Integrating wearables in stress management interventions: Promising evidence from a randomized trial.

Abstract

Although workplace stress management interventions have been shown to be effective, they are limited by how and when they deliver, contextualize, and reinforce content. In the current article, we evaluate whether a wearable-based stress management intervention can improve mental health outcomes. Employees (N = 169) drawn from a large technology corporation were randomly assigned to either a wearable-based treatment or waitlist control. The treatment consisted of a very brief mindfulness-based training accompanied by a physiological monitoring device capable of sensing respiratory patterns and a smartphone application that allowed participants to visualize respiratory changes over time, observe real-time biofeedback, and receive real-time notifications of physiological stress. After the 4-week intervention period, the treatment group reported experiencing 15.8% fewer negative instances of stress, 13.0% fewer distressing symptoms, and 28.2% fewer days feeling anxious or stressed compared with a control group. We also find marginal evidence that the treatment group reported fewer negative emotions, but do not find robust evidence that the intervention increased broad measures of well-being. The results suggest the use of wearables as a scalable means of complementing existing workplace stress management interventions and policies. Further research is needed to distinguish how interventions incorporating wearable-based components may impact mental health beyond stand-alone mindfulness trainings.

Smart Devices and Wearable Technologies to Detect and Monitor Mental Health Conditions and Stress: A Systematic Review

“…Four studies [ 13 , 14 , 24 , 27 ] were identified for inclusion in this review based on the secondary search term “anxiety”. The study by Balconi et al (2019) used wearable EEG and ECG (for subsequent HRV computation) devices, including either the Muse™ headband (InteraXon Inc., Toronto, ON, Canada) or the Lowdown Focus glasses (SmithOptics Inc., Clearfield, UT, USA) to determine the effects of mindfulness exercises on both an individual’s objective and subjective levels of stress and anxiety [ 14 ].…”

“…Cardiac activity has been the predominant objectively measurable physiological parameter of anxiety in the literature; however, respiratory patterns have been reported to robustly indicate cognitive emotional stress [ 39 , 40 ]. The second article included in the present review, Smith et al (2020), attempted to measure respiratory rate and variability to compare physiological parameters with subjective scores of anxiety and stress, using the only wearable device (Spire Stone (Spire Health, Stanford, California)) available at the time that could measure these parameters unobtrusively [ 27 ]. Despite the capability of the device in measuring respiratory rate and variability, there was a lack of compliance by subjects in the experimental group (they only wore the device 52% of the study days), despite the majority of subjects having reported high tolerability for the device.…”

“…Despite the capability of the device in measuring respiratory rate and variability, there was a lack of compliance by subjects in the experimental group (they only wore the device 52% of the study days), despite the majority of subjects having reported high tolerability for the device. It was noted that breathing exercises are often implemented to regulate anxiety in people and were not assessed in the biofeedback model of the study [ 27 ], which may be worth investigating in the future, as slow, deep breathing is useful in reducing anxiety. The third article included in this review for anxiety, Alberts et al (2020), also used the Spire Stone (Spire Health, Stanford, CA, USA)) and an adapted version, the Spire Health Tag respiratory monitor (Spire Health, San Francisco, CA, USA).…”

Let’s Focus on Solutions to Entrepreneurial Ill-Being! Recovery Interventions to Enhance Entrepreneurial Well-Being

“…Reminder functions on smart-phones, apps, or smartwatches can support interventions, and allow them to be tailored to entrepreneurs' current level of recovery engagement (Eatough et al, 2016). A recent study using smart-watches to deliver and monitor a breathing intervention, for example, reported one sixth fewer stress instances among participants randomly assigned to the smart-watches group compared to the waiting list group (Smith et al, 2020). Smart-watches and associated health apps allow users to share information on their current levels of activity, physical exercise, and sleep (Pakhomov et al, 2020).…”

Wearable Respiratory Monitoring and Feedback for Chronic Pain in Adult Survivors of Childhood Cancer: A Feasibility Randomized Controlled Trial From the Childhood Cancer Survivor Study

“…Posttreatment improvement was significantly greater in the intervention group compared with the control group only for negative affect, consistent with findings of previous studies of healthy adults. 62,63 In addition, the observed improvement in pain-related disability was statistically significant in the adjusted analyses, providing preliminary evidence that diaphragmatic breathing interventions may reduce painrelated disability among survivors with chronic pain. Although results suggest some improvement on measures of pain intensity, depression, sleep, and HRQOL (specifically the physical functioning component), they were not statistically significant and require assessment in larger samples.…”