes (Pascoe et al., 2022). From a theoretical perspective, TTT (version 2022) was structured around what we proposed as the EMERALD model (Dias et al., 2023) an acronym summarising the six domains of wellbeing the programme covers (Emotions, Meaning & Engagement, Relationships, Achievements, Living Better, and Driving Change). This theoretical model represents an expansion of the PERMA model for wellbeing (Seligman, 2011), recognising (1) the need to accept stress and work with negative emotions as acknowledged by second-wave positive psychology (Lomas & Ivtzan, 2016); (2) that lower self-confidence and impostor syndrome can impede goal achievement and psychological wellbeing (Sakulku, 2011); and (3) that lifestyle factors such as sleep, nutrition, physical exercise, and mindfulness practice impact wellbeing (Dawson et al., 2020; Ekman et al., 2022). Finally, EMERALD recognises that how one moves through transitions and adapts to change and the skills one develops to handle this process are key to wellbeing and achieving purposeful change. Preliminary findings from a small sample of undergraduate students across KCL faculties indicated TTT’s high acceptability (Dias et al., 2023).

The present study builds on our latest work and evaluates TTT for undergraduate students (version 2022). Specifically, we aimed to answer the following two research questions:

(1)

How effective is TTT for undergraduate students’ mental wellbeing?

(2)

How do students make sense of their experience with the TTT programme?

2. Methods

2.1. Research Design

A mixed-methods design was implemented to address the research questions. Namely, aiming to verify effectiveness, the quantitative arm involved a randomised controlled trial (RCT) to determine whether participation in the TTT programme impacted student wellbeing. RCTs are widely considered as the benchmark design for evaluating causal relationships between interventions and outcomes, as a result of their ability to reduce biases, like self-selection, and to ensure the even distribution of confounding variables between groups (Hariton & Locascio, 2018).

Additionally, the qualitative arm aimed to explore students’ subjective experiences and meaning making, to address how they make sense of their engagement with the wellbeing programme. The inclusion of a qualitative arm also aligns with recent recommendations in positive psychology, calling for more mixed-methods studies that allow space for participants to have their voices heard, an approach particularly relevant in the evaluation of wellbeing interventions (Lomas et al., 2021).

Based on the power calculation (G*Power; Faul et al., 2007), to observe an effect size of 0.3 and have 80% power, a total sample size of 72 was needed.

2.2. Recruitment

Participants were recruited among undergraduate courses across KCL faculties through voluntary response sampling. Information about the research was circulated between August 2022 and February 2023 through departmental and faculty newsletters, student experience managers, personal tutors, course forums, social media, the KCL Research Participation System, and brief oral presentations during lectures and welcome week events. Students from any undergraduate course at KCL were welcome to join the study, with the only requirement being that they be at least 16 years old.

Furthermore, efforts were put into making the dissemination of the programme more personal and direct, with members of the research team attending induction events to talk to students about the programme and study aims, as well as before and after lectures upon the agreement of lecturers, and advertising the study on the university’s social media platforms.

Upon expressing interest in participating in the study via an MS Form, to obtain participant informed consent, interested students were contacted by the research team with more information about the study. They were sent an electronic copy of the information sheet, which they were encouraged to read carefully. The research team informed them that they would learn their group allocation shortly. Upon written agreement to participate, the student was randomly allocated to one of two groups. They were then sent a Qualtrics link to fill out the consent form electronically and, after giving their consent, they completed the pre-TTT survey. It is also worth noting that students who expressed interest within two weeks after the intervention group gained access to TTT were not denied participation. Instead, they were allocated to the control group, as it was considered important to offer any student who met the eligibility criteria the opportunity to engage with resources they could find helpful for their wellbeing. This approach led to having more students in the control arm than the intervention.

The study received ethical approval by the KCL Psychiatry, Nursing & Midwifery (PNM) Research Ethics Panel (LRS/DP-21/22-28286, LRM-22/23-28286). Participants were reimbursed with £10 vouchers for their time filling out the pre-post TTT surveys, and those participating in the interviews received an extra £10 voucher.

2.3. Participants

Overall, 125 students signed up for the study. Upon agreement to participate, students were randomly allocated to the intervention (n = 58) or control group (n = 68), this latter receiving access to the online TTT platform after data collection was completed. The final sample (N = 44; 18 in the intervention group and 26 in the control group) included only participant cases who completed both pre-TTT and post-TTT scores for the outcome measures. The demographics of the sample were collected in the pre-TTT survey. The sample’s description was as follows: by gender, 37 participants identified as female (84.1%), 6 as non-binary (13.6%), and 1 as other (2.3%); by ethnicity, 22 identified as Asian (50%), 11 as white (25%), 3 as mixed (6.8%), 2 as Black (4.5), and 1 (2.3%) preferred not to disclose this information, while 5 identified as ‘other’ (11.4%), 4 of them later specifying this as Arab; and, by current university year, 25 students were first-years (56.8%), 9 second-years (20.5%), 9 third-years (20.5%), and 1 fourth-year (2.3%). Additionally, participants’ age ranged between seventeen and twenty-seven years (Mdn = 19.0, Mode = 19.0).

2.4. Programme Delivery

The present undergraduate version of TTT was developed based on the original face-to-face programme, TTF (Dias et al., 2019), and adapted for undergraduate students through a co-creation approach (Dias et al., 2023). This undergraduate version of TTT comprised six topics: Emotions, Meaning and Engagement, Relationships, Achievements, Living Better, and Driving Change (the EMERALD model; Dias et al., 2023). The programme was delivered mainly online via the university’s e-learning platform, combining synchronous and asynchronous activities. Each topic included a pre-recorded animated presentation, experiential exercises, takeaway messages, a case study and quiz, and further suggested resources.

Feedback from the pilot delivery (Dias et al., 2023) was implemented, adding more opportunities for interaction. Regarding synchronous activities implemented to make the programme more interactive, four live online sessions were held in the second and sixth week of the programme, two each week at different times and days to accommodate different schedules. During these sessions, students could ask clarifying questions and discuss with their peers and programme facilitators, using case studies and experiential exercises as ice-breakers, with the facilitators highlighting that these were safe and confidential spaces where students could discuss wellbeing topics and strategies. Moreover, a face-to-face workshop was held on week 3 of the programme, during which students could participate in a yoga or arts-doodle session with mindfulness colouring, strengths-based drawing, or brick construction. As the programme was self-paced, all six topics were available from the start. However, students were encouraged to engage with one topic per week following the pre-designated order from Topic 1 to Topic 6.

Moreover, to further address previously collected feedback from the pilot delivery of the 2022 version (Dias et al., 2023), the timing of the delivery was scheduled between February and March, a lighter workload period for the students, while its duration was adjusted to seven weeks in total, allowing one week for each of the six topics and an additional break-week in the middle. Additionally, a range of suggested additional resources were added to each topic, like Ted Talks, YouTube videos, and articles.

2.5. Measures and Data Collection

Participants were invited to fill out pre-post TTT measures. Pre-post TTT surveys were built in Qualtrics and distributed via email. Both included the Short Warwick-Edinburgh Wellbeing Scale (SWEMWBS), the Brief Resilience Scale (BRS), and the Flourishing Scale (FS). The SWEMWBS is a short 7-item version of the WEMWBS, a standardised scale measuring mental wellbeing by focusing on positive aspects of mental health (Tennant et al., 2007). The BRS is a 6-item self-rating scale measuring the competence to bounce back or recuperate from stress (B. W. Smith et al., 2008). Finally, the FS is a brief 8-item summary measure of the respondent’s perception of their success in pivotal domains like relationships, self-esteem, purpose, and optimism (Diener et al., 2010). Given that two scales measuring wellbeing were used, the rationale behind this decision is worth noting. FS was administered to ensure the study’s methodology abided by Seligman’s (2011) recommendation to assess flourishing as the gold-standard measure of wellbeing while the SWEMWBS allows comparability with other studies focusing on the wellbeing of students in the UK (A. Dodd et al., 2022). A Spearman’s rank-order correlation showed a statistically significant strong positive correlation between SWEMWBS and FS, r_(s) = 0.76, p < 0.001, indicating that the two scales were very similar but not identical, thus measuring different outcomes relating to wellbeing. Participants were also asked to complete a sociodemographic data questionnaire as part of the pre-TTT survey, and participants in the intervention group completed a brief feedback survey as part of the post-TTT survey.

