Effectiveness and Usability of Digital Slow Breathing and Detached Mindfulness Interventions in Late Adolescents: Mixed Methods Study.
Ruya Akdag, Anja Van der Voort, Lisa Tessensohn, Julian Versteeg, Simone Vogelaar
JMIR Formative Research September 22, 2026 DOI: 10.2196/94578 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Randomized controlled trial with mixed methods (quantitative and qualitative) Peer reviewed |
|---|---|
| Sample size | 147 |
| Population | University students aged 16 to 19 years |
| Interventions | Detached mindfulness (DM) Slow breathing (SB) |
| Duration | 1-week intervention; assessments at pre- and postintervention |
| Topics | Meditation |
| Keywords | Detached mindfulness Negative metacognitive beliefs Slow breathing Social anxiety Stress User experience |
| Key findings | One week of daily detached mindfulness significantly reduced stress compared with a passive control, while no other differences emerged for stress, anxiety, or negative metacognitive beliefs. In the slow breathing group, higher perceived usability was associated with greater stress reductions. Participants found both interventions calming, easy to use, and acceptable, but reported challenges with motivation and integrating the exercises into daily routines. |
Abstract
Many adolescents experience elevated stress and anxiety; yet, access to effective psychological support is limited. Brief digital mental health interventions, such as slow breathing (SB) and detached mindfulness (DM), offer a potentially scalable approach to promoting emotion regulation in daily life. This study aimed to investigate whether 1 week of daily practice with a SB or DM intervention reduced stress, anxiety, and negative metacognitive beliefs in youth, and explored participants' experiences to inform the development of accessible, youth-tailored digital interventions. A mixed method approach was used, including quantitative and qualitative data. A total of 147 university students between 16 and 19 years old were randomly allocated to the DM (n=49), SB (n=49), or passive control group (n=49). Participants who were allocated to DM or SB practiced the intervention for 1 week. Stress, anxiety, and negative metacognitive beliefs were assessed at pre- and postintervention using self-report questionnaires. The quantitative data were analyzed with linear mixed-effects models, and we explored daily changes in intervention effect. After posttest, participants were invited to focus groups to evaluate their experience with the interventions (n=37). The qualitative data were analyzed with a content analysis. Our results showed that a week-long DM intervention significantly reduced stress compared with the control condition. No other differences emerged for the main outcomes on pre- and postmeasurements. However, in the SB group, higher perceived usability was associated with greater reductions in stress. Qualitative findings showed that both interventions were viewed as calming, easy to use, and acceptable, while also highlighting challenges such as maintaining motivation and integrating the exercises into daily routines. This study provides early formative evidence that brief digital interventions such as SB and DM are feasible and usable, with preliminary indication that DM intervention may support short-term stress reduction. Future research should focus on enhancing motivation and sustained engagement to maximize the effectiveness of digital mental health tools for late adolescents.
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
Cites 3
- Brief structured respiration practices enhance mood and reduce physiological arousal Cell Reports Medicine 2023
- Slow breathing for reducing stress: The effect of extending exhale. Complementary Therapies in Medicine March 5, 2023
- Effects of Mindfulness-Based Stress Reduction on Depression in Adolescents and Young Adults: A Systematic Review and Meta-Analysis Frontiers in Psychology June 21, 2018