Abstract

BackgroundAs the need for effective scalable interventions for mental health conditions such as depression, anxiety, and stress has grown, the digital delivery of mindfulness-based stress reduction (MBSR) has gained interest as a promising intervention in this domain.ObjectiveThis study aims to evaluate the changes in perceived stress following a 10-week digital MBSR program that combined an app-based digital program with weekly one-on-one remote sessions with a health coach.MethodsThis study used a retrospective, observational design. A total of 229 participants with moderate-to-high perceived stress scores as assessed by the Perceived Stress Scale (PSS)-10 enrolled in the 10-week Vida Health MBSR program. The program included weekly remote sessions with a certified health coach and digital content based on concepts fundamental to mindfulness practice. The PSS-10 was used to evaluate perceived stress. Of the 229 participants, 131 (57.2%) were considered program completers and provided at least one follow-up PSS-10. A secondary analysis examined the changes in stress scores at 6 months. This analysis was restricted to participants who had been enrolled in the program for at least 6 months (n=121). To account for random and fixed effects, linear mixed effects modeling was used to assess changes in stress scores over time. An intention-to-treat approach was used to evaluate the changes in perceived stress across the entire study cohort, including those who were lost to follow-up. In addition, a reliable change index was computed to evaluate the changes in scores from the baseline.ResultsThe findings revealed a significant positive association between program time and stress reduction (B=−0.365; P<.001) at 12 weeks. We observed an average reduction in stress scores of 3.17 points (95% CI −3.93 to −2.44) by program week 6 and 4.86 points (95% CI −5.86 to −3.85) by program week 12. Overall, 83.2% (109/131) of participants showed a reduction in stress scores by week 12, with 40.5% (53/131) of participants showing reliable improvement at 12 weeks and 47.8% (56/131) of participants showing a shift to a lower stress level category (ie, moderate-to-low stress). The intention-to-treat analysis revealed a significant, although attenuated, reduction in stress scores at 12 weeks (B=−0.23; P<.001). Participants who completed more lessons had an increased likelihood of moving down at least one stress level category (odds ratio 1.512, 95% CI 1.056 to 2.166; P=.02). In assessing medium-term outcomes, among participants who had completed at least 6 months in the program, 48.8% (59/121) of members provided a 6-month assessment. We observed a significant reduction in stress scores at 6 months (t58=10.24; P<.001), with 61% (36/59) of participants showing reliable improvement.ConclusionsThe findings of this retrospective, observational study suggest that a blended, digital mindfulness-based intervention may support program uptake and meaningful, sustained reduction in stress outcomes.

Highlights

  • BackgroundIt is without question that the demand for mental health services has substantially increased in recent times, given the health, social, and economic ramifications of the COVID-19 pandemic [1,2]

  • digital mental health intervention mindfulness-based interventions (MBIs) (DMHI) can be heterogeneous in terms of their approach, area of focus, and method of delivery, they appear to be as effective as traditional forms of in-person treatment interventions [11,12,13]

  • The purpose of this study is to evaluate the effect of a mindfulness-based DMHI program delivered via a smartphone on perceived stress

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Summary

Introduction

BackgroundIt is without question that the demand for mental health services has substantially increased in recent times, given the health, social, and economic ramifications of the COVID-19 pandemic [1,2]. Digital mental health interventions (DMHIs) delivered via apps, web-based platforms, or text messaging have shown promise in addressing these concerns. As the need for effective scalable interventions for mental health conditions such as depression, anxiety, and stress has grown, the digital delivery of mindfulness-based stress reduction (MBSR) has gained interest as a promising intervention in this domain. Objective: This study aims to evaluate the changes in perceived stress following a 10-week digital MBSR program that combined an app-based digital program with weekly one-on-one remote sessions with a health coach. Conclusions: The findings of this retrospective, observational study suggest that a blended, digital mindfulness-based intervention may support program uptake and meaningful, sustained reduction in stress outcomes

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