Figure 1 contains a flowchart capturing participation and data collection procedures. Pre-intervention survey data were collected from participants before the intervention group started engaging with TTT, and post-intervention survey data were collected approximately eight weeks later. Then, participants in the control group received access to TTT and were given eight weeks to engage with the programme. Pre-intervention data were collected from 38 participants in the intervention group and 53 in the control group. Post-intervention data were collected from 19 participants in the intervention group and 28 in the control group.

Following the completion of TTT, participants in the intervention group were invited to in-depth semi-structured interviews to explore their subjective experience with the programme and obtain their input and recommendations for future improvements (n = 5) [see Appendix A]. The first and third authors conducted the interviews remotely on Microsoft Teams, which allowed their recording and transcription.

2.6. Data Analyses

2.6.1. Quantitative Arm

The data from the three outcome measures of wellbeing, resilience, and flourishing were analysed using SPSS version 29.0 (IBM Corp, 2023). Of the 19 participants in the intervention group and 28 in the control group who completed the post-TTT survey, 18 and 26 participant cases, respectively, were successfully matched to their pre-TTT survey counterparts and carried forward for the analyses. To measure TTT’s impact, analyses of covariance (ANCOVAs) were undertaken to estimate the difference between groups in the three outcome measures at post-intervention while considering individual baseline measurements as a covariate. Consequently, the following statistical tests were used: descriptive statistics (means and standard deviations) and variance analysis (ANOVA) to determine the homogeneity of the sample with each of the scores collected in the scales in the pre-TTT phase. Similarly, descriptive statistics (means and standard deviations) and ANCOVAs of the post-TTT scores were performed, the covariates being the pre-TTT scores on each scale. The analyses included only participants who completed both pre- and post-TTT surveys. Firstly, the normality of the variables was assessed using the Shapiro-Wilk test. Although three variables deviated significantly from normality, i.e., wellbeing pre-TTT (W = 0.90, p = 0.04) and post-TTT (W = 0.86, p = 0.01) for the intervention group as well as wellbeing post-TTT for the control group (W = 0.90, p = 0.01), it was decided that the analysis should proceed since ANCOVA is considered relatively robust to deviations from normality. Secondly, reliability evidence was assessed using Cronbach’s alpha reliability coefficient.

Participants were asked to complete a short feedback form as part of the post-TTT survey regarding the overall perception of various features of TTT. Descriptive statistics from SPSS were used to analyse and summarise their responses.

2.6.2. Qualitative Arm

Regarding the interviews that were conducted to explore how student participants interpreted their experience with TTT, guided by the study’s focus on subjective and recent experiences, the relative homogeneity of the sample (undergraduate students at the same university taking part in TTT), as well as the sample size and richness of the interview data, Interpretative Phenomenological Analysis (IPA; J. A. Smith et al., 2022; J. A. Smith & Osborn, 2003) was considered the most appropriate methodology to deeply explore meaning-making and experience at an idiographic level.

It is important to fully explain the rationale for using IPA. Given the focus in the interviews on experiences and meaning-making related to the intervention, thematic analysis (TA; Braun & Clarke, 2021) could also be considered an appropriate analytical approach. However, the decision to use IPA instead of TA is supported by this study’s qualitative research question: “How do students make sense of their experience with the TTT programme?”. Here, rather than focus explicitly on how TTT affected their perceptions of wellbeing, an aim which may be better suited to a TA approach (Spiers & Riley, 2019), the present study aims to produce knowledge about the multiple ways in which students, at an individual level, may personally experience and understand TTT, not limited to any one area of their lives. Allowing for and expecting a multiplicity of ways in which TTT could be experienced, rather than looking for commonality of impact on more discrete areas such as wellbeing, or grades, is in keeping with IPA; all students experienced TTT, but, beyond this, the study aimed to develop a strongly experiential narrative account with an idiographic focus. This aim, in addition to the small sample, the suitability of the interview questions, and the richness of the data, underlies the choice of IPA as a suitable analytic approach.

After being auto-generated through Microsoft Teams, the transcripts were cleaned and cross-checked with the video recordings in preparation for analysis by the second author. Four of the five transcripts were selected for IPA, and the fifth was considered unsuitable for analysis due to technical connectivity issues the participant encountered while being interviewed, which affected the pacing and clarity of their responses.

Two researchers independently attempted to clean the data and discern the participant’s words, but, given their persistent disagreement, they decided to exclude this particular transcript. The first and second authors conducted the analysis, resulting in three Group Experiential Themes (GETs) and five sub-themes within the first GET. The analysis included the following steps (J. A. Smith et al., 2022): (1) familiarisation with the first case, (2) initial exploratory noting for the first participant case, (3) constructing experiential statements, (4) searching for connections across experiential statements, (5) developing the Personal Experiential Themes (PETs), and consolidating and organising them in a table, (6) resuming the individual analysis of the other three transcripts repeating each of the previous steps, and (7) working with PETs to build GETs across cases. The first two cases were analysed by both authors, who met after each step to discuss their analytic approaches and agree on and refine their themes. This process allowed them to establish an aligned implementation of the abovementioned steps. Subsequently, they split the remaining two cases, going through all the steps independently and sending each other their final PETs. They each then conducted a brief sense check of the transcript and PETs for the case they did not analyse, which resulted in minor changes to the names of some PETs. Lastly, each participant was assigned a pseudonym to protect their identity while describing the interpretation of their experiences with TTT, ensuring anonymity and ethical research practices.

3. Results

3.1. Quantitative Evaluation of TTT: Results from RCT

The results of the ANOVA in the pre-TTT scores indicated no significant differences between the TTT group and the control group in any of the variables analysed (

Table 1. Means and standard deviations of the pre-TTT and post-TTT measurements in the intervention and control group; ANOVA; ANCOVA; and partial η² in the outcomes measured: psychological wellbeing, mental wellbeing, and resilience.

Outcomes	Pre-TTT				ANOVA			Post-Test				ANCOVA
	Intervention		Control					Intervention		Control
	M	SD	M	SD	F	p	η2	M	SD	M	SD	F	p	η2
Psychological wellbeing (FS)	41.67	2.09	40.54	1.76	0.17	0.68	0.004	45.06	1.79	39.44	1.91	8.02	0.01	0.17
Mental wellbeing (SWEMWBS)	21.74	1.07	19.98	0.67	2.17	0.15	0.05	22.29	1.17	20.25	0.84	0.35	0.56	0.009
Resilience (BRS)	3.30	0.17	3.05	0.14	1.28	0.26	0.03	3.48	0.18	3.09	0.15	1.40	0.24	0.03

).

3.1.1. Effects on Psychological Wellbeing (FS)

The ANCOVA results showed significant improvements in psychological wellbeing in the TTT group compared to the control group at the post-TTT phase (pre-TTT scores as covariates) with a medium effect size (F_(1,40) = 8.02, p < 0.01; η² = 0.17; Table 1). The effect size of the differences with partial eta squared (η²) was calculated following the statistical features (Tabachnick & Fidell, 2019): negligible (0  ≤  η² ≤ 0.009); small (0.01  ≤  η² ≤ 0.089); medium (0.09  ≤  η² ≤ 0.249); and large (η² ≥ 0.25). Figure 2 shows the marginal means of psychological wellbeing for the intervention, and the control group measured pre-post TTT while adjusting for the baseline psychological wellbeing scores.

3.1.2. Effects on Mental Wellbeing (SWEMWBS)

However, the ANCOVA analysis performed for wellbeing using pre-TTT wellbeing scores as covariates did not show any significant differences between the TTT and control groups in the post-TTT scores (F_(1,41) = 0.35, p = 0.56; Table 1).

