Venkatesan Aarathi, Krymis Holly, Scharff Jenny, Waber Art
Vida Health, San Francisco, CA, United States.
JMIR Form Res. 2021 May 25;5(5):e25078. doi: 10.2196/25078.
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.
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.
This 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.
The 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.
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.
随着对抑郁症、焦虑症和压力等心理健康状况进行有效可扩展干预措施的需求不断增加，基于正念减压疗法（MBSR）的数字化交付作为该领域一种有前景的干预措施受到了关注。
本研究旨在评估一项为期10周的数字化MBSR项目后感知压力的变化，该项目将基于应用程序的数字化项目与每周与健康教练进行的一对一远程课程相结合。
本研究采用回顾性观察设计。共有229名通过感知压力量表（PSS）-10评估为中度至高度感知压力得分的参与者参加了为期10周的Vida Health MBSR项目。该项目包括每周与认证健康教练进行的远程课程以及基于正念练习基本概念的数字化内容。使用PSS-10评估感知压力。在229名参与者中，131名（57.2%）被视为项目完成者，并提供了至少一次随访的PSS-10。二次分析检查了6个月时压力得分的变化。该分析仅限于参加该项目至少6个月的参与者（n = 121）。为了考虑随机和固定效应，使用线性混合效应模型评估压力得分随时间的变化。采用意向性分析方法评估整个研究队列中感知压力的变化，包括那些失访的参与者。此外，计算了可靠变化指数以评估与基线相比得分的变化。
研究结果显示，在12周时，项目时间与压力降低之间存在显著正相关（B = -0.365；P <.001）。我们观察到，到项目第6周时，压力得分平均降低3.17分（95%CI -3.93至-2.44），到项目第12周时，压力得分平均降低4.86分（95%CI -5.86至-3.85）。总体而言，到第12周时，83.2%（109/131）的参与者压力得分降低，40.5%（53/131）的参与者在12周时显示出可靠的改善，47.8%（56/131）的参与者压力水平类别转变为较低水平（即中度至低度压力）。意向性分析显示，在12周时压力得分有显著降低，尽管有所减弱（B = -0.23；P <.001）。完成课程较多的参与者压力水平类别至少降低一级的可能性增加（优势比1.512，95%CI 1.056至2.166；P =.02）。在评估中期结果时，在参加该项目至少6个月的参与者中，48.8%（59/121）的成员进行了6个月的评估。我们观察到6个月时压力得分有显著降低（t58 = 10.24；P <.001），61%（36/59）的参与者显示出可靠的改善。
这项回顾性观察研究的结果表明，一种混合的、基于数字化正念的干预措施可能有助于项目的推广，并能实现压力结果的有意义且持续的降低。
