Positive Health Online

Abstract

HUBERTY and COLLEAGUES, 1 College of Health Solutions, Arizona State University, Phoenix, AZ, United States; 2 Department of Student Affairs, University of Redlands, Redlands, CA, United States; 3 College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, United States; 4 Behavioral Research and Analytics, LLC, Salt Lake City, UT, United States aimed to test the initial efficacy and sustained effects of an 8-week mindfulness meditation mobile app-Calm-compared to a wait-list control on stress, mindfulness, and self-compassion in college students with elevated stress and also explored the intervention's effect on health behaviours (i.e. sleep disturbance, alcohol consumption [binge drinking], physical activity, and healthy eating [fruit and vegetable consumption]) and the feasibility and acceptability of the app.

Background

College students experience high levels of stress. Mindfulness meditation delivered via a mobile app may be an appealing, efficacious way to reduce stress in college students. The authors aimed to test the initial efficacy and sustained effects of an 8-week mindfulness meditation mobile app-Calm-compared to a wait-list control on stress, mindfulness, and self-compassion in college students with elevated stress. The authors also explored the intervention's effect on health behaviours (i.e. sleep disturbance, alcohol consumption [binge drinking], physical activity, and healthy eating [fruit and vegetable consumption]) and the feasibility and acceptability of the app.

Methodology

This study was a randomized, wait-list, control trial with assessments at baseline, postintervention (8 weeks), and at follow-up (12 weeks). Participants were eligible if they were current full-time undergraduate students and (1) at least 18 years of age, (2) scored ≥14 points on the Perceived Stress Scale, (3) owned a smartphone, (4) were willing to download the Calm app, (5) were willing to be randomized, and (7) were able to read and understand English. Participants were asked to meditate using Calm at least 10 minutes per day. A P value ≤.05 was considered statistically significant.

Results

A total of 88 participants were included in the analysis. The mean age (SD) was 20.41 (2.31) years for the intervention group and 21.85 (6.3) years for the control group. There were significant differences in all outcomes (stress, mindfulness, and self-compassion) between the intervention and control groups after adjustment for covariates postintervention (all P<.04). These effects persisted at follow-up (all P<.03), except for the non-reacting subscale of mindfulness (P=.08). There was a significant interaction between group and time factors in perceived stress (P=.002), mindfulness (P<.001), and self-compassion (P<.001). Bonferroni post hoc tests showed significant within-group mean differences for perceived stress in the intervention group (P<.001), while there were no significant within-group mean differences in the control group (all P>.19). Similar results were found for mindfulness and self-compassion. Effect sizes ranged from moderate (0.59) to large (1.24) across all outcomes. A significant group×time interaction in models of sleep disturbance was found, but no significant effects were found for other health behaviours. The majority of students in the intervention group reported that Calm was helpful to reduce stress and stated they would use Calm in the future. The majority were satisfied using Calm and likely to recommend it to other college students. The intervention group participated in meditation for an average of 38 minutes/week during the intervention and 20 minutes/week during follow-up.

Conclusion

Calm is an effective modality to deliver mindfulness meditation in order to reduce stress and improve mindfulness and self-compassion in stressed college students. Our findings provide important information that can be applied to the design of future studies or mental health resources in university programs. Trial registration: ClinicalTrials.gov NCT03891810; https://clinicaltrials.gov/ct2/show/NCT03891810 . ©Jennifer Huberty, Jeni Green, Christine Glissmann, Linda Larkey, Megan Puzia, Chong Lee. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 25.06.2019. Conflicts of Interest: JH is currently the Director of Science at Calm (although she was engaged in this role almost 1 year after the design, collection of data, and analysis of results of the study presented in this paper). None of the authors declare any conflicts of interest.

References

Jennifer Huberty  1 , Jeni Green  1 , Christine Glissmann  2 , Linda Larkey  3 , Megan Puzia   4 , Chong Lee  1. Efficacy of the Mindfulness Meditation Mobile App "Calm" to Reduce Stress Among College Students: Randomized Controlled Trial JMIR Mhealth Uhealth.  ;7(6):e14273. doi: 10.2196/14273. Jun 25 2019.