3.1.3. Effects on Resilience (BRS)

ANCOVA analysis did not reveal any statistically significant differences in post-TTT resilience between the two groups (F_(1,40) = 1.40, p = 0.24; Table 1).

3.2. Feedback Survey Findings

Table 2. Descriptive statistics summarising the findings from the feedback survey collected from participants in the intervention group during the post-TTT measurement (n = 18).

Time to Thrive had a variety of content and resources available. Which resources did you engage with?	Videos	12 (70.6%)
	Podcast	10 (58.8%)
	Printable version or transcript	9 (52.9%)
	Takeaway messages & interactive quiz	12 (70.6%)
	Suggested additional resources	4 (23.5%)
	Experiential exercises	6 (35.3%)
	Online sessions, face-to-face workshop	5 (29.4%)
Usefulness of experiential exercises	Rating between 1 (not at all useful) and 5 (very useful)	Mdn = 4.00
		Mode = 4.00
	‘I haven’t looked at any of the experiential exercises’	7 (39.0%)
Intention of participation if no incentives were offered	Yes	6 (33.3%)
	No	8 (44.4%)
	Considerations around timing, optional research activity versus course embedded in the curriculum, incentives facilitating commitment to engage	4 (22.2%)
Would you like the programme to be expanded and offered as a credit-bearing module for your undergraduate degree?	Yes	14 (82.4%)
	No	3 (17.6%)
Usefulness and enjoyability of topics	Topic 1: Stress, resilience & positive emotions	Mdn: 4.00
		Mode: 4.00
	Topic 2: Values, purpose & the solution-focused approach	Mdn: 4.00
		Mode: 4.00
	Topic 3: Positive communication, social connectedness & loneliness	Mdn: 4.00
		Mode: 4.00
	Topic 4: Impostor syndrome & overcoming procrastination	Mdn: 5.00
		Mode: 5.00
	Topic 5: Eat, sleep, exercise, mindfulness & developing self-acceptance	Mdn: 4.00
		Mode: 4.00
	Topic 6: Navigating transitions & developing self-growth	Mdn: 4.00
		Mode: 4.00
Programme’s impact on wellbeing	Yes	15 (83.3%)
	No	2 (11.1%)
	Some components of TTT being impactful	1 (5.6%)
Duration of TTT	Just about right	16 (94.1%)
	Too long	1 (5.9%)
Overall satisfaction with TTT	Mdn: 8.00	Mode: 6.00
Would you recommend TTT to a friend?	Mdn: 7	Mode: 7.00

summarises the survey findings, as these were generated using descriptive statistics, regarding the overall perception of various features of TTT. As an indication of engagement, participants were asked, “Time to Thrive had a variety of content and resources available. Which resources did you engage with?”. Students could choose more than one answer: 70.6% engaged with the videos, 58.8% with the podcast version of the materials, and 52.9% with the printable version or transcript, while 70.6% saw the takeaway messages and completed the interactive quizzes at the end of the topics; 23.5% of the students engaged with the suggested additional resources, and 29.4% attended some of the online sessions or the face-to-face workshop.

Regarding the experiential exercises, 35.3% of the students stated that they engaged with them. In a later question, participants were also asked to rate the feature of experiential exercises on a scale from 1 (not at all useful) to 5 (very useful), with a sixth option available: ‘I haven’t looked at any of the experiential exercises’. The experiential exercises were quite helpful for those who looked at them (Mdn = 4.00, Mode = 4.00). However, around 39% of the students said they did not look at them.

Students were asked whether they would have participated in TTT without any incentives, and 44.4% stated that they would not have participated if no incentives were offered. They were also asked if they would like the programme to be expanded and offered as a credit-bearing module as part of their undergraduate degree, with 82.4% saying they would.

Moreover, they were asked to rate each of the three topics on a scale from 1 to 5, considering how useful and enjoyable they found them, with the majority rating each topic highly (Table 2). Students were also asked whether they believed the programme impacted their wellbeing, and 83.3% indicated that it had. Moreover, 94.1% found the programme was of an appropriate duration.

Additionally, they were requested to state on a scale from 1 to 10 how satisfied they were with their overall participation in TTT; participants were moderately satisfied (Mdn = 8.0, Mode = 6.0). Lastly, participants were asked to state on a scale from 1 (“I definitely will not”) to 10 (“I definitely will”) whether they would recommend TTT to a friend: the programme was rated in a mildly favourable way (Mdn = 7.0, Mode = 7.0).

3.3. IPA Findings: How Students Make Sense of Their TTT Experience

Our overall research question for the qualitative component was how students make sense of their TTT experience; we aimed to interpret both surface-level and deeper conceptualisations of what TTT ‘was’ for them. From their responses to questions about the motivation for joining, personal impact in terms of behaviour change, what they liked or disliked about the programme, and barriers to engagement, we collected a rich dataset covering a variety of meanings and interpretations of different aspects of TTT. We developed three distinct group experiential themes that helped us address how the interviewees made sense of their TTT experience: the differing functions of TTT, the personal impact of TTT, and placing students who need it the most at the heart of TTT. As highlighted above, all names used represent pseudonyms.

3.3.1. Differing Functions of TTT for the Student

Each participant shared their personal perspectives on TTT’s meaning for them. There was considerable variety in their answers, suggesting a range of interpretations of what TTT is for each person that points to multiple functions of the programme (see Figure 3). Another way to think of this theme is in terms of what TTT ‘does’ for the student, hence the deliberate use of the word ‘function’ here to convey what TTT does for them and how they might describe its function or purpose to others. This theme captures differences as well as commonalities amongst the interviewees in how they made sense of TTT’s functions.

Learning Opportunity

Layla and Olana each perceived TTT as a learning activity, each making a unique contribution to this sub-theme. Layla talked about liking the organisation and design of the programme: “I found it quite useful anyway…Uh, yeah, but the actual, like, the programme itself, the actual, like, KEATS [KCL e-learning platform] programme, I wouldn’t change much cause I liked how it was split up, and I also liked how the resources were organised as well” (answer [ans] 9, p. 3). The importance she places on the organisation of the material to justify the programme’s usefulness suggests she engaged with TTT as if she were considering an academic course delivered in the university’s e-learning environment, like the rest of her modules. She also mentions that she expects TTT to be grounded in research, referring to learning about techniques that “the researchers would recommend”. Thus, Layla views TTT as a learning activity in some respects, but she also uses terms like “resources” rather than “lectures” and describes TTT as “self-paced” with optional “exercises”. Out of all the participants interviewed, she perhaps makes the most explicit distinction between TTT as a learning activity conceptually very distinct from other modules (learning activities) she is taking.

Olana approached TTT as an opportunity to learn more about herself and others and focused on the breadth and depth of the programme: “I like that it was informative. Um. Yeah, I actually did it last year as well, but I still wanted to do it again cause I wanted to see if there was something new. I think the topics were the same, but still, like, it was still useful as a refresher” (ans 4 & 10, pp. 1–2). She liked the topics and felt that this second round refreshed her understanding of the concepts, such as the psychological explanations of why we feel or behave in certain ways: “I liked that it included, like, kind of psychological theories and like with the, I think there’s one about procrastination and imposter syndrome … So it makes it more useful to analyse yourself” (ans 4, p. 1). However, she wanted something more, “I would just be interested to see like more topics like whatever you could come up with”.

Initially, it is unclear what Olana means by “something new” or “to see more topics”; taken together with the fact that she took part in the programme again, does this mean, like a diligent learner, she wants to make sure that all relevant topics for student wellbeing are included in TTT? Exploring this further, it became apparent that this sense of something missing, or wanting something more, could be understood by thinking about different cultural mindsets concerning mental health:

“It’s kind of related to culture, but you know, sometimes people are brought up with certain ideas of like they need to keep things to themselves or like stuff like that. Like something that mentions those kinds of things, so that it makes it easier for people to analyse themselves and like … something related to, um, gender stereotypes and like culture, like different cultures, like the type of beliefs that people tend to grow up with…there was one topic about conflict…but, like, with an extra one about, like, different mindsets and that could add…so that people are more able to understand each other. Like a kind of cultural competency thing.”

