Examining equity in access and utilization of a freely available meditation app

Abstract

Digital interventions have the potential to alleviate mental health disparities for marginalized and minoritized communities. The current study examined whether disparities in access and utilization of meditation in the United States (US) were reduced for a freely available meditation app. We analyzed demographic and usage data from US-based users of the Healthy Minds Program (HMP; N = 66,482) between October 2019 and July 2022. College education was associated with a greater likelihood of accessing (65.0% of users vs. 32.9% of the US population) and continuing to utilize the app (β = 0.11–0.17). Conversely, identifying as African American was associated lower likelihood of accessing (5.3% vs. 13.4% of the US population) and continuing to utilize the app (β = −0.02–0.03). African Americans were more likely to access content from an African American meditation teacher, but this did not appear to increase utilization. Additional efforts are warranted to identify factors that might reduce disparities.

Prevalence and 20-year Trends in Meditation, Yoga, Guided Imagery and Progressive Relaxation Use Among US Adults From 2002 to 2022

“…The most highly represented sociodemographic subgroups among meditation users in 2022 were younger-to-middle-aged (25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44), female, White or 'Other' race, not in a relationship, more educated (bachelor, master or higher), and residing in the West (Figure 1, Table 1, Table S6). The least represented groups were young (18)(19)(20)(21)(22)(23)(24) or older (45-64, 65+), male, Hispanic race, in a relationship, less educated (less than high school, high school) and residing in the South.…”

“…By contrast, only Hispanic men were less likely to meditate than White men 54 . It could be that current meditation (and other CAM) research 34 and practice offerings aren't sufficiently representative 55 , culturally appropriate 37,56 and/or accessible 29 to men, or people of color, though this pattern of results could equally represent disparities in employment or caring duties and other life pressures in these groups 29 . For example, women with high income are more likely than men with high income to meditate 54 , and African American women cite care and work obligations as barriers to accessing meditation offerings 29 .…”

“…Traditional barriers to access have decreased markedly in recent years 30 with the explosion of digital 31 and app delivered meditation, yoga, and other digital mental health offerings. However, while current digital treatment offerings are largely low cost and broadly accessible 32,33 , how effectively they are enabling use by underrepresented sociodemographic groups in both research [34][35][36] and practice 37 is not yet clear. Meanwhile, recent data suggest significant unmet need for healthcare in the US, especially mental health services 38,39 .…”

The impact of mindfulness apps on psychological processes of change: a systematic review

“…Related, greater empirical focus is needed on evaluating mindfulness apps in minoritized populations, who continue to be underrepresented in mHealth research 92 —a trend that also became apparent in the studies included in this review. Some evidence suggests that being African American is associated with lower odds of accessing and continuing to use a leading commercially available mindfulness app 93 , and lower educational attainment is also associated with lower odds of app access 93 . It is critical that future research studies focus on minoritized populations to avoid perpetuating disparities and introducing new ones in the form of digital inequities.…”

Prevalence and 20-year trends in meditation, yoga, guided imagery and progressive relaxation use among US adults from 2002 to 2022

“…Traditional barriers to access have decreased markedly in recent years 30 with the explosion of digital 31 and app delivered meditation, yoga, and other digital mental health offerings. However, while current digital treatment offerings are largely low cost and broadly accessible 32 , 33 , how effectively they are enabling use by underrepresented sociodemographic groups in both research 34 – 36 and practice 37 is not yet clear. Meanwhile, recent data suggest significant unmet need for healthcare in the US, especially mental health services 38 , 39 .…”