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Background While mindfulness apps have received growing clinical attention, their integration within health systems has received limited empirical investigation. In this study, we evaluated a mindfulness app as a low-intensity treatment option for adults waiting for psychological services. A non-randomized clinical trial was conducted with a 4-week acute intervention period with an 8-week follow-up. Adults (N = 193) with moderate depression and anxiety symptoms, completed a baseline session and received access to AmDTx, a mobile mindfulness training app. Additional assessments were completed at 2, 4, 8, and 12 weeks. Descriptive statistics of attrition, adoption, acceptability, and engagement were computed. Linear mixed models estimated treatment outcomes for functional disability (primary endpoint), depression, anxiety, stress, rumination, and mindful awareness/acceptance. We also evaluated the dose-response association between app use and functional disability. Results Using intent-to-treat analyses, there was a 75% adoption of the app and a 30% attrition rate in the first 4 weeks. In addition, 1.09 hours of meditation time and 9.16 exercises were recorded on average within the first 4 weeks. Participants reported positive credibility, acceptability, and usability ratings on established measures. Treatment effects were observed in the expected direction for all outcomes but one (mindful awareness). Dose-response relationships indicated that increases in app engagement correlated with decreases in functional disability. Conclusions The findings reinforce the potential for AmDTx, and mindfulness apps more broadly, to serve as low-intensity tools to alleviate unmet service needs and impart clinically meaningful benefit for a significant subset of those waiting for psychological services. Clinical Trial Registration: Clinicaltrials.gov, NCT05211960, Registered 2022-01-26.
Background While mindfulness apps have received growing clinical attention, their integration within health systems has received limited empirical investigation. In this study, we evaluated a mindfulness app as a low-intensity treatment option for adults waiting for psychological services. A non-randomized clinical trial was conducted with a 4-week acute intervention period with an 8-week follow-up. Adults (N = 193) with moderate depression and anxiety symptoms, completed a baseline session and received access to AmDTx, a mobile mindfulness training app. Additional assessments were completed at 2, 4, 8, and 12 weeks. Descriptive statistics of attrition, adoption, acceptability, and engagement were computed. Linear mixed models estimated treatment outcomes for functional disability (primary endpoint), depression, anxiety, stress, rumination, and mindful awareness/acceptance. We also evaluated the dose-response association between app use and functional disability. Results Using intent-to-treat analyses, there was a 75% adoption of the app and a 30% attrition rate in the first 4 weeks. In addition, 1.09 hours of meditation time and 9.16 exercises were recorded on average within the first 4 weeks. Participants reported positive credibility, acceptability, and usability ratings on established measures. Treatment effects were observed in the expected direction for all outcomes but one (mindful awareness). Dose-response relationships indicated that increases in app engagement correlated with decreases in functional disability. Conclusions The findings reinforce the potential for AmDTx, and mindfulness apps more broadly, to serve as low-intensity tools to alleviate unmet service needs and impart clinically meaningful benefit for a significant subset of those waiting for psychological services. Clinical Trial Registration: Clinicaltrials.gov, NCT05211960, Registered 2022-01-26.
BACKGROUND Mindfulness-based interventions have been demonstrated to be an effective method to improve bodily and emotional well-being, but few studies have explored individual differences and heterogeneity in the self-perceived benefits of digital mindfulness among older adults aged 65 and above. Although voice-based mindfulness technologies can increase the accessibility of mindfulness training, the expected effects may not be similar to all user groups. Digital health technologies are often used by individuals with a high digital health literacy. OBJECTIVE The study investigates to what extent a voice-based digital mindfulness app can improve the self-perceived bodily and emotional well-being among older adults (aged 65 and above), how older adults incorporate the digital mindfulness app to their daily routines, and how different interaction modalities with the app impacts digital mindfulness experience. METHODS A mixed method study combining quantitative survey questionnaires and qualitative semi-structured interviews was conducted among older adults aged 65 and over who used a voice-based mindfulness app for a 3-week period in their homes in Sweden (N=15). The effects of the mindfulness app on self-perceived well-being were measured with Five Facets Mindfulness Questionnaire, and WHO5 Well-being Index, which were analysed through descriptive statistics. Qualitative content analysis was conducted to explore the heterogeneity in the self-perceived bodily and emotional benefits of digital mindfulness, and the user engagement with the app. RESULTS Results of the WHO-5 Well-being index showed an overall improvement in mean values of self-perceived well-being, and results from the Five Facets Mindfulness Questionnaire showed an improvement in 11 of 15 questions, particularly in non-reactivity. Younger participants (under 76) and those who evaluated their self-perceived health as high reported higher improvements in the mindfulness scale after the app use. Due to the small sample size, these differences were not statistically significant. Qualitative content analysis identified four main themes for self-perceived benefits: (1) Relaxation and breathing, (2) Improved bodily awareness, (3) Improved emotional awareness and (4) Pain management. Participants described that continuity and temporality with the app use was significant in noticing the self-perceived effects of digital mindfulness. Voice interaction and persona of the digital mindfulness coach was reported as an essential part of the mindfulness experience. CONCLUSIONS Voice-based digital mindfulness apps can increase the accessibility and flexibility of mindfulness training, but the expected benefits may not be similar to all user groups. Individual differences in the self-perceived benefits of digital mindfulness were pronounced in relation to older adults’ health status and age. Practicing digital mindfulness with a voice-based app provides possibilities for a sense of improved agency in maintenance of well-being. However, voice interaction and the mindfulness coach persona should be personalised according to older adults’ individual preferences.
IntroductionAnxiety and depression are major causes of disability in Arab countries, yet resources for mental health services are insufficient. Mobile devices may improve mental health care delivery (mental m-Health), but the Arab region's mental m-Health app landscape remains under-documented. This study aims to systematically assess the features, quality, and digital safety of mental m-Health apps available in the Arab marketplace. We also contrast a set of recommended Australian apps to benchmark current strategies and evidence-based practices and suggest areas for improvement in Arabic apps.MethodsFifteen Arab country-specific iOS Apple Stores and an Android Google Play Store were searched. Apps that met the inclusion criteria were downloaded and evaluated using the Mobile App Rating Scale (MARS) and the Mobile App Development and Assessment Guide (MAG).ResultsTwenty-two apps met the inclusion criteria. The majority of apps showed no evidence of mental health experts being involved in the app design processes. Most apps offered real-time communication with specialists through video, text, or audio calls rather than evidence-based self-help techniques. Standardized quality assessment showed low scores for design features related to engagement, information, safety, security, privacy, usability, transparency, and technical support. In comparison to apps available in Australia, Arabic apps did not include evidence-based interventions like CBT, self-help tools and crisis-specific resources, including a suicide support hotline and emergency numbers.DiscussionIn conclusion, dedicated frameworks and strategies are required to facilitate the effective development, validation, and uptake of Arabic mental mHealth apps. Involving end users and healthcare professionals in the design process may help improve app quality, dependability, and efficacy.
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