(ans 18–21, pp. 4–5)

Although it is unclear whether this additional topic had occurred to Olana whilst she participated in TTT or arose during the interview, it is notable that, at this stage, she spoke slowly and repeated her ideas in slightly different ways, suggesting that the process of reflection that took place in the interview helped her identify a potential ‘gap’ around cultural competencies and potential intersection with gender stereotypes in TTT. It could also reflect the personal nature and relevance of these concerns for Olana, as a student from an ethnic minority with knowledge or perhaps experience of stigma around mental health and gender-based roles. Her careful approach to this subject and use of the expression “analyse themselves” (as well as “analyse yourself”), together with her appreciation for learning about psychological theories, emphasises her interest in applying the learning from TTT to oneself, as a way to understand oneself better, but also points to a desire that people should want to learn about others too, and the cultural contexts that explain differing attitudes to mental health and help-seeking. Thus, TTT is a learning activity for Olana, with a desire for greater provision in learning more about oneself and others.

A Step Towards Personal Development

For Laxmi, TTT represented a carefully considered step in her self-development journey, more so than for the other students:

“I knew it was from King’s, so I knew it would be good … on the basis that my teacher said it was good, especially for self-developmental um things, and I have gone to my tutor for, you know, asking how to cope with stress and manage my time better. And so she said that this programme will help me do that.”

(ans 28 & 30, p. 4)

She saw that the programme could help her work on herself, but her decision to join was not taken lightly. It was instead backed up by her tutor’s guidance, the trust that, because this specific university offers it, it would be high quality, and it occurred within the context of her longer-term history of coping with stress and time management concerns. Thus, the critical function of TTT for Laxmi is as an opportunity to further her personal development and improve for the future. This focus on development and change is distinct from the previous theme’s focus on TTT as a learning opportunity. Whilst there is perhaps some overlap with Olana’s thoughts on how TTT could increase knowledge of oneself and others, self-awareness is not the same as a desire to change oneself and it is this striving for self-development and TTT’s role in fostering this for Laxmi that makes this a distinct theme.

Perhaps part of the reason her decision to join is not taken lightly is that she intends to be a fully engaged participant, and, in many ways, her engagement is similar to that required for academic success in a compulsory academic module. In this way, we see her also relating to TTT as a learning activity, and her utter commitment is evident from her behaviour and mindset: “I took it upon myself to go do extra reading to actually focus on the things you guys told me to focus on” (ans 34, p. 5). Her determination points towards a self-directed learner who “takes it upon” herself to do the extra components to ensure maximum understanding. Building on this, later on, Laxmi emphasised the need for personal responsibility and perseverance in engaging with the programme without relying on external motivation: “It’s less on you guys (the programme team) and more on us (the students)” (ans 104, p. 14). Thus, it is worth considering whether her dedication at times turned into rigidness towards herself to engage fully with an optional programme and whether this attitude could be a source of the stress she has previously experienced in other contexts.

However, Laxmi acknowledged that her intrinsic motivation and commitment (“because I scheduled it in”) allowed her to experience her TTT journey as being in therapy with herself: “And because I scheduled it in it, it was almost like a mini therapy session with myself.” (ans 33, p. 5).

Some of the programme characteristics seem to have reinforced this more therapeutic aspect of the programme for Laxmi: “The lectures were all like the voices are just so soothing and so calming, and so it just felt like, you know, 30–40 min kind of meditation lesson.” (ans 11, p. 2).

Thus, for Laxmi, TTT functions as more than a learning opportunity; instead, it is a process of active, self-motivated learning that functions in service of her personal development. Her references to therapy, self-development, and concerns about stress all point to her desire to bring about meaningful change in herself, which goes beyond the function of TTT as a learning opportunity, even whilst it involves a considerable amount of learning. Laxmi’s attitude to learning enables her perception of consistent engagement and, thus, the ‘reward’ of soothing or therapeutic experiences as part of her self-development journey.

Opportunity to Better Understand the Research Process

Guangli had a radically different approach: “Because I’m a Psychology student, I think it looks like a psychology experiment or something. So, I also want to learn how to do a project like this for me.” (ans 3, p. 1).

For her, driven by her interest in learning more about doing research, TTT was an opportunity to gain knowledge in psychological experiments and use this experience as a research participant to become a research expert, and this approach may even have influenced her decision to take part in the interview. At the end of the interview, she proactively asked about the control group and their access to the materials, even suggesting that the researchers could look at engagement levels in the control group: “Er, I have a question. Is that another group of people in the control group that didn’t engage all the times, right? … But for those people (the control group) … maybe they may engage more. I’m not sure. Yeah, maybe you can have a look.” (ans 92 & 95, p. 18).

Therefore, for Guangli, an essential function of TTT was enabling her to learn how this kind of intervention is carried out and make sense of TTT as a piece of research, demonstrating another potential function of TTT as an opportunity to understand better the research process, which relates to her status as a Psychology student at a research-intensive university. While we will see later that Guangli did experience some personal benefits from TTT, it made the most sense to her as a psychology experiment.

Toolkit of Techniques and Strategies

Another function of TTT was as a toolkit of techniques and strategies for future use. Layla and Olana both perceived TTT as a toolkit, a set of strategies and techniques to help them navigate their everyday lives, and, for both, this is how they made sense of the overall experience. For example, Layla said:

“My expectations were that it was going to be a programme that was self-paced online that would help my mental health and wellbeing in, you know, in a few different techniques that the researchers would recommend … I now have a few techniques that I can sort of instil in my everyday life … So I think I’ll definitely be using some of the techniques.”

(ans 6–8, p. 2)

Here, Layla points to the expectation that ΤΤΤ would provide her with a readily available toolkit to support her in case she needed it. Feeling that her expectations have been met, she intends to refer to the tools she picked up in the future. Olana echoed this idea of a toolkit for the future:

“I think I’ll use it in the future. I don’t know about, like, on a daily basis, but it, but um, I have like, when something is related to one of the topics comes up, I do sometimes remember the facts.”

(ans 15, p. 3)

However, apart from having TTT as a box of tools that she intends to use in the future like Layla, Olana has already encountered situations where her learnings from TTT were applicable and ‘directly’ helpful in planning her studies: “And actually the topic about goals, that one I found most helpful because it was like directly useful to, um, planning my like studying and stuff like that …” (ans 11, p. 3).

This idea of a toolkit of techniques suggests something they keep in the background ready for use if they are needed, rather than a developing set of knowledge, habits, and strategies that they tried to embed or practise day to day as TTT unfolded, which was more akin to the approach used by Laxmi of deeper learning and experiential engagement during the programme.

Olana’s comment captures one potential problem of their approach: “I do sometimes remember the facts” (ans 15, p. 3). Layla perhaps also suggests that she may not remember the full range of strategies from TTT, as she repeatedly refers to having “a few techniques” without specifying which ones are the most relevant for her. The risk of simply forgetting the strategies from TTT appears to be a potential problem, even though both students spoke favourably about the utility of their “toolkit”. Also relevant here is Olana’s description of the topic of achievement as something ‘directly useful’, and her wording suggests she has used this topic already. Here, we can see that Layla and Olana may pick and choose according to whether a topic or technique is perceived as performing a valuable function for them, with the rest potentially discarded or forgotten.

Opportunity to Make Connections

The final function of TTT that we identified was as an opportunity to connect with the TTT team. We present this sub-theme briefly and cautiously, as only two interviewees contributed their thoughts.

Guangli enjoyed opportunities to see and feel closer to the programme team, like the face-to-face workshop she attended:

“If we can see you on, I think, your group, it would be much more, um, I will feel more close to you than just see the emails.”

(ans 82, p. 16)

For Guangli, note how contact through emails felt less personal; she wants to experience a greater sense of closeness with the people delivering TTT. Similarly, Laxmi pointed to the value of feeling close to others by expressing her preference for TTT to reading books on similar topics:

“It wasn’t like a task for us to finish and with a lot of these mindfulness books, it just seems so detached cause it’s on a book … like you can’t form that connection with the authors, but whereas in the lectures because we can hear your voice because we’ve seen a couple of you in the workshops and stuff it was easy to make that connection.”

