Efficacy and Moderation of Mobile App–Based Programs for Mindfulness-Based Training, Self-Compassion Training, and Cognitive Behavioral Psychoeducation on Mental Health: Randomized Controlled Noninferiority Trial
Winnie W. S. Mak, Alan C. Y. Tong, Sindy Y. C. Yip, Wacy W. S. Lui, Floria H. N. Chio, Amy TY Chan, Celia C. Y. Wong
JMIR Mental Health July 29, 2018 DOI: 10.2196/mental.8597 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Randomized controlled noninferiority trial Peer reviewed |
|---|---|
| Sample size | 2,161 |
| Population | Adults using mobile app-based psychological training programs |
| Interventions | Mindfulness-based program Self-compassion program Cognitive behavioral psychoeducation program |
| Duration | 4-week, 28-session program with 3-month follow-up |
| Topics | Meditation |
| Citations | 135 |
| Key findings | All three mobile app programs—mindfulness-based, self-compassion, and cognitive behavioral psychoeducation—improved mental well-being and reduced psychological distress at postprogram and 3-month follow-up, with no significant differences among them. Cognitive behavioral psychoeducation and the self-compassion program, but not the mindfulness program, significantly enhanced self-compassion at postprogram. Neither discomfort with emotions nor tolerance for ambiguity moderated outcomes. |
Abstract
Background: Mindfulness-based interventions, self-compassion training, and cognitive behavioral therapy have garnered much evidence in its salutary effects on mental health. With increasing application of smartphone and mobile technology on health promotion, this study investigated the efficacy and possible moderators of mindfulness, self-compassion, and cognitive behavioral psychoeducation training mobile apps in the improvement of mental health.
Objective: The aim of this study was to examine the efficacy of 3 mobile app-based programs: mindfulness-based program, self-compassion program, and cognitive behavioral psychoeducation program in improving mental well-being and reducing psychological distress. Changes in mindful awareness and self-compassion were also assessed. To further delineate the suitability of each program for different types of individuals, individual difference variables (ie, discomfort with emotions and tolerance for ambiguity) were explored for potential moderation.
Methods: This study was a 3-arm, randomized, controlled, noninferiority trial examining the efficacy of mindfulness-based program, self-compassion program, and cognitive behavioral psychoeducation. Participants were randomized into either 1 of the 3 conditions. Throughout the 4-week, 28-session program, participants spent 10-15 min daily reviewing the course content and practicing various related exercises. At preprogram, postprogram, and 3-month follow-up, participants also completed Web-based measures of mental well-being, psychological distress, mindful-awareness, and self-compassion as well as the proposed moderators.
Results: Among the 2161 study participants, 508 and 349 completed the post- and 3-month follow-up assessment, respectively. All 3 conditions (mindfulness-based program: N=703; cognitive behavioral psychoeducation: N=753; self-compassion program: N=705) were found to be efficacious in improving mental well-being and reducing psychological distress. All conditions enhanced mindful awareness at postprogram. Significant interaction effect was found on self-compassion; cognitive behavioral psychoeducation and self-compassion program, but not mindfulness-based program, significantly enhanced self-compassion at postprogram. No significant differences regarding usage and users' satisfaction were found among the 3 conditions. None of the proposed moderators were found to be significant.
Conclusions: Mindfulness-based, self-compassion, and cognitive behavioral psychoeducation mobile apps were efficacious in improving mental well-being and reducing psychological distress among adults at postprogram and 3-month follow-up. Future app-based psychological training programs should consider gamification and personalization of content or feedback to enhance engagement and mitigate the high attrition rates that are common in app-based health promotion programs.
Trial Registration: Chinese Clinical Trial Registry (ChiCTR) ChiCTR-TRC-13003468; http://www.chictr.org.cn/hvshowproject.aspx?id=6220 (Archived by WebCite at http://www.webcitation.org/734PlOz50).
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 15
- Testing the Efficacy of a Multicomponent, Self-Guided, Smartphone-Based Meditation App: Three-Armed Randomized Controlled Trial JMIR Mental Health November 27, 2020
- Mindfulness-Based Mobile Apps and Their Impact on Well-Being in Nonclinical Populations: Systematic Review of Randomized Controlled Trials Journal of Medical Internet Research June 21, 2023
- Effectiveness and experiences of integrating Mindfulness into Peer-assisted Learning (PAL) in clinical education for nursing students: A mixed method study. Nurse Education Today 2024
- Mindfulness in treatment-seeking adults with comorbid obsessive-compulsive and major depressive disorders: Mediating effects of obsessive beliefs and mental well-being. Indian Journal of Psychiatry May 1, 2025
- The Cumulative Effect of a 12-Week Online Mindfulness-Based Meditation Intervention Programme on Autonomic Nerve Functions by Pupillary Light Reflex: A Pilot Randomised Controlled Trial. Stress and Health August 1, 2025
and 10 more in the library
Cites 11
- The benefits of being present: Mindfulness and its role in psychological well-being. Journal of Personality and Social Psychology 2003
- Mindfulness: A proposed operational definition. Clinical Psychology Science and Practice 2004
- Inside the Mindful Mind Current Directions in Psychological Science December 1, 2013
- Culturally-Competent Treatments for Asian Americans: The Relevance of Mindfulness and Acceptance-Based Psychotherapies. Clinical Psychology Science and Practice September 1, 2011
- Mindfulness-Based Cognitive Therapy Versus Pure Cognitive Behavioural Self-Help for Perfectionism: a Pilot Randomised Study Mindfulness October 13, 2017
and 6 more in the library