JMIR Publications

ABSTRACT

Background:

As the need for effective, scalable interventions for mental health conditions such as depression, anxiety and stress has grown, the digital delivery of mindfulness-based stress reduction (MBSR) has gained research interest as a promising intervention in this domain.

Objective:

In the present study, we evaluate changes in perceived stress following a 10-week digital mindfulness-based stress reduction program that combined an app-based digital program with weekly one-on-one remote sessions with a health coach.

Methods:

The study utilized a retrospective, observational design. 229 participants with moderate to high perceived stress score as assessed by the PSS-10 enrolled in the 10-week Vida Health mindfulness-based stress reduction program. The program included weekly remote sessions with a certified health coach and digital content based on core concepts fundamental to mindfulness practice. The clinically validated Perceived Stress Scale (PSS-10) was used to evaluate perceived stress. Of the 229 participants, 131 (57.2%) were considered program completers and provided at least one follow-up PSS-10. A secondary analysis examined changes in stress scores at 6 months. This analysis was restricted to participants who had been enrolled in the program for at least 6 months (N = 121). To account for random and fixed effects, linear mixed effects modeling (MLM) was employed to assess changes in stress scores over time. Additionally, the reliable change index was computed to evaluate changes in stress scores from baseline.

Results:

The results revealed a significant positive association of program time on stress reduction (B = -0.365, P = .000) at 12 weeks. We observed an average reduction in stress scores of 3.17 points (95% CI -3.93 to -2.44) by program week 6 and 4.86 points (95% CI -5.86 to -3.85) by program week 12. Overall, 83.2% (109/131) of participants showed a reduction in perceived stress scores by week 12 with 40.46% (53/131) of participants showing reliable improvement in 12 weeks and 47.75% (56/131) participants showing a shift to a lower stress level category (i.e., moderate to low stress). Participants who completed more lessons had an increased likelihood of moving down at least one stress-level category (OR = 1.512, 95% CI 1.056 to 2.166, P = .024). In assessing medium-term stress outcomes, among participants who had completed at least 6 months since starting the program, 59 (48.76%) members provided a 6-month assessment. We observed a significant reduction in stress scores at 6 months, t(58) = 10.24, P =.000, with 61.01% of participants (36/59) showing a reliable improvement.

Conclusions:

The findings in this retrospective, observational study suggest that a blended digital mindfulness-based intervention may support program uptake and meaningful, sustained reduction in stress outcomes.