Acceptability, engagement, outcomes, and dose–response associations of a mindfulness-based meditation app in individuals waiting for psychological services
Alexander R. Daros, Alina Patel, Oghenetega Otevwe, Santiago Sotelo, Bechara John Saab, L. Quilty
BMC Digital Health June 17, 2025 DOI: 10.1186/s44247-025-00155-7 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Non-randomized clinical trial Peer reviewed |
|---|---|
| Sample size | 193 |
| Population | Adults with moderate depression and anxiety symptoms waiting for psychological services |
| Duration | 4-week intervention period and 8-week follow-up (assessments at 2, 4, 8, and 12 weeks post-baseline) |
| Topics | Meditation |
| Registration | NCT05211960 |
| Key findings | Among adults waiting for psychological services, a 4-week mindfulness app intervention showed a 75% adoption rate and 30% attrition at post-treatment, with average use of 1.09 meditation hours and 9.16 exercises. Outcomes for functional disability, depression, anxiety, stress, and rumination improved in the expected direction, while mindful awareness did not. Greater app engagement correlated with larger reductions in functional disability. |
Abstract
While mindfulness apps have received growing clinical attention, their integration within health systems has received limited investigation. In this study, we evaluated a mindfulness app in adults waiting for psychological services. A non-randomized clinical trial was conducted with a 4-week intervention period and 8-week follow-up. At baseline, adults (N = 193) with moderate depression and anxiety symptoms completed an assessment and received access to a mobile mindfulness app called AmDTx. Additional assessments were completed at 2-, 4-, 8-, and 12-weeks post-baseline. Descriptive statistics of attrition, adoption, acceptability, and engagement were computed. Linear mixed models estimated treatment outcomes for functional disability (primary outcome), depression, anxiety, stress, rumination, and mindful awareness/acceptance. We also evaluated the dose–response association between app use and functional disability. Using intent-to-treat (ITT) analyses, there was a 75% adoption rate and a 30% attrition rate at post-treatment (i.e., 4 weeks post-baseline). In addition, 1.09 hours of meditation time and 9.16 exercises were recorded on average at post-treatment. During follow-up, less than a third of participants remained active users, but they reported increases in meditation hours and number of exercises. Participants reported positive ratings of credibility, acceptability, and usability ratings. Treatment effects were observed in the expected direction for all outcomes but one (mindful awareness). Dose-response relationships indicated that increases in app engagement correlated with decreases in functional disability The findings reinforce the potential for AmDTx, and mindfulness apps more broadly, to serve as low-intensity tools to alleviate unmet service needs and impart clinically meaningful benefit for a significant subset of those waiting for psychological services. ClinicalTrials.gov NCT05211960, Registered 2022–01-26.
Comparable studies
Other non-randomized and open-label trials on meditation, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Mindfulness-Based Stress Reduction in Relation to Quality of Life, Mood, Symptoms of Stress, and Immune Parameters in Breast and Prostate Cancer Outpatients Early-stage breast and prostate cancer patients | 2003 | Pre-post intervention study | n = 59 |
| Exploring self‐compassion and empathy in the context of mindfulness‐based stress reduction (MBSR) Community sample | 2010 | Pre-post intervention study | |
| Mindfulness-Based Stress Reduction Lowers Psychological Distress In Medical Students Second-year medical students | 2003 | Prospective nonrandomized cohort-controlled study | n = 302 |
| Intensive meditation training, immune cell telomerase activity, and psychological mediators. Retreat participants and matched controls | 2011 | Controlled trial with wait-list control group | n = 60 |
| The Effectiveness of Mindfulness Training for Children with ADHD and Mindful Parenting for their Parents Children aged 8-12 with ADHD and their parents | 2011 | Within-group waitlist controlled trial | n = 22 |
Citations in the library
Cited by 2
- Mindfulness-Based Psychoeducation App to Improve the Well-Being of Parents and Caregivers of Children With Autism: Development and Usability Study. JMIR Pediatrics and Parenting June 4, 2026
- The Effects of a Digital Mindfulness Intervention on Mental Health and Vision-Related Quality of Life in Non-infectious Uveitis. Ophthalmology June 1, 2026
Cites 10
- The Empirical Status of Mindfulness-Based Interventions: A Systematic Review of 44 Meta-Analyses of Randomized Controlled Trials Perspectives on Psychological Science February 16, 2021
- Testing the Efficacy of a Multicomponent, Self-Guided, Smartphone-Based Meditation App: Three-Armed Randomized Controlled Trial JMIR Mental Health November 27, 2020
- The efficacy of mindfulness apps on symptoms of depression and anxiety: An updated meta-analysis of randomized controlled trials. Clinical Psychology Review February 1, 2024
- Is dosage of a meditation app associated with changes in psychological distress? It depends on how you ask. Clinical Psychological Science March 1, 2025
- Smartphone App-Delivered Mindfulness-Based Intervention for Mild Traumatic Brain Injury in Adolescents: Protocol for a Feasibility Randomized Controlled Trial. JMIR Research Protocols April 11, 2024
and 5 more in the library