Meditation Apps for Stress Management in Black Women

Feasibility, Acceptability, and Preliminary Effects of Culturally-Adapted and Generic Meditation Apps for Stress Reduction in Middle-Aged Black Women

This randomized remote pilot study will evaluate the feasibility, acceptability, and preliminary effects of two meditation and mindfulness applications among approximately 40 Black women ages 35-64 experiencing moderate to high stress.

Participants will be randomly assigned in a 1:1 ratio to Exhale™, a culturally adapted meditation app designed for Black women, or Levelhead, a general mindfulness app. Participants will be asked to complete at least one session using their assigned app per day, lasting approximately 5 minutes or longer, at least 5 days per week for 4 weeks.

Participants will complete online questionnaires at baseline and after the 4-week intervention. Daily Remind messages and weekly study check-ins will support engagement. Outcomes include recruitment, retention, adherence, assessment completion, satisfaction, usability, perceived stress, race-based stress, sleep, depression, anxiety, cultural relevance, and brief participant feedback.

Study Overview

• Status: Not yet recruiting
• Conditions: Psychological Stress
• Intervention / Treatment: Behavioral: Exhale™ Meditation App; Behavioral: Levelhead Mindfulness App

Detailed Description

This study is a two-arm, randomized, fully remote pilot study comparing Exhale™, a culturally adapted meditation application designed for Black women, with Levelhead, a general science-based mindfulness application.

Approximately 40 Black women ages 35-64 who report moderate to high perceived stress will be enrolled. After eligibility screening, informed consent, and completion of baseline questionnaires through REDCap, participants will be randomized in a 1:1 ratio to Exhale™ or Levelhead using the REDCap randomization module.

Participants in both groups will be asked to complete at least one app-based meditation or mindfulness session per day, lasting approximately 5 minutes or longer, at least 5 days per week for 4 weeks. Participants may complete additional or longer sessions but will not be required to make up missed sessions. Daily Remind messages will ask participants whether they completed a session and the approximate number of minutes practiced. Weekly check-ins will provide study reminders and opportunities to request technical assistance.

Remote questionnaires will be administered at baseline and at the end of Week 4. Primary outcomes will assess feasibility and acceptability through recruitment, retention, adherence, assessment completion, satisfaction, and usability. Secondary outcomes will examine preliminary changes in perceived stress, race-based stress, sleep, depression, and anxiety. Cultural relevance and brief open-ended participant feedback will also be collected. Some participants may be invited to complete an optional brief remote exit interview.

• Study Type: Interventional
• Enrollment (Estimated): 40
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Sunny Kim, PhD; Phone Number: 602-496-6789; Email: sunny.kim@asu.edu

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

Self-identifies as a Black or African American woman Ages 35-64 years Able to read and speak English Perceived Stress Scale-10 screening score greater than 14 Has access to a smartphone or tablet with internet access Willing to complete remote baseline and post-intervention assessments Willing to attempt the assigned app-based practice for 4 weeks Willing to receive study communications

Exclusion Criteria:

Regular use of meditation or mindfulness applications within the previous 6 months Any prior use of Exhale™ Significant hearing impairment that prevents engagement with audio-based application content Self-reported difficulty navigating smartphone applications that would prevent participation

