Impact of App-Delivered Mindfulness Meditation on Functional Connectivity, Mental Health, and Sleep Disturbances Among Physician Assistant Students: Randomized, Wait-list Controlled Pilot Study.
Jeremy L Smith, Jason W Allen, Carla I Haack, Kathryn Wehrmeyer, Kayley G Alden, Maha B Lund, Jennifer S Mascaro
JMIR Formative Research October 19, 2021 DOI: 10.2196/24208 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Randomized wait-list-controlled trial Longitudinal Pilot study Peer reviewed |
|---|---|
| Population | Physician assistant students in their third semester |
| Duration | 8-week intervention |
| Topics | Meditation |
| Keywords | Connectivity FMRI Mobile phone Resting state |
| Key findings | App-delivered mindfulness meditation improved sleep impairment in PA students, with a 19% reduction in the mindfulness group versus 1% in controls, and no significant changes in other mental health outcomes. |
Abstract
Health care provider and trainee burnout results in substantial national and institutional costs and profound social effects. Identifying effective solutions and interventions to cultivate resilience among health care trainees is critical. Although less is known about the mental health needs of physician assistants (PAs) or PA students, accumulating research indicates that they experience similarly alarming rates of burnout, depression, and emotional exhaustion. Mobile app-delivered mindfulness meditation may be an effective part of salubrious programming to bolster long-term resilience and health among PA students. This study aims to examine the impact of app-delivered mindfulness meditation on self-reported mental health symptoms among PA students. A secondary aim is to investigate changes in brain connectivity to identify neurobiological changes related to changes in mental health symptoms. We recruited PA students enrolled in their third semester of PA school and used a longitudinal, randomized, wait-list-controlled design. Participants randomized to the mindfulness group were provided 1-year subscriptions to the 10% Happier app, a consumer-based meditation app, and asked to practice every day for 8 weeks. Before randomization and again after completion of the 8-week program, all participants completed resting-state functional magnetic resonance imaging as well as self-report assessments of burnout, depression, anxiety, and sleep impairment. App use was acquired as a measure of mindfulness practice time. PA students randomized to the mindfulness group reported improvements in sleep impairment compared with those randomized to the wait-list control group (ηp2=0.42; P=.01). Sleep impairment decreased significantly in the mindfulness group (19% reduction; P=.006) but not in the control group (1% reduction; P=.71). There were no other significant changes in mental health for those randomized to app-delivered mindfulness. Across all students, changes in sleep impairment were associated with increased resting-state functional connectivity between the medial prefrontal cortex (a component of the default mode network) and the superior temporal gyrus, as well as between areas important for working memory. Changes in connectivity predicted categorical conversion from impaired to nonimpaired sleep in the mindfulness group. This pilot study is the first to examine app-based mindfulness for PA students' mental health and investigate the impact of mindfulness on PA students' brain function. These findings suggest that app-delivered mindfulness may be an effective tool to improve sleep dysfunction and that it may be an important part of the programming necessary to reduce the epidemic of suffering among health profession trainees.
Comparable studies
Other randomized controlled trials on meditation, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Alterations in Brain and Immune Function Produced by Mindfulness Meditation Healthy employees in a work environment | 2003 | Randomized controlled trial | n = 41 |
| Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. Recovered recurrently depressed patients | 2000 | Randomized controlled trial | n = 145 |
| Open hearts build lives: Positive emotions, induced through loving-kindness meditation, build consequential personal resources. Working adults | 2008 | Randomized controlled trial | n = 139 |
| Short-term meditation training improves attention and self-regulation Undergraduate Chinese students | 2007 | Randomized controlled trial | n = 40 |
| Mindfulness-Based Cognitive Therapy for Depression: Replication and Exploration of Differential Relapse Prevention Effects. Recovered recurrently depressed patients | 2004 | Randomized controlled trial | n = 73 |
Citations in the library
Cited by 8
- Neural correlates of mindfulness meditation and hypnosis on magnetic resonance imaging: similarities and differences. A scoping review. Journal of neuroradiology = Journal de neuroradiologie March 1, 2024
- Impacts of the Mindfulness Meditation Mobile App Calm on Undergraduate Students' Sleep and Emotional State: Pilot Randomized Controlled Trial. JMIR Formative Research June 11, 2025
- Developing and evaluating a Portuguese-language meditation App for medical students: motivation, adherence, and emotional effects. Frontiers in Psychology 2025
- Falling Asleep on the Job: The Efficacy of a Short App-Based Mindfulness Intervention to Improve Sleep Quality and Quantity Within the Workforce. Stress and Health February 1, 2025
- Brain resting state functional connectivity changes with aerobic exercise, and mindfulness: A narrative review. Sports Medicine and Health Science July 1, 2026
and 3 more in the library
Cites 13
- Meditation Programs for Psychological Stress and Well-being JAMA Internal Medicine January 6, 2014
- How Does Mindfulness Training Affect Health? A Mindfulness Stress Buffering Account Current Directions in Psychological Science December 1, 2014
- Neural mechanisms of symptom improvements in generalized anxiety disorder following mindfulness training NeuroImage: Clinical 2013
- Teaching mindfulness in medical school: where are we now and where are we going? Medical Education July 10, 2013
- A systematic review of the impact of mindfulness on the well-being of healthcare professionals. Journal of Clinical Psychology March 2018
and 8 more in the library