Review and Evaluation of Mindfulness-Based iPhone Apps

Madhavan Mani, David J Kavanagh, Leanne Hides, Stoyan R Stoyanov, Madhavan Mani, David J Kavanagh, Leanne Hides, Stoyan R Stoyanov

Abstract

Background: There is growing evidence for the positive impact of mindfulness on wellbeing. Mindfulness-based mobile apps may have potential as an alternative delivery medium for training. While there are hundreds of such apps, there is little information on their quality.

Objective: This study aimed to conduct a systematic review of mindfulness-based iPhone mobile apps and to evaluate their quality using a recently-developed expert rating scale, the Mobile Application Rating Scale (MARS). It also aimed to describe features of selected high-quality mindfulness apps.

Methods: A search for "mindfulness" was conducted in iTunes and Google Apps Marketplace. Apps that provided mindfulness training and education were included. Those containing only reminders, timers or guided meditation tracks were excluded. An expert rater reviewed and rated app quality using the MARS engagement, functionality, visual aesthetics, information quality and subjective quality subscales. A second rater provided MARS ratings on 30% of the apps for inter-rater reliability purposes.

Results: The "mindfulness" search identified 700 apps. However, 94 were duplicates, 6 were not accessible and 40 were not in English. Of the remaining 560, 23 apps met inclusion criteria and were reviewed. The median MARS score was 3.2 (out of 5.0), which exceeded the minimum acceptable score (3.0). The Headspace app had the highest average score (4.0), followed by Smiling Mind (3.7), iMindfulness (3.5) and Mindfulness Daily (3.5). There was a high level of inter-rater reliability between the two MARS raters.

Conclusions: Though many apps claim to be mindfulness-related, most were guided meditation apps, timers, or reminders. Very few had high ratings on the MARS subscales of visual aesthetics, engagement, functionality or information quality. Little evidence is available on the efficacy of the apps in developing mindfulness.

Keywords: mental health; mindfulness; mindfulness-based mobile apps; mobile health (mHealth).

Conflict of interest statement

Conflicts of Interest: None declared.

Figures

Figure 1
Figure 1
Systematic search for mindfulness apps in Apple store.

