Feasibility and Acceptability of a Mobile Mindfulness Meditation Intervention Among Women: Intervention Study (Preprint)

Abstract

BACKGROUND Traditional Mindfulness-Based Stress Reduction (MBSR) programs can be resource-intensive for providers and time- and cost-intensive for participants, but the use of mobile technologies may be particularly convenient and cost-effective for populations that are busy, less affluent, or geographically distant from skilled providers. Women in southern Louisiana live in a vulnerable, disaster-prone region and are highly stressed, making a mobile MBSR intervention particularly suited to exploring in this population. OBJECTIVE The objectives of this study were to assess the feasibility and acceptability of a mobile mindfulness intervention under real-world conditions in a pilot study among a community sample of women residing in southern Louisiana; to describe predictors of intervention usage; and to assess the effect of the intervention on secondary health outcomes. METHODS Women were recruited from a study of the health effects of an oil spill in southern Louisiana. 236 women completed a baseline survey, were offered the mobile mindfulness intervention, the smartphone- or web-based HeadspaceTM app, and completed a follow-up survey. All study procedures were completed online. The primary outcomes were feasibility and acceptability of the app and characteristics of app utilization. Secondary outcomes included mindfulness, depressive symptoms, perceived stress, sleep quality, spousal disagreement, physical activity, body mass index, tobacco and alcohol use, and healthy eating. RESULTS 74% of subjects completed the follow-up survey, and 14% participated in the intervention, defined as logging into the HeadspaceTM app at least once. The main barrier to app usage was a lack of time, cited by 37% of users and 49% of non-users of the app. Women who chose to use the app tended to be more highly educated (63% had at least a college education vs. 34% of non-participants, P<.001), have higher incomes (58% had incomes >$50,000/yr vs. 43% of non-participants), and be employed (79% vs 63% of non-participants, P=.047). Those who did engage with the app did so at high levels, with 72% of participants self-reporting completion of some if not all of the sessions, and 74% reporting high levels of satisfaction with the app. Participation with the app had a beneficial impact on depressive symptoms (OR 0.3, 95% CI 0.11-0.81), sleep quality (OR 0.1, 95% CI 0.02-0.96), sleep duration (OR 0.3, 95% CI 0.07-0.86), sleep latency (OR 0.3, 95% CI 0.11-0.81), physical activity (2.8 95% CI 1.0-7.8), and fruit and vegetable intake (OR 3.0, 95% CI 1.00-8.83), but mindfulness scores, other sleep indicators, perceived stress, and BMI did not change from baseline to follow-up CONCLUSIONS The HeadspaceTM mobile mindfulness app was feasible to implement as an intervention and acceptable to those who chose to participate in this sample of southern Louisiana women. Several short-term benefits of the intervention were identified, particularly for depression and sleep.