JMIR Publications

ABSTRACT

Background:

Mindfulness-based interventions have been demonstrated to be an effective method to improve bodily and emotional well-being, but few studies have explored individual differences and heterogeneity in the self-perceived benefits of digital mindfulness among older adults aged 65 and above. Although voice-based mindfulness technologies can increase the accessibility of mindfulness training, the expected effects may not be similar to all user groups. Digital health technologies are often used by individuals with a high digital health literacy.

Objective:

The study investigates to what extent a voice-based digital mindfulness app can improve the self-perceived bodily and emotional well-being among older adults (aged 65 and above), how older adults incorporate the digital mindfulness app to their daily routines, and how different interaction modalities with the app impacts digital mindfulness experience.

Methods:

A mixed method study combining quantitative survey questionnaires and qualitative semi-structured interviews was conducted among older adults aged 65 and over who used a voice-based mindfulness app for a 3-week period in their homes in Sweden (N=15). The effects of the mindfulness app on self-perceived well-being were measured with Five Facets Mindfulness Questionnaire, and WHO5 Well-being Index, which were analysed through descriptive statistics. Qualitative content analysis was conducted to explore the heterogeneity in the self-perceived bodily and emotional benefits of digital mindfulness, and the user engagement with the app.

Results:

Results of the WHO-5 Well-being index showed an overall improvement in mean values of self-perceived well-being, and results from the Five Facets Mindfulness Questionnaire showed an improvement in 11 of 15 questions, particularly in non-reactivity. Younger participants (under 76) and those who evaluated their self-perceived health as high reported higher improvements in the mindfulness scale after the app use. Due to the small sample size, these differences were not statistically significant. Qualitative content analysis identified four main themes for self-perceived benefits: (1) Relaxation and breathing, (2) Improved bodily awareness, (3) Improved emotional awareness and (4) Pain management. Participants described that continuity and temporality with the app use was significant in noticing the self-perceived effects of digital mindfulness. Voice interaction and persona of the digital mindfulness coach was reported as an essential part of the mindfulness experience.

Conclusions:

Voice-based digital mindfulness apps can increase the accessibility and flexibility of mindfulness training, but the expected benefits may not be similar to all user groups. Individual differences in the self-perceived benefits of digital mindfulness were pronounced in relation to older adults’ health status and age. Practicing digital mindfulness with a voice-based app provides possibilities for a sense of improved agency in maintenance of well-being. However, voice interaction and the mindfulness coach persona should be personalised according to older adults’ individual preferences.