Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Sep 17, 2025
Date Accepted: Mar 26, 2026
A self-guided app-based mindfulness intervention for racially and ethnically minoritized individuals who experience discrimination-related mental health symptoms: Randomized controlled trial
ABSTRACT
Background:
Racially and ethnically minoritized individuals (REMs) who experience discrimination are at risk of developing stress, anxiety, and depression symptoms. Mindfulness interventions may be especially well-suited to help REMs cope with the mental health consequences of discrimination. However, these groups have limited access to these mental health treatments. Digital mental health interventions (DMHIs), especially those that are self-guided and leverage smartphone ownership, represent a potential avenue to reduce this treatment gap.
Objective:
This randomized controlled trial tested the effectiveness and feasibility of a self-guided app-based mindfulness DMHI for REMs exposed to elevated levels of discrimination.
Methods:
A total of 155 participants (mean age 27.28 SD=9.61) were randomized to either receiving the DMHI for 4 weeks (n=80) or treatment as usual (TAU) (n=75). The racial and ethnic composition of the sample was 38.7% (60/155) Latinx, 37.4% (58/155) Asian, 11.6% (18/155) Black, 10.3% (16/155) Multiracial, and 2% (3/155) Native American. Participants completed measures of stress, anxiety, and depression at baseline (week 0), mid-treatment (week 2), and post-treatment (week 4). Feasibility outcomes included the percentage of participants who accessed the DMHI, days using it, meditations completed, total time meditated, and the percentage of participants who dropped out of the study.
Results:
Multilevel regression models revealed greater reductions in stress (from baseline to mid-treatment b=-2.41, 95% CI -4.14, -0.67, P= .006; from mid-treatment to post-treatment b=-2.11, 95% CI -3.90, -0.32, P=.020; from baseline to post-treatment b=-4.52, 95% CI -6.54, -2.51, P< .001; pseudo-R2=.41), anxiety (from baseline to mid-treatment b=-2.31, 95% CI -3.77, -0.85, P=.002; from baseline to post-treatment b=-3.31, 95% CI -4.89, -1.74, P<.001; pseudo-R2=.45), and depression (from baseline to mid-treatment b=-1.86, 95% CI -3.38, -0.33, P=.020; from baseline to post-treatment b=-2.84, 95% CI -4.57, -1.12, P<.001; pseudo-R2=.53) in the intervention group compared with the control group. In terms of feasibility outcomes, all participants in the intervention group downloaded the app (80/80 100%) and used it, on average, 16.97 (SD = 7.9) days, completed 25.31 (SD = 24.71) mediations, and mediated 246.63 (SD = 274.9) minutes. Of 155 participants, only 12 (8%) dropped out of this study, with 11 of them (7%) coming from the intervention group.
Conclusions:
A self-guided app-based mindfulness DMHI emerges as an effective and feasible approach to provide REMs with an evidence-based treatment to reduce common mental health symptoms associated with experiencing discrimination. Clinical Trial: Trial Registration: ClinicalTrials.gov NCT05027113; https://clinicaltrials.gov/ct2/show/NCT05027113 International Registered Report Identifier (IRRID): DERR1-10.2196/35196
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