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Exhale™ Meditation App; Participants assigned to Exhale™ will use a culturally adapted meditation application designed for Black women. Participants will be asked to complete at least one meditation session per day, lasting approximately 5 minutes or longer, at least 5 days per week for 4 weeks. Participants will receive daily Remind messages, weekly study check-ins, and remote technical support as needed.	Behavioral: Exhale™ Meditation App; A culturally adapted meditation application designed for Black women that provides guided meditation and mindfulness content addressing stress, rest, grounding, self-care, and culturally relevant experiences. Participants will manually select sessions and complete approximately 5 minutes or longer of practice at least 5 days per week for 4 weeks.
Active Comparator: Levelhead Mindfulness App; Participants assigned to Levelhead will use a general science-based mindfulness application. Participants will be asked to complete at least one mindfulness session per day, totaling approximately 5 minutes or longer, at least 5 days per week for 4 weeks. Participants will receive daily Remind messages, weekly study check-ins, and remote technical support as needed.	Behavioral: Levelhead Mindfulness App; A general science-based mindfulness application that provides brief lessons addressing topics such as stress, focus, gratitude, and well-being. Participants will complete approximately 5 minutes or longer of mindfulness practice at least 5 days per week for 4 weeks.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Participant Retention Rate at Week 4	Percentage of enrolled participants who complete the 4-week intervention and post-intervention assessment. The feasibility benchmark is greater than 75%.	Baseline through Week 4
Percentage of Eligible Individuals Who Consent and Enroll	Recruitment rate will equal the number of eligible individuals who consent and enroll divided by the total number determined eligible, multiplied by 100. The feasibility benchmark is greater than 70%.	From recruitment opening through enrollment of the final participant, up to 6 months.
Percentage of Recommended Practice Days Completed	Adherence will be calculated from participant self-reports as completed practice days divided by 20 recommended practice days, multiplied by 100. The benchmark is greater than 75%.	During the 4-week intervention
Assessment Completion Rate	Percentage of expected baseline and post-intervention questionnaires completed by enrolled participants. The benchmark is greater than 75%.	Baseline and Week 4
Participant Satisfaction With Assigned App	Satisfaction will be measured with the assigned-app satisfaction questionnaire. Items are rated from 1 to 5, with higher scores indicating greater satisfaction. Results will be summarized overall and by intervention arm.	Week 4
Assigned-App Usability Measured by the System Usability Scale	The 10-item System Usability Scale produces a total score from 0 to 100. Higher scores indicate better perceived usability.	Week 4

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in Perceived Stress Scale-10 Score	The PSS-10 contains 10 items and produces a total score from 0 to 40. Higher scores indicate greater perceived stress. Change from baseline will be reported overall and by arm.	Baseline to Week 4
Change in Index of Race-Related Stress-Brief Score	The 22-item IRRS-B produces a total score from 0 to 88. Higher scores indicate greater race-related stress. Change from baseline will be reported overall and by arm.	Baseline to Week 4
Change in POMS-SF Depression Subscale Score	The six-item depression subscale produces a score from 0 to 24. Higher scores indicate greater depressive mood disturbance.	Baseline to Week 4
Change in POMS-SF Tension/Anxiety Subscale Score	The six-item tension/anxiety subscale produces a score from 0 to 24. Higher scores indicate greater tension or anxiety.	Baseline to Week 4
Change in Insomnia Severity Index Score	The seven-item Insomnia Severity Index produces a total score from 0 to 28. Higher scores indicate more severe insomnia symptoms.	Baseline to Week 4

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Participant-Reported Cultural Relevance and App Feedback	Cultural relevance, perceived usefulness, barriers, benefits, and recommendations will be assessed through post-intervention items and brief open-ended feedback. Optional remote interviews may provide additional qualitative feedback.	Week 4 and, when applicable, within approximately 1 week after Week 4

Collaborators and Investigators

• Sponsor: Arizona State University

Study record dates

Study Major Dates

• Study Start (Estimated): September 16, 2026
• Primary Completion (Estimated): January 1, 2027
• Study Completion (Estimated): January 1, 2027

Study Registration Dates

• First Submitted: September 2, 2026
• First Submitted That Met QC Criteria: September 2, 2026
• First Posted (Actual): September 8, 2026

Study Record Updates

• Last Update Posted (Actual): September 8, 2026
• Last Update Submitted That Met QC Criteria: September 2, 2026
• Last Verified: September 1, 2026

More Information

Terms related to this study

• Keywords: mobile health; mindfulness; meditation; feasibility; digital health; stress management; Black women; African American women; culturally adapted intervention; race-based stresss; acceptibility
• Additional Relevant MeSH Terms: Behavioral Symptoms; Behavior; Stress, Psychological
• Other Study ID Numbers: STUDY00023706

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: Individual participant data will not be made publicly available. Aggregate or de-identified summary findings may be disseminated through presentations, publications, or participant summaries. Any future sharing of de-identified participant data would require additional institutional review and must be consistent with the informed consent form and Arizona State University requirements.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No