(ans 39–40, pp. 5–6)

Here, it seems that Laxmi was satisfied with the level of connection with the TTT team, whilst Guangli wanted more. This difference may relate to their individual needs for personal connection; Laxmi finds it “easy” to make “that connection” between people she has seen in the live online drop-in sessions and then hear their voices in the pre-recorded (i.e., not live) lectures. For Guangli, seeing and engaging with the team on a live channel is required to experience greater closeness with them. Overall, though, it is evident that a core component of their TTT experience lies in moments of connection. We present this as a function, or potential function of TTT, rather than an impact of the programme, given the relative scarcity of this sub-theme in the data and the relative lack of discussion about what effect such a connection had, or would have, on them. Instead, these students speak of opportunity, or missed opportunity, for TTT to function as a way to make connections.

In summary, interpreting the functions of TTT for the interviewees is the most prominent group theme we identified. The interviewees experienced multiple functions of TTT (see Figure 3). At first glance, it broadly functioned as a ‘learning activity’ for all. However, it also functioned as a means of fostering personal development for Laxmi, a way to understand oneself and others better for Olana, an opportunity to understand the research process for Guangli, as a toolkit of techniques and strategies for future wellbeing for Layla and Olana, and as an opportunity to experience connections with the TTT team for both Laxmi and Guangli.

3.3.2. Personal Impact of TTT

Most participants commented on the programme’s effectiveness and contributed ways TTT helped them. We have named this theme to convey a focus on the types and depth of impact for each interviewee. This theme is distinct from the consideration of the functions of TTT; the personal impact can be thought of as asking, ‘Did it help and if so, how?’, and interpreting answers regarding the effect on behaviour, thoughts, or feelings.

Laxmi saw the greatest benefit from her experience, wondering how she would cope if she had not taken part: “If I didn’t take this, I don’t think, I don’t know where I would be with, you know, stress and stuff with university.” (ans 86, p. 13).

For Laxmi, participating in TTT was an “opportunity”, a gift for which she was grateful:

“I’m very happy that I was given this opportunity because … it’s helped me (short pause) just not focus on the grades so much and just focus on the bigger things in life.”

(ans 30, p. 4)

She explained that, through the programme, she managed to break free from a lifelong experience of study-related stress and boost her grades: “I think like for someone that’s, you know, been stressed my whole life kind of thing because of my studies. This has shown me that I can study but not be stressed … positive impact is I can see my grades are getting better.” (ans 71–72, p. 11).

Her improved relationship with the learning process benefited her mental health, but the programme also supported her in navigating the mental health of significant others in her life:

“It’s helped me a lot in terms of my own mental health, the mental health of others, like my family (ans 33, p. 5). Later on, to elaborate further, she added: So it wasn’t just focused on us. I like the fact that you guys focus on other people as well. Like looking after friends and family.”

(ans 77, p. 12)

One of the programme’s topics focused on relationships and how we can improve them. Laxmi was the only interviewee who mentioned this aspect of TTT, suggesting this may be a particularly relevant area for her. Whilst she did not provide specific details of how this topic helped her or her family, her repeated mention of this component suggests it has personal meaning and utility for her.

In addition, Laxmi, sharing the same ethnic identity as one of the lecturers, felt even more seen, represented, and, thus, more connected to the people behind the programme:

“And I don’t know if you’re [ethnolinguistic group]. Are you [ethnolinguistic group]? So, as soon as I saw your name, I was like ohh, there’s a [ethnolinguistic group] lecturer … I was so proud of you, and I was just like so happy that I could join this.”

(ans 43, p. 6)

We interpret this pride, happiness, and representation as further unexpected but entirely positive impacts of TTT for Laxmi, reinforcing her feeling that TTT is ‘a gift’.

For Guangli, TTT also had a positive impact. Guangli did not address her grades or the mental health of others in her life but found that TTT encouraged her to use strategies to re-arrange her life demands. According to her, the content was very relatable to her life and concerns as a student. Thus, it was easy to apply the recommended strategies:

“I think everything I learned is very close to my problems, and as a first-year university student, those things were very helpful…. And of those information from the video, from take your message, and a meeting very close to my life. So I will do all those things, like er (pause), it changed my life demands. Let me show you. For example, I have a notebook to list what I should do, so I will not delay for, er, then, my plan but sometimes it will be, er, also to go relax or something.”

(ans 20 & 25, pp. 5–6)

By offering specific examples, Guangli illustrated how she incorporated what she had learned from TTT and started planning her tasks, better managing her time, and making room for the self-care and relaxation she needed.

For Layla, things were different. While she mentioned that TTT helped her, an absence of self-involvement in the programme was observed throughout her responses, leaving any personal impact hidden. For instance, she offered suggestions on improvements or additions but did not relate them to herself, although they raise the question of whether they do in fact relate to her:

“Yeah, maybe some sort of of, um, yeah, strategies that may help to, like, stop procrastinating and, and boost productivity … But yeah, I think it was well in the programme anyway (ans 14, p. 4) or like I was able to keep track on it (what was going on during the programme) and it was fine because I think there were reminders … but maybe for some students who have a bit going on…”

(ans 17, p. 5)

She was generally most articulate about areas where she was comfortable, such as the programme design and delivery:

“I think it was delivered quite well, especially the topics being sort of split up into the different weeks and then also having the Teams channel and the in-person sessions, …, everything that I would think of has been thought about already and even some things I hadn’t thought about you guys already did.”

(ans 15, p. 4)

Whilst this comment is rather evaluative and, thus, tells us little about the meaning of TTT for Layla, it is interesting to contrast how much more comfortable she was with this than trying to relate her own experiences. Hence, her approach could reflect a natural reserve or unwillingness to be fully open with the interviewer, or, more simply, could reflect that the programme had little impact on her despite her mostly positive evaluations and evident knowledge of TTT’s key components and structure.

In summary (see Figure 4), Laxmi and Guangli explained in detail how the programme helped them, offering personal examples that covered behaviour change, thoughts, and feelings, and strongly suggesting meaningful and positive impacts. In contrast, Layla kept to an outer layer of her experience, focusing on more evaluative comments and, thus, suggesting little personal meaning or impact despite her positive evaluations of TTT as a learning activity.

3.3.3. Placing Students Who Need It the Most at the Heart of TTT

This theme captures an experience shared by all participants—the importance of the different components of TTT being accessible to those who need it the most, considering factors that could prevent students from engaging. Accessibility here is defined as the programme catering to different learning styles and needs by offering materials in a variety of formats, as well as the different opportunities for participation in live sessions, and how students are encouraged to engage in a committed way throughout the programme.

Firstly, for Layla, placing the student at the heart of TTT was a central consideration, and she had a detailed knowledge of the structure and design of the programme and views on how this may encourage or inhibit engagement. Whilst the personal impact of TTT for Layla remained hidden, at the level of design and delivery, she shared nuanced and informed considerations. She discussed ways in which she thought TTT already considered students’ needs but suggested improving its delivery:

“I think in terms of how the resources were, sort of, put up on the KEATS page, I wouldn’t say there were any sort of initial barriers because it had them, like I say, like, split up into the topics, but then also split up into what the resource is. But in terms of how the students may engage with them I would say perhaps, maybe the barriers may be that, um, they may find the, like, the plethora of resources could be maybe overwhelming to some students to see, like, a, a lot up there … I guess, um, reemphasising that, you know, these are optional for you if you want to go into further detail, but the videos are the main thing of, of this programme.”

(ans 16, p. 5)

While she found that the design and delivery did not create any barriers to engagement overall, the same did not apply to the amount of information provided. She often considered students who might benefit from certain adjustments in her answers and emphasised that “other” students could feel “overwhelmed” or confused without clarifications on the programme’s core components. Thus, she suggested changing how the delivery of the in-person activities is decided to ensure it accommodates the students, implying that the priority should be on what works for them instead of what suits the programme facilitators:

“What I would add on to that is it would be great if there was a poll beforehand that we can say what day or time, um, would have suited us and then maybe the majority, um, we could go with that… like 2 weeks in advance, um, could hopefully give enough time for you to organise it”

(ans 9 & 20, pp. 3 & 8)

It is hard to tell if Layla’s less positive comments reflect her own experiences—she places distance between herself and “the students” or “some students” when considering the organisation of materials on KEATS, but, whilst discussing the scheduling of in-person activities, she refers to herself as well, suggesting that she too experienced some barriers to engagement.

