JMIR Publications

ABSTRACT

Background:

Mobile health (mHealth) apps typically collect intensive data on app usage that allows researchers to investigate factors influencing the habit formation process. This is an important behavioral target to understand given the well-known struggles that users experience with sustaining healthy behavior over time.

Objective:

Data from a commercial meditation app (n = 14,879; 899,071 total app uses) was analyzed to assess the validity of commonly given habit formation advice to meditate at roughly the same time every day, preferably in the morning.

Methods:

First, the change in probability of meditating in four non-overlapping time windows (morning, midday, evening, late-night) on a given day over the first 180 days after creating a meditation app account was calculated via a generalized additive mixed models (GAMMs). Second, users’ time of day preferences were calculated as the percentage of all meditation sessions that occurred within each of the four time windows. Additionally, the temporal consistency of daily meditation behavior was calculated as the entropy of the timing of app usage sessions. Linear regression was used to examine the effect of time-of-day preference and temporal consistency on two outcomes: i.) short-term engagement, defined as the number of meditation sessions completed within the sixth and seventh month of an account’s existence (M67) and ii.) long-term use, defined as the time until the last observed meditation session.

Results:

Large reductions in the probability of meditation at any time of day were seen over the first 180 days after creating an account. However, this effect was smallest for morning meditation sessions (63.4% reduction vs. [67.8%, 74.5%] range for other times). A greater proportion of meditation in the morning was also significantly associated with better short-term (regression coefficient [B]=2.76, p<0.001) and-long-term (B=50.6, p<0.001) outcomes. The opposite was true for late-night meditation sessions (Short-Term: B=-2.06, p<0.001, Long-Term: B =-51.7, p=0.001), while a significant relationship was not found for long-term outcomes for midday and evening sessions. Additionally, temporal consistency in the performance of morning meditation sessions was associated with better short-term outcomes (B=-1.64, p<0.001), but worse long-term outcomes (B=55.8, p<0.001). Similar-sized temporal consistency effects were found for all other time windows.

Conclusions:

Meditating in the morning was associated with higher rates of sustaining a meditation practice with the app, which is consistent with findings from other habit formation studies that have hypothesized that the strength of existing morning routines and/or circadian rhythms may make the morning more appropriate for building new habits. In the long term, less temporal consistency in meditation sessions was associated with more sustained app use, perhaps because this represents beneficial flexibility in behavior performance. These findings improve our understanding of the habit formation process and can inform the design of mHealth habit promoting protocol. Clinical Trial: N/A