References

    1. Keng S, Smoski MJ, Robins CJ. Effects of mindfulness on psychological health: a review of empirical studies. Clin Psychol Rev. 2011 Aug;31(6):1041–56. doi: 10.1016/j.cpr.2011.04.006.
    1. Slade Mike. Mental illness and well-being: the central importance of positive psychology and recovery approaches. BMC Health Serv Res. 2010;10:26. doi: 10.1186/1472-6963-10-26.
    1. Kabat-Zinn J. Mindfulness-Based Interventions in Context: Past, Present, and Future. Clinical Psychology: Science and Practice. 2006;10(2):144–156. doi: 10.1093/clipsy.bpg016.
    1. Langer E. Matters of mind: Mindfulness/mindlessness in perspective. Consciousness and Cognition. 1992 Sep;1(3):289–305. doi: 10.1016/1053-8100(92)90066-J.
    1. Langer EJ, Moldoveanu M. The Construct of Mindfulness. J Social Isssues. 2000 Jan;56(1):1–9. doi: 10.1111/0022-4537.00148.
    1. Brown K, Ryan R, Creswell J. Mindfulness: Theoretical Foundations and Evidence for its Salutary Effects. Psychological Inquiry. 2007 Oct 19;18(4):211–237. doi: 10.1080/10478400701598298.
    1. Coffey KA, Hartman M, Fredrickson BL. Deconstructing Mindfulness and Constructing Mental Health: Understanding Mindfulness and its Mechanisms of Action. Mindfulness. 2010 Oct 29;1(4):235–253. doi: 10.1007/s12671-010-0033-2.
    1. Irving Julie Anne, Dobkin Patricia L, Park Jeeseon. Cultivating mindfulness in health care professionals: a review of empirical studies of mindfulness-based stress reduction (MBSR) Complement Ther Clin Pract. 2009 May;15(2):61–6. doi: 10.1016/j.ctcp.2009.01.002.
    1. Khoury Bassam, Lecomte Tania, Fortin Guillaume, Masse Marjolaine, Therien Phillip, Bouchard Vanessa, Chapleau Marie-Andrée, Paquin Karine, Hofmann Stefan G. Mindfulness-based therapy: a comprehensive meta-analysis. Clin Psychol Rev. 2013 Aug;33(6):763–71. doi: 10.1016/j.cpr.2013.05.005.
    1. Chiesa Alberto, Serretti Alessandro. Mindfulness based cognitive therapy for psychiatric disorders: a systematic review and meta-analysis. Psychiatry Res. 2011 May 30;187(3):441–53. doi: 10.1016/j.psychres.2010.08.011.
    1. Kazdin A, Rabbitt S. Novel Models for Delivering Mental Health Services and Reducing the Burdens of Mental Illness. Clinical Psychological Science. 2013 Jan 23;1(2):170–191. doi: 10.1177/2167702612463566.
    1. Geraghty Adam W A. Torres Leandro D, Leykin Yan, Pérez-Stable Eliseo J, Muñoz Ricardo F. Understanding attrition from international Internet health interventions: a step towards global eHealth. Health Promot Int. 2013 Sep;28(3):442–52. doi: 10.1093/heapro/das029.
    1. Free Caroline, Phillips Gemma, Watson Louise, Galli Leandro, Felix Lambert, Edwards Phil, Patel Vikram, Haines Andy. The effectiveness of mobile-health technologies to improve health care service delivery processes: a systematic review and meta-analysis. PLoS Med. 2013;10(1):e1001363. doi: 10.1371/journal.pmed.1001363.
    1. Meeker M. Internet Trends. 2014. [2015-02-08]. 2014 .
    1. Mackay MM. AIMIA. 2014. [2015-02-08]. Australian mobile phone lifestyle index .
    1. Statista Number of mobile app downloads worldwide from to (in millions) 2009. [2015-02-08]. 2014
    1. 2013. [2015-02-08]. Mobile apps: putting the ‘smart’ in smartphones .
    1. Burns Jane M, Davenport Tracey A, Durkin Lauren A, Luscombe Georgina M, Hickie Ian B. The internet as a setting for mental health service utilisation by young people. Med J Aust. 2010 Jun 7;192(11 Suppl):S22–6.
    1. Christensen H, Hickie I. Using e-health applications to deliver new mental health services. Med J Aust. 2010 Jun 7;192(11 Suppl):S53–6.
    1. Statista 2015. [2015-06-08]. Most popular Apple App Store categories in March 2015, by share of available apps
    1. Mohr David C, Cheung Ken, Schueller Stephen M, Hendricks Brown C, Duan Naihua. Continuous evaluation of evolving behavioral intervention technologies. Am J Prev Med. 2013 Oct;45(4):517–23. doi: 10.1016/j.amepre.2013.06.006.
    1. Lewis T, Wyatt J. mHealth and mobile medical Apps: a framework to assess risk and promote safer use. J Med Internet Res. 2014;16(9):e210. doi: 10.2196/jmir.3133.
    1. Howells A, Ivtzan I, Eiroa-Orosa F. Putting the ‘app’ in Happiness: A Randomised Controlled Trial of a Smartphone-Based Mindfulness Intervention to Enhance Wellbeing. J Happiness Stud. 2014 Oct 29; doi: 10.1007/s10902-014-9589-1.
    1. Stoyanov S, Hides L, Kavanagh D, Tjondronegoro D, Zelenko O, Mani M. Mobile App Rating Scale: A new tool for assessing the quality of health-related mobile apps. JMIR mhealth and uhealth. 2015;3(1):e27.
    1. Kabat-Zinn J. Full catastrophe living, revised edition: how to cope with stress, pain and illness using mindfulness meditation. London: Hachette UK; 2013.
    1. Gunaratana B. Mindfulness in Plain English: 20th Anniversary Edition. Boston: Wisdom Publications; 2011. Mindfulness in plain English.
    1. Thompson B, Waltz J. Everyday mindfulness and mindfulness meditation: Overlapping constructs or not? Personality and Individual Differences. 2007 Nov;43(7):1875–1885. doi: 10.1016/j.paid.2007.06.017.
    1. Olendzki A. Mindfulness and Meditation. In: Didonna F, editor. Clinical handbook of mindfulness. New York: Springer; 2009. pp. 37–44.
    1. Monteiro LM, Musten RF, Compson J. Traditional and Contemporary Mindfulness: Finding the Middle Path in the Tangle of Concerns. Mindfulness. 2014 Apr 29;6(1):1–13. doi: 10.1007/s12671-014-0301-7.
    1. Grossman Paul, Niemann Ludger, Schmidt Stefan, Walach Harald. Mindfulness-based stress reduction and health benefits. A meta-analysis. J Psychosom Res. 2004 Jul;57(1):35–43. doi: 10.1016/S0022-3999(03)00573-7.
    1. Bishop Scott R. What do we really know about mindfulness-based stress reduction? Psychosom Med. 2002;64(1):71–83.
    1. Pollak SM. Teaching mindfulness in therapy. In: Germer CK, editor. Mindfulness and psychotherapy. New York: Guilford Press; 2005. pp. 113–129.
    1. Cyr D, Head M, Ivanov A. Design aesthetics leading to m-loyalty in mobile commerce. Information & Management. 2006 Dec;43(8):950–963. doi: 10.1016/j.im.2006.08.009.
    1. Maghnati F, Ling K. Exploring the Relationship between Experiential Value and Usage Attitude towards Mobile Apps among the Smartphone Users. IJBM. 2013 Jan 17;8(4) doi: 10.5539/ijbm.v8n4p1.
    1. Ba S, Wang L. Digital health communities: The effect of their motivation mechanisms. Decision Support Systems. 2013 Nov;55(4):941–947. doi: 10.1016/j.dss.2013.01.003.
    1. Boudreaux E, Waring M, Hayes R, Sadasivam R, Mullen S, Pagoto S. Evaluating and selecting mobile health apps: strategies for healthcare providers and healthcare organizations. Translational behavioral medicine.2014/12/ 2014;4(4):363–371. doi: 10.1007/s13142-014-0293-9.
    1. Farrington C, Aristidou A, Ruggeri K. mHealth and global mental health: still waiting for the mH2 wedding? Global Health. 2014;10:17. doi: 10.1186/1744-8603-10-17.
    1. Harrison Virginia, Proudfoot Judith, Wee Pang Ping, Parker Gordon, Pavlovic Dusan Hadzi, Manicavasagar Vijaya. Mobile mental health: review of the emerging field and proof of concept study. J Ment Health. 2011 Dec;20(6):509–24. doi: 10.3109/09638237.2011.608746.
    1. Free Caroline, Phillips Gemma, Galli Leandro, Watson Louise, Felix Lambert, Edwards Phil, Patel Vikram, Haines Andy. The effectiveness of mobile-health technology-based health behaviour change or disease management interventions for health care consumers: a systematic review. PLoS Med. 2013;10(1):e1001362. doi: 10.1371/journal.pmed.1001362.

Source: PubMed

Sponsors and Collaborators

Medical Conditions

Drug Interventions

3
Subscribe