The value of considering the needs of students was also relevant for Guangli, who recognised that the self-paced nature of the programme was not the best fit for her as she struggles with time management and procrastination. For example, she said, “I always delay on watching the lecture videos. As well for Time to Thrive, I always, the last week I watched all the videos for the previous weeks” (ans 12, p. 3). She then added that students sharing her difficulties might need some kind of external pressure or closer monitoring by the programme team to engage more systematically with the materials:

“I think if we have an online meeting every week like one hour or one hour and a half … So we don’t need to do it by ourselves … I think because for my type of people. Yeah, maybe we don’t, er, do this by ourself, but if there is something push us to do it, it would be very helpful.”

(ans 12, 15, 16, p. 3–4)

Here, Guangli explicitly categorises herself within the “type” who will not “do this” by themselves: there was no solid internal motivation to engage. Her comment leads us to consider to what extent TTT’s self-paced and optional nature may create a barrier to engagement. Guangli later says:

“Uh, one thing like for me is that maybe I would think I should finish other modules coursework before the Time to Thrive… It’s maybe a little bit a problem…Maybe, just maybe because it’s not compulsory…from my understanding if something is not compulsory, I would be very lazy.”

(ans 72–75, p. 14)

Guangli’s admission prompts a deeper consideration of whether her reluctance to engage stems from procrastination or a broader issue regarding the perceived value of non-compulsory programmes for students. Olana mirrors her thoughts:

“I didn’t attend any of the, the live workshops they did, …the first few weeks I didn’t watch anything because I kept, like, forgetting… I think maybe, maybe it’s just the fact that it’s like, kind of like an optional thing, so people will tend to not prioritise it”

(ans 22 & 25, pp. 5–6)

Here, Olana indicates that the optional nature of TTT is a barrier to engagement, not just for herself but for others. She and other students prioritise mandatory learning activities and do not prioritise TTT. Thus, Olana alludes to whether expecting students to prioritise optional activities alongside compulsory ones is realistic.

It is interesting to bring in Laxmi’s perspective on the self-paced and optional nature of TTT; in fact, she does not comment directly on whether it being optional affected engagement. Instead, she says:

“Compared to other mindfulness and self-developing … this is more engaging because it is long-term… and we had a lot more time afterwards to go over the content, …, there’s no rush to the, to finish the content in that one week.”

(ans 21–23, p. 3)

Laxmi stressed that the extended timeframe allowed more time for students to absorb the content, promoting a more relaxed and stress-free approach to learning, which she appreciated. The programme’s format and pacing seemed to align with her needs, allowing her to engage with the materials in a manageable and effective way rather than watching many videos back-to-back to catch up (like Guangli). However, we should remember that Laxmi is highly self-directed and committed to scheduling in and engaging with the programme: “If I signed up to this, I need to be committed to this throughout everything” (ans 105, p. 14). Her other answers suggest that she would complete the core materials and the extra readings week by week. Thus, neither the optional nor the self-paced nature of TTT created a barrier for her and this was not an area she reflected on deeply.

Guangli and Olana did not construe TTT’s self-paced, optional nature as liberating and potentially stress-reducing, as it was for Laxmi. It negatively affected how they tried to make sense of TTT and, thus, their degree of engagement.

Lastly, Laxmi introduced a more personal and emotional barrier to participating in the group activities offered in TTT by highlighting the impact of group size on her engagement:

“I also think that smaller groups would help engage students better cause I’m the type, like, if there’s…more than 15 people in the Teams or Zoom meeting that I won’t say anything on the chat at all cause I’m such a shy person, but when there’s like 5 people, I tend to engage a lot more”

(ans 65–67, p. 9)

Laxmi signifies the challenge faced by people who, like her, feel shy in bigger groups. What might be considered a ‘good turnout’ of 15 people will hinder active engagement; she becomes a bystander, in contrast to her deep participation in TTT when alone.

Guangli also suggests small group discussions and activities but is more enthusiastic about the opportunities such sessions could provide beyond engagement:

“Maybe next time, you did not need you maybe cannot show those takeaway message before the seminar and on the seminar, you even could have, if there are more people, you can have some small group discussion. I don’t know if Teams have the breakout rooms … it could improve the attention and understand those things much more.”

(ans 85–87, pp. 16–17)

For her, the existing approach of re-viewing activities during the session felt redundant and unengaging, especially when these were available beforehand. The lack of interactive exchange with other students made the sessions less enjoyable and hindered her ability to grasp the discussed concepts fully. By highlighting the need for discussion in small breakout groups, Guangli emphasises the value and novelty of active participation in enhancing her learning outcomes and, presumably, fostering her engagement.

In summary (see Figure 5), Olana and Guangli’s experience of a tension, or paradox, between wanting to engage in an optional programme and—in effect—being prevented from doing so by its optional nature is perhaps at the heart of this group theme. Their lack of engagement did not seem to be driven by TTT being uninteresting or irrelevant to their needs; instead, it seemed to stem from how they made sense of TTT as a learning activity that became de-prioritised against their mandatory learning activities. Whilst they, as well as Layla, considered specific ways to drive engagement and, thus, place students who would most benefit from TTT at its heart, the core issue was being able to choose, repeatedly, whether or not they wanted to engage, with no academic penalty for choosing not to. For Laxmi, motivation was purely internal; constantly aware of choice and time, she repeatedly pushed herself to engage fully and viewed this as a personal commitment.

4. Discussion

This mixed-methods study evaluated the TTT wellbeing programme for undergraduate students at a London university. The quantitative findings from the RCT demonstrated that TTT was effective in enhancing student wellbeing. Additionally, through the qualitative arm of the project, we aimed to gain a deeper understanding of how students perceive their TTT experience. Guided by our research question, we employed IPA to explore and interpret how students conceptualised what TTT meant for them. Our analysis led to the development of three group experiential themes that describe how we interpreted the four students-interviewees’ understanding of their participation in the wellbeing programme: the differing functions of TTT, the personal impact of TTT, and placing students who need it the most at the heart of TTT. These findings will be discussed below, starting with the effectiveness of TTT and followed by the three IPA-developed group experiential themes.

4.1. TTT’s Effectiveness on Student Wellbeing

The RCT arm of this study aimed to determine whether acquiring theoretical and practical knowledge on emotions, meaning and engagement, relationships, achievement, improved living, and driving change through participation in TTT would enhance undergraduate students’ wellbeing. Specifically, TTT significantly improved students’ psychological wellbeing, as measured by the FS, with the intervention group scoring significantly higher than the control group in the post-intervention assessment. However, no significant differences were observed in mental wellbeing levels, as measured by the SWEMWBS.

Firstly, the study’s key finding on the programme’s positive impact on psychological wellbeing can be interpreted by integrating Ryff’s framework of psychological wellbeing as a multifaceted construct including self-acceptance, autonomy, environmental mastery, positive relationships, purpose in life, and personal growth (Ryff, 1989) and the EMERALD framework for wellbeing (Dias et al., 2023). In TTT (version 2022), students are invited to think of their wellbeing in a reflective and holistic manner, accepting all emotions, finding meaning and being actively engaged in their life, nurturing positive relationships, and overcoming impostor syndrome and procrastination to facilitate achievement. Moreover, students are supported to live well and drive meaningful change by approaching uncertainty and challenges as opportunities for growth. Thus, they come to appreciate that wellbeing depends on maintaining a dynamic balance between positive and negative experiences, as emphasised in the principles of second-wave positive psychology (Lomas & Ivtzan, 2016; Wong, 2019). Building on previous evidence that TTT can promote postgraduate students’ psychological wellbeing (Vourda et al., in press), findings from the present study suggest that undergraduate students, too, can be effectively empowered to build practical skills, identify areas for personal development, and apply these techniques to make sustainable changes in their lives.

