Department of Psychology, University of Bath, Bath, United Kingdom.
School of Psychology, University of Southampton, Southampton, United Kingdom.
J Med Internet Res. 2023 Sep 28;25:e44220. doi: 10.2196/44220.
Digital mindfulness-based interventions (MBIs) are a promising approach to deliver accessible and scalable mindfulness training and have been shown to improve a range of health outcomes. However, the success of digital MBIs is reliant on adequate engagement, which remains a crucial challenge. Understanding people's experiences of using digital MBIs and identifying the core factors that facilitate or act as barriers to engagement is essential to inform intervention development and maximize engagement and outcomes.
This study aims to systematically map the literature on people's experiences of using digital MBIs that target psychosocial variables (eg, anxiety, depression, distress, and well-being) and identify key barriers to and facilitators of engagement.
We conducted a scoping review to synthesize empirical qualitative research on people's experiences of using digital MBIs. We adopted a streamlined approach to ensure that the evidence could be incorporated into the early stages of intervention development. The search strategy identified articles with at least one keyword related to mindfulness, digital, user experience, and psychosocial variables in their title or abstract. Inclusion criteria specified that articles must have a qualitative component, report on participants' experiences of using a digital MBI designed to improve psychosocial variables, and have a sample age range that at least partially overlapped with 16 to 35 years. Qualitative data on user experience were charted and analyzed using inductive thematic synthesis to generate understandings that go beyond the content of the original studies. We used the Quality of Reporting Tool to critically appraise the included sources of evidence.
The search identified 530 studies, 22 (4.2%) of which met the inclusion criteria. Overall, the samples were approximately 78% female and 79% White; participants were aged between 16 and 69 years; and the most used measures in intervention studies were mindfulness, psychological flexibility, and variables related to mental health (including depression, anxiety, stress, and well-being). All studies were judged to be adequately reported. We identified 3 themes characterizing barriers to and facilitators of engagement: responses to own practice (ie, negative reactions to one's own practice are common and can deplete motivation), making mindfulness a habit (ie, creating a consistent training routine is essential yet challenging), and leaning on others (ie, those engaging depend on someone else for support).
The themes identified in this review provide crucial insights as to why people frequently stop engaging with digital MBIs. Researchers and developers should consider using person-based coparticipatory methods to improve acceptability of and engagement with digital MBIs, increase their effectiveness, and support their translation to real-world use. Such strategies must be grounded in relevant literature and meet the priorities and needs of the individuals who will use the interventions.
数字正念干预（MBI）是一种有前途的方法，可以提供可访问和可扩展的正念培训，并且已经证明可以改善一系列健康结果。然而，数字 MBI 的成功依赖于足够的参与度，这仍然是一个关键挑战。了解人们使用数字 MBI 的体验，并确定促进或阻碍参与的核心因素对于告知干预措施的发展以及最大限度地提高参与度和结果至关重要。
本研究旨在系统地描述针对心理社会变量（如焦虑、抑郁、困扰和幸福感）的数字 MBI 使用的文献，并确定参与的主要障碍和促进因素。
我们进行了范围综述，以综合关于人们使用数字 MBI 改善心理社会变量的经验的实证定性研究。我们采用了简化的方法，以确保证据可以纳入干预措施开发的早期阶段。搜索策略确定了至少有一个与正念、数字、用户体验和心理社会变量相关的关键词出现在标题或摘要中的文章。纳入标准规定，文章必须具有定性部分，报告参与者使用旨在改善心理社会变量的数字 MBI 的体验，并且样本年龄范围至少部分重叠在 16 至 35 岁之间。使用归纳主题合成对用户体验的定性数据进行图表和分析，以生成超越原始研究内容的理解。我们使用报告质量评估工具批判性地评估纳入的证据来源。
搜索确定了 530 项研究，其中 22 项（4.2%）符合纳入标准。总体而言，样本中约 78%为女性，79%为白人；参与者年龄在 16 至 69 岁之间；干预研究中最常用的措施是正念、心理灵活性和与心理健康相关的变量（包括抑郁、焦虑、压力和幸福感）。所有研究都被认为报告得足够充分。我们确定了 3 个主题，这些主题描述了参与的障碍和促进因素：对自己实践的反应（即，对自己实践的负面反应很常见，并且会耗尽动力）、使正念成为习惯（即，创建一致的培训常规是必不可少的，但具有挑战性）和依靠他人（即，参与的人依靠他人提供支持）。
本综述中确定的主题提供了重要的见解，说明为什么人们经常停止使用数字 MBI。研究人员和开发人员应该考虑使用基于人的共同参与方法来提高数字 MBI 的可接受性和参与度，提高其有效性，并支持其向实际应用的转化。这些策略必须基于相关文献，并满足将使用干预措施的个人的优先事项和需求。
