Acceptability, engagement, outcomes, and dose-response associations of a mindfulness-based meditation app in individuals waiting for psychological services

Abstract Background While mindfulness apps have received growing clinical attention, their integration within health systems has received limited empirical investigation. In this study, we evaluated a mindfulness app as a low-intensity treatment option for adults waiting for psychological services. A non-randomized clinical trial was conducted with a 4-week acute intervention period with an 8-week follow-up. Adults (N = 193) with moderate depression and anxiety symptoms, completed a baseline session and received access to AmDTx, a mobile mindfulness training app. Additional assessments were completed at 2, 4, 8, and 12 weeks. Descriptive statistics of attrition, adoption, acceptability, and engagement were computed. Linear mixed models estimated treatment outcomes for functional disability (primary endpoint), depression, anxiety, stress, rumination, and mindful awareness/acceptance. We also evaluated the dose-response association between app use and functional disability. Results Using intent-to-treat analyses, there was a 75% adoption of the app and a 30% attrition rate in the first 4 weeks. In addition, 1.09 hours of meditation time and 9.16 exercises were recorded on average within the first 4 weeks. Participants reported positive credibility, acceptability, and usability ratings on established measures. Treatment effects were observed in the expected direction for all outcomes but one (mindful awareness). Dose-response relationships indicated that increases in app engagement correlated with decreases in functional disability. Conclusions The findings reinforce the potential for AmDTx, and mindfulness apps more broadly, to serve as low-intensity tools to alleviate unmet service needs and impart clinically meaningful benefit for a significant subset of those waiting for psychological services. Clinical Trial Registration: Clinicaltrials.gov, NCT05211960, Registered 2022-01-26.