JMIR Publications

ABSTRACT

Background:

Physical and mental health benefits can be attained from persistent, long-term performance of mindfulness meditation with a mobile meditation app, but in general, few mobile health app users persistently engage at a level necessary to attain the corresponding health benefits. Anchoring, or pairing, meditation with a mobile app to an existing daily routine can establish an unconsciously initiated meditation routine that may improve meditation persistence.

Objective:

The purpose of this study was to test the use of either personalized anchors or fixed anchors for establishing a persistent meditation app routine with the mobile app Calm.

Methods:

A randomized controlled trial was implemented that randomly assigned participants to one of three study groups: a) Personalized Anchor (PA), b) Fixed Anchor (FA), or a c) control group that did not use the anchoring strategy. All participants received app-delivered reminder messages to meditate for at least 10 minutes a day for an eight-week intervention period, and app usage data continued to be collected for an eight-week follow-up period to measure meditation persistence. Baseline, week eight, and week 16 surveys were administered to assess demographics, socioeconomic status, and changes in self-reported habit strength.

Results:

A total of 101 participants across the three study groups were included in the final analysis: a) PA (N=56), b) FA (N=49), and c) control group (N=62). Participants were predominantly White (81%), female (76%), and college educated (i.e., bachelor’s or graduate degree; 81%). The FA group had a significantly higher odds of daily meditation at the start of the intervention (1.14 OR; 95% CI 1.02 – 1.33; P = 0.04), and all participants experienced a linear decline in their odds of daily meditation during the eight-week intervention (0.96 OR; 95% CI 0.95 – 0.96; P < 0.01). Importantly, only the FA group showed a significantly smaller decline in the linear trend of their odds of daily meditation during the eight-week follow-up (their daily trend increased by 1.04 OR; 95% CI 1.01 – 1.06; P = 0.03). Additionally, those who more frequently adhered to their anchoring strategy during the intervention showed a significantly smaller decline in the linear trend of their odds of daily meditation during the eight-week follow-up period (1.13 OR; 95% CI 1.02 – 1.35; P < 0.01).

Conclusions:

The FA group had more persistent meditation with the app, but participants in either the FA or PA groups who more frequently adhered to their anchoring strategy during the intervention had the most persistent meditation routines, and almost all of these high-anchorers used morning anchors. These findings suggest that using the anchoring strategy can create persistent meditation routines with a mobile app. However, future studies should test additional intervention tools (i.e., reminders plus incentives) to help more participants successfully adhere to their anchored meditation routine.