Nevertheless, the absence of a significant effect on mental wellbeing contrasts with previous findings from TTT’s evaluation in postgraduate students (Vourda et al., in press). As previously discussed, the FS and SWEMWBS assess different aspects of wellbeing. While both scales measure social support, eudaimonic wellbeing, and self-beliefs, the SWEMWBS also captures coping and hedonic wellbeing (A. Dodd et al., 2022). Although TTT addresses positive emotions, life satisfaction, and skills for managing life’s challenges, its limited effect on mental wellbeing may be related to students’ engagement with the programme. Effective preventative interventions must provide explicit theoretical knowledge (Nation et al., 2003) alongside structured opportunities to apply learning in a supervised setting to develop relevant skills (Worsley et al., 2022). While TTT adhered to these recommendations by offering rich theoretical material, tailored experiential exercises, and drop-in sessions for further clarification, engagement with these components varied. Feedback indicated that approximately one-third of students practised the experiential exercises, while attendance in the online sessions and face-to-face workshop, where they could discuss these in more detail as well as interact with their peers, was rather low. Although most students reported engaging with some theoretical content and completing the interactive quiz at the end of each topic, these self-reported responses may have been influenced by social desirability bias. Additionally, the absence of the appropriate technology prevented the research team from objectively verifying students’ level of engagement.

Furthermore, TTT did not significantly enhance resilience levels among students, a finding consistent with prior research showing that resilience-building interventions rarely lead to substantial improvements in university students’ resilience (Abulfaraj et al., 2024). This underscores the growing need to rethink resilience in higher education, particularly in identifying and developing effective strategies to enhance this crucial employability skill (Scott & Willison, 2021).

4.2. The Differing Functions of TTT for the Student

The framework of functions and forms of complex health interventions has been introduced as a tool for understanding how specific interventions achieve their effects (Esmail et al., 2020). Functions refer to the primary objectives of an intervention, representing its core principles, whereas forms describe the methods and components through which these functions are achieved (Perez Jolles et al., 2019). Additionally, forms are the adaptable elements of an intervention that can be modified to fit the specific context of implementation while maintaining the intervention’s original conceptualisation and effectiveness (Hill et al., 2020; Terrana et al., 2024).

The IPA findings indicate that students often define the purpose of an intervention or programme in their own unique ways. Specifically, the following interpretations around TTT functions were described: (1) as a learning opportunity; (2) as a step towards personal development; (3) as an opportunity to better understand the research process; (4) as a toolkit of techniques and strategies; and (5) as an opportunity to make connections.

Given how the programme was conceptualised, structured, and delivered through the university’s online learning platform, it is rather unsurprising that students viewed TTT as a way to enhance their wellbeing knowledge, develop self-awareness, and build skills for personal growth and success. However, while online and self-paced delivery is common for PPIs in higher education (Hobbs et al., 2022b; Hood et al., 2021), perceiving TTT as just another learning activity alongside academic demands could reduce its appeal and diminish students’ motivation to engage with a programme designed to actively support their wellbeing.

Interestingly, for some students, participating in TTT was an opportunity to deepen their understanding of the research process. University students are often motivated to participate in psychology-focused studies to learn more about their own and others’ wellbeing and to better understand research methodologies and design, pointing to an additional educational dimension of such initiatives (Zannella et al., 2020).

Moreover, although among the programme’s core aims was to offer students a readily available toolkit of techniques to support their wellbeing, some participants shared their intention to keep these resources at hand for future use rather than apply them straight away. This suggests a more passive approach to engagement, which is notable since the greatest benefits from similar programmes are experienced by those who actively use the provided resources and materials (Hobbs et al., 2024). Alternatively, it could also mean that one of the functions of TTT is to signpost participants to self-guiding resources for future, on-demand use. If students do engage with the materials later but on an ongoing basis, TTT could lead to long-lasting outcomes in their sense of flourishing—a hypothesis that warrant further exploration in future studies. Finally, engaging in TTT to form new connections was deemed as another key function of the programme. This finding aligns with the existing literature, which highlights that feeling connected to others, including fellow students and staff, as well as having opportunities to meet new people through societies, events, and clubs are vital for fostering a sense of belonging at university (A. L. Miller et al., 2018; van Gijn-Grosvenor & Huisman, 2020). Interestingly, one of the students who identified this function was a first-year student, highlighting the value of social integration at the early stages of university life. Forming new connections and becoming part of the university community is consistently reported as one of the main facilitators for a smooth transition into and through university for first-year students (Kahu et al., 2022). These findings further affirm the capacity of PPIs that focus on social connectedness to foster meaningful relationships and alleviate loneliness among young people (Ellard et al., 2023).

4.3. Personal Impact of TTT

This theme links with the quantitative findings mentioned above, offering insights into the potential mechanisms behind the programme’s effectiveness in boosting student wellbeing. Although further research is needed to determine whether these mechanisms go beyond the subjective experiences of participants in this sample, and to formalise a theory of change, this theme explored whether TTT supported students and offers a novel interpretation within the TTT body of work regarding how any positive changes occurred.

TTT could help students engage with the learning process in a more relaxed way, thus shifting their attitudes towards academic performance and redefining what success means. It may also assist them in managing their time and prioritising responsibilities more effectively, motivating them to experiment with new techniques that facilitate skill development and sustained behaviour change. Grounded in the ICBC model (Dias et al., 2017), TTT draws from cognitive–behavioural coaching (Palmer & Szymanska, 2007), particularly in terms of identifying and disputing negative thinking especially when students are struggling to achieve their desired goals. Meanwhile, the solution-focused approach (Greene & Grant, 2003) emphasises that students are resourceful and capable of recognising and addressing unhelpful thinking patterns and habits. The tools and techniques integrated throughout the programme, like the ABCDEF (Whitmore, 2002) and GROW models, are purposefully selected to cultivate a sense of mastery (Ryff, 1989), enabling students to feel more in control as they navigate daily responsibilities, stressors, and challenges.

Furthermore, offering relatable resources seems to be crucial to ensuring student satisfaction with the programme and increasing the likelihood of engagement and improved wellbeing after completion. In line with recent recommendations for offering students more appealing interventions (Worsley et al., 2022) and findings suggesting that students prefer online interventions with relatable content (Özer et al., 2024), special attention has been given to co-designing elements of TTT that foster student identification (Dias et al., 2023). This goes beyond simply including interesting topics; for instance, the case studies at the end of each topic are based on fictional characters with whom students can identify, centred around practical activities they can incorporate into their daily lives.

4.4. Placing Students Who Need It the Most at the Heart of TTT

This final group theme was presented with concerns regarding the authors’ capacity to draw a line between participants adopting an evaluative lens to the programme and volunteering their interpretations of their experience. Nevertheless, we decided to include it since all students contributed extensively to the barriers to engagement, indicating a pure interest in the topic. Additionally, the interviewees might have found it challenging to express critical views directly to the interviewers, highlighting the authenticity and significance of their insights on the engagement with TTT.

The optional nature of the programme was reported as the most important barrier to engagement, as many students struggled to prioritise it alongside academic responsibilities. Some suggested making TTT credit-bearing, aligning with research that highlights the effectiveness of embedding wellbeing programmes within the curriculum rather than treating them as add-ons (Hobbs et al., 2022b; Young et al., 2022). Participants also emphasised the role of incentives in promoting engagement, particularly for those lacking intrinsic motivation. While participants were compensated through vouchers for the research arm of TTT, this may not have been enough to motivate them to engage with the programme itself more consistently. To promote participation beyond completing surveys and participating in interviews, alternative incentives, like academic credits or opportunities to meet other students and make new connections, could promote further engagement.

