Sitting and Active Meditation Practice: Utilization and Associations with Outcomes in Naturalistic and Clinical Trial Data.

Objectives: Digital technology opens the possibility of providing meditation instruction in the midst of daily activities. This study explores the use of "active" meditation practices which involve meditating while completing daily activities (e.g., folding laundry).

Method: We use data from public users of the Healthy Minds Program (HMP) meditation app (N = 26,532, Sample 1) and from a recently completed trial testing the HMP app (N = 248, Sample 2). We examine associations between the proportion of practices completed as active practices (Active Proportion) with participant demographics, baseline psychological distress, patterns of app utilization, and changes in psychological distress.

Results: Although sitting practice was used more commonly than active practices, active practices were frequently used (38% and 28% in Samples 1 and 2, respectively). Identifying as a woman or other gender was associated with a higher Proportion Active in Sample 1 (but not Sample 2). Associations with utilization differed across samples. Sample 1 showed a positive quadratic association where participants who primarily used active or sitting practices, rather than a combination, showed greater utilization. The opposite pattern was observed in Sample 2 (i.e., negative quadratic). Results were fairly consistent across sensitivity analyses. Use of active practice was not associated with poorer clinical effects.

Conclusions: Active practices are commonly used when offered as a viable form of meditation and may be non-inferior to sitting practices. Further research manipulating practice posture (i.e., sitting versus active) is warranted. Preregistration: The randomized controlled trial from which Sample 2 was drawn was preregistered through clinicaltrials.gov (https://clinicaltrials.gov/ct2/show/NCT04426318). All analyses reported here were not preregistered.