Laird Breanne, Puzia Megan, Larkey Linda, Ehlers Diane, Huberty Jennifer
Arizona State University, Phoenix, AZ, United States.
Behavioral Research and Analytics, LLC, Salt Lake City, UT, United States.
JMIR Form Res. 2022 May 24;6(5):e30294. doi: 10.2196/30294.
Middle-aged adults (40-65 years) report higher stress levels than most other age groups. There is a need to determine the feasibility of using a meditation app to reduce stress and improve stress-related outcomes in middle-aged adults with a focus on men, as previous meditation app-based studies have reported a low proportion of or even no male participants.
This study aims to (1) determine the feasibility (ie, acceptability and demand with a focus on men) of a consumer-based meditation app (Calm), to reduce stress among middle-aged adults reporting elevated stress levels, and (2) explore the preliminary effects of Calm on perceived stress, psychological outcomes (anxiety, depressive symptoms, mindfulness, and general coping), health behaviors (physical activity and eating habits), and COVID-19 perceptions.
This feasibility randomized controlled trial evaluated an app-based meditation intervention in middle-aged adults (N=83) with elevated stress levels (ie, Perceived Stress Scale score ≥15) and limited or no previous experience with meditation. Participants were randomized to the intervention group (Calm app) or a control (educational podcasts; POD) group. Participants completed self-report assessments at baseline and postintervention (week 4). Feasibility was measured as acceptability and demand using Bowen framework. Feasibility and COVID-19 perceptions data were examined using descriptive statistics, and preliminary effects were evaluated using repeated measures analysis of variance.
Participants were satisfied with Calm (27/28, 96%) and found it appropriate or useful (26/28, 93%). Most reported they would likely continue using the Calm app (18/28, 64%). More Calm users reported satisfaction, appropriateness or usefulness, and intent to continue app use than POD users. Calm users (n=33) completed a mean of 20 (SD 31.1) minutes of meditation on the days they meditated and 103 (SD 109.1) minutes of meditation per week. The average adherence rate to the prescribed meditation was 71% among Calm app users, compared to 62% among POD users. Recruitment rate of men was 35% (29/83). Of those randomized to Calm, 55% (15/29) were men, and retention among them was higher (14/15, 93%) than that among women (12/20, 60%). No significant within or between group differences were observed.
A 4-week, app-based mindfulness meditation intervention (Calm) may be feasible for middle-aged adults and a useful stress-management tool. Calm users expressed satisfaction with the app and felt it was appropriate and useful. Significant improvements in perceived stress and psychological outcomes or stress-related health behaviors were not observed. Even though men spent less time in meditation than women did and completed fewer weekly sessions, they were more likely to adhere to the prescription. Further research is needed for improving stress and stress-related outcomes among middle-aged adults with emphasis on the effects of mindfulness meditation apps for men.
ClinicalTrials.gov NCT04272138; https://clinicaltrials.gov/ct2/show/NCT04272138.
中年成年人（40 - 65岁）报告的压力水平高于大多数其他年龄组。有必要确定使用一款冥想应用程序来减轻压力并改善中年成年人与压力相关结果的可行性，重点关注男性，因为以往基于冥想应用程序的研究报告男性参与者比例较低甚至没有男性参与者。
本研究旨在（1）确定一款基于消费者的冥想应用程序（Calm）对于报告压力水平较高的中年成年人减轻压力的可行性（即接受度和需求，重点关注男性），以及（2）探索Calm对感知压力、心理结果（焦虑、抑郁症状、正念和一般应对方式）、健康行为（身体活动和饮食习惯）以及对新冠病毒的认知的初步影响。
这项可行性随机对照试验评估了一款基于应用程序的冥想干预措施，针对压力水平较高（即感知压力量表得分≥15）且之前冥想经验有限或无冥想经验的中年成年人（N = 83）。参与者被随机分为干预组（Calm应用程序）或对照组（教育播客；POD）。参与者在基线和干预后（第4周）完成自我报告评估。使用鲍文框架将可行性衡量为接受度和需求。使用描述性统计分析可行性和对新冠病毒的认知数据，并使用重复测量方差分析评估初步影响。
参与者对Calm感到满意（27/28，96%），并认为它合适或有用（26/28，93%）。大多数人报告他们可能会继续使用Calm应用程序（18/28，64%）。与POD用户相比，更多Calm用户报告了满意度、合适性或有用性以及继续使用应用程序的意愿。Calm用户（n = 33）在冥想日平均完成20（标准差31.1）分钟的冥想，每周平均冥想103（标准差109.1）分钟。Calm应用程序用户对规定冥想的平均依从率为71%，而POD用户为62%。男性招募率为35%（29/83）。在随机分配到Calm组的人中，55%（15/29）是男性，他们的留存率（14/15，93%）高于女性（12/20，60%）。未观察到组内或组间的显著差异。
为期4周的基于应用程序的正念冥想干预（Calm）对于中年成年人可能是可行的，并且是一种有用的压力管理工具。Calm用户对该应用程序表示满意，并认为它合适且有用。未观察到感知压力、心理结果或与压力相关的健康行为有显著改善。尽管男性冥想时间比女性少，每周完成的课程也更少，但他们更有可能坚持规定。需要进一步研究以改善中年成年人的压力及与压力相关的结果，重点关注正念冥想应用程序对男性的影响。
ClinicalTrials.gov NCT04272138；https://clinicaltrials.gov/ct2/show/NCT04272138