Another key finding was the identification of the self-paced nature of TTT as a barrier to engagement. While delivering the programme in a self-paced, predominantly online format increases scalability and cost-effectiveness, it raises the question of whether scalability compromises commitment to completing the programme. Our findings revealed diverse levels of engagement, with some students fully committed, while others struggled due to procrastination and time-management difficulties. If these engagement patterns are common among TTT participants, it is crucial that we consider better support to those who need the programme most but may find its current structure insufficiently accessible in terms of encouragement to engage with materials and live sessions. TTT could enhance engagement through a more structured approach by applying scaffolding principles from self-directed learning (Knowles, 1975; Robinson & Persky, 2020). This may include highlighting core programme materials for students to prioritise, offering more live meetings, providing weekly calendars outlining key activities, and sending regular reminders and prompts to encourage practice. These elements could better support students through a TTT journey that aids them in enriching their university experience and promoting their wellbeing and growth.

4.5. Implications and Future Research

Building on previous TTT work (Dias et al., 2023; Vourda et al., in press), this study substantially contributes to student mental health research by demonstrating the positive impact of a university-delivered, preventative intervention on undergraduate wellbeing.

In terms of theoretical implications, this study contributes to advancing contemporary perspectives in the field of positive psychology. Namely, the study’s theoretical underpinnings align with the recommendations of second-wave positive psychology, which emphasises the dialectical nature of wellbeing, the idea that a good life comprises a dynamic balance between positive and negative experiences (Lomas & Ivtzan, 2016). More importantly, the findings suggest that students can be supported in acknowledging the importance of all emotions, including difficult ones such as study-related stress and procrastination. Students can recognise that uncertainty and adversity are inherent parts of life that cannot be overlooked or avoided (Wong, 2019). With appropriate support and resources, they can learn to reframe challenges into opportunities for self-discovery and growth, thus building on their capacity to stay and live well.

Our methodology aligns with the gold-standard recommendations for effectiveness research (Hariton & Locascio, 2018). It also follows the principles of co-creation and participatory involvement in positive psychology research (Lomas et al., 2021) and intervention design (Leask et al., 2019). The mixed-methods approach, particularly the selection of in-depth interviews and IPA methodology, aims to address the call for a more qualitative inquiry and methodological diversity in positive psychology (Hefferon et al., 2017).

Additionally, given the mixed effects observed in other positive psychology interventions (Cheung et al., 2021; Hobbs et al., 2022b; Hood et al., 2021; Kounenou et al., 2022; Lambert et al., 2023), our findings highlight the potential of such initiatives, especially when embedded within the academic curriculum, which may enhance feasibility and student engagement (Hobbs et al., 2022b; Young et al., 2022).

Our qualitative findings provide valuable insights into students’ lived experiences participating in TTT, shedding light on the underlying mechanisms driving its positive effects. Future research should focus on which mechanisms are most impactful and how positive change is achieved. Additionally, this study raises a critical question about how universities, while striving to offer scalable and accessible student support (Worsley et al., 2022), might be overlooking students’ need for human connection.

Originally, TTT was designed as an exclusively in-person initiative (Dias et al., 2019). However, in response to the pandemic, delivery shifted entirely online, with reported benefits for postgraduate students (Vourda et al., in press). More recently, based on student feedback, small doses of live, in-person interaction have been reinstated, transitioning towards a hybrid-oriented delivery to promote student engagement. Hybrid delivery supported by interactive activities has been effective within higher education, particularly in helping students become more autonomous and independent in their learning (Coyne et al., 2018; Yamamoto et al., 2023). Consequently, future research on TTT and other student-wellbeing-promoting interventions could investigate how to optimise hybrid formats that maximise engagement and, thus, effectiveness.

Lastly, a follow-up measurement would be beneficial for assessing the long-term effects of TTT on student wellbeing, while including measures of academic performance in our research design could help explore potential pathways and mediating factors between engagement with the programme and improved wellbeing.

4.6. Limitations

While engagement with TTT yielded positive outcomes for undergraduate students, this study has some limitations that should be acknowledged. Although a power calculation was conducted before recruitment, and the initial sample met the power requirements, attrition between the two time points ultimately compromised statistical power. Therefore, any reported positive effects should be interpreted with caution. Attrition may have resulted from students’ wish to have gone through the majority of the materials to complete the second measurement and offer feedback, and they might have been prevented from doing so due to their academic responsibilities. Another point to consider is that TTT (version 2022) was co-developed as an in-house wellbeing programme, tailored to meet the specific needs of undergraduate students at KCL, and is subject to copyright restrictions. Therefore, it would not be directly transferable to other higher education institutions. However, its theoretical underpinnings and guiding philosophy can inform the development of similar programmes across the sector.

Furthermore, no male students participated in this study. Young male underrepresentation in mental research has often been reported (Perowne et al., 2024), with male students also being less likely to seek support from services (Rafal et al., 2018; Sheu & Sedlacek, 2004). While research has focused on understanding gender-specific barriers to help-seeking (Rice et al., 2018), future studies should explore ways to engage male students in research and design tailored wellbeing interventions that effectively appeal to them (Sagar-Ouriaghli et al., 2020).

Additionally, the interview protocol was not initially designed for IPA. This may explain why some participant responses tended to be more evaluative than reflective and interpretative of their subjective experiences. Nevertheless, since our aim was to explore and understand how individual students comprehend their lived experience as participants in TTT and by developing interview questions that could elicit detailed and subjective responses, IPA was deemed an appropriate approach for the study. Furthermore, we remained mindful of this limitation and prioritised capturing how students made sense of their engagement with TTT in our interpretations.

Lastly, another limitation of the present study was that at least one participant had previously participated in TTT. Thus, this repeated exposure may have influenced their perceptions of the programme, possibly priming participants into perceiving the programme and its impact more positively (Zajonc, 1968). However, meta-analytic findings indicated that, although repeated exposure enhances recognition and familiarity, it does not consistently lead to increased liking, with some models suggesting that it may even lead to boredom (Montoya et al., 2017). Therefore, future work on TTT, particularly with larger samples, should control for prior engagement to assess how familiarity interacts with programme effectiveness. Another point worth mentioning is that, in a digital age where young people rely heavily on digital media to seek health-related information (Ito & Brown, 2010) and alter their behaviour accordingly (Raeside et al., 2022), it may be challenging to recruit participants without prior exposure to self-care materials. Future research should consider how pre-existing experiences, attitudes, and exposure to wellbeing content may influence participants’ engagement with and uptake of structured interventions like TTT.

5. Conclusions

This paper extends the previous work and highlights the unique contribution of TTT, a programme designed and delivered at KCLto support in-house university student wellbeing. The findings from our mixed-methods evaluation demonstrate that TTT effectively promotes psychological wellbeing among undergraduate students.

Considering the theoretical implications, this study helps advance contemporary perspectives in second-wave positive psychology, emphasising the dialectical nature of wellbeing. The findings suggest that, with appropriate support, students can learn to embrace all emotions, including stress and adversity, and reframe challenges as opportunities for growth, enhancing their ability to stay and live well, within and beyond university.

From a practical perspective, the evaluation results form a strong foundation for broader implementation within the particular higher education institution where TTT was co-developed and may inspire similar initiatives across the sector. Furthermore, the study adds to the growing evidence supporting wellbeing interventions for all students, regardless of current or past mental health issues.

Our qualitative findings offer a deeper understanding of what participation in TTT means to students, contributing to a more holistic understanding of how TTT may be achieving its effects, the functions it serves for students, and considering barriers to engagement among students who could benefit the most from engaging with the programme.

Nevertheless, this study presented limitations, such as a reduced statistical power due to attrition and the lack of male representation, highlighting the need for more inclusive recruitment strategies.

The following steps in our research on TTT focus on establishing which of the programme’s mechanisms are the most impactful and how positive change is achieved, pilot-offering the programme as an optional credit-bearing module that will be part of the academic curriculum, addressing the most prominent barrier around its engagement. Currently, work is being undertaken to adapt TTT to meet the needs of more vulnerable and less represented student groups within the UK higher education context, like competing student-athletes and students from minoritised ethnicities, who could benefit from more tailored support resources.

Future research should explore the long-term effects of TTT, consider academic outcomes as potential mediators, and examine how the prior or ongoing exposure to self-development content may influence the effectiveness of TTT and other wellbeing programmes.