Testing the Efficacy of a Multicomponent, Self-Guided, Smartphone-Based Meditation App: Three-Armed Randomized Controlled Trial.
Level 2 - randomized trial
Individual randomized controlled trial
PubMed 33245288 · doi:10.2196/23825
What was done
In a fully remote, three-arm randomized controlled trial, 343 adults (>=18 years) without extensive meditation experience were assigned for 8 weeks to one of two versions of a self-guided smartphone meditation app (Healthy Minds Program: Awareness+Connection vs Awareness+Insight) or a waitlist control. The primary outcome was psychological distress (depression, anxiety, and stress). Secondary outcomes included social connection, empathy, compassion, self-reflection, insight, rumination, defusion, and mindfulness, measured at pretest, midtreatment, and posttest. Analyses followed intention-to-treat principles using maximum likelihood estimation.
What was found
Of 343 randomized participants, 186 (54.2%) completed at least one posttest assessment, and 166 of 228 (72.8%) assigned to intervention downloaded the app. The two active app conditions did not differ from each other on any outcome. Compared to waitlist control, both app arms combined demonstrated greater improvements in distress, social connectedness, mindfulness, and insight-related measures (d = -0.28 to 0.41, P <= .02). Distress reductions were positively associated with days of app use.
Why it matters
This trial demonstrates that multicomponent, self-guided mobile meditation training incorporating connection and insight modules can reduce distress and improve social connectedness over 8 weeks.
Limits
Attrition was substantial, with only 54.2% completing posttest measures. The comparator was an inactive waitlist control rather than an active digital sham, meaning non-specific digital engagement or expectancy effects cannot be ruled out. App adoption was imperfect (27.2% did not download the app), and long-term durability beyond posttest was not reported.
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