The Indirect Effects of a Mindfulness Mobile App on Productivity Through Changes in Sleep Among Retail Employees: Secondary Analysis

Hallie Espel-Huynh, Matthew Baldwin, Megan Puzia, Jennifer Huberty, Hallie Espel-Huynh, Matthew Baldwin, Megan Puzia, Jennifer Huberty

Abstract

Background: Chronic sleep disturbance is prevalent among United States employees and associated with costly productivity impairment. Mindfulness interventions improve sleep (ie, insomnia and daytime sleepiness) and productivity outcomes, and mobile apps provide scalable means of intervention delivery. However, few studies have examined the effects of mindfulness mobile apps on employees, and no research to date has tested the role of sleep improvement as a potential mechanism of action for productivity outcomes.

Objective: This study examined the effects of Calm, a consumer-based mindfulness app, and sleep coaching, on productivity impairment among retail employees through the indirect effects of changes in insomnia and daytime sleepiness.

Methods: This study was a secondary analysis of data from a randomized controlled trial (N=1029) comparing the use of Calm (n=585, 56.9%) to a waitlist control (n=444, 43.2%) for 8 weeks among employees of a large retail employer in the United States. A subset of individuals with elevated insomnia symptoms also had access to brief sleep coaching with Calm (n=101, 9.8%). Insomnia symptom severity, daytime sleepiness, and productivity impairment (ie, absenteeism, presenteeism, overall productivity impairment, and non-work activity impairment) were assessed at baseline and weeks 2, 4, 6, and 8. Indirect effects were evaluated with latent growth curve modeling to test whether the Calm intervention (Calm group vs waitlist control) was effective in reducing work productivity impairment through changes in sleep disturbance.

Results: No significant main effects of Calm intervention on productivity impairment were detected for any outcome at α level of .05, with the exception of non-work activity impairment models, in which Calm intervention reduced non-work activity impairment over time (P=.01 and P=.02 for insomnia and sleepiness models, respectively). Significant indirect effects of insomnia were detected for presenteeism (P=.002), overall work productivity (P=.01), and non-work activity impairment (P=.002); Calm intervention produced significantly greater reductions in insomnia symptoms (relative to waitlist control), and decreases in insomnia were associated with decreases in work productivity impairment. There was no significant indirect effect of change in insomnia on changes in absenteeism (P=.20). Furthermore, we detected no significant indirect effects of daytime sleepiness on productivity impairment.

Conclusions: We found that Calm (plus sleep coaching for a small subset of individuals) had beneficial effects on employee sleep, and these benefits on sleep were related to indirect effects on productivity impairment (ie, presenteeism, overall work productivity impairment, and non-work activity impairment). There were no overall main effects of Calm intervention on productivity impairment; however, insomnia appears to be a mechanism associated with benefits for employee productivity. This is one of the first studies to suggest that sleep benefits of a mindfulness mobile app may also indirectly relate to benefits for workplace productivity.

Trial registration: ClinicalTrials.gov NCT05120310; https://ichgcp.net/clinical-trials-registry/NCT05120310.

Keywords: mindfulness; mobile apps; mobile phone; presenteeism; sleep; workforce; workplace.

Conflict of interest statement

Conflicts of Interest: HEH, MB, and JH disclose that they receive an annual salary from Calm and hold stock within the company. However, their salary and equity were not dependent on the results of their research. MP discloses that she is a paid contractor (ie, the research coordinator) of Calm.

©Hallie Espel-Huynh, Matthew Baldwin, Megan Puzia, Jennifer Huberty. Originally published in JMIR mHealth and uHealth (https://mhealth.jmir.org), 28.09.2022.

Figures

Figure 1
Figure 1
Conceptual depiction of the latent growth curve model, with primary elements of the indirect effect in bold. Mean structures, variances, and covariates were removed for simplicity. Factor loadings for baseline and 8 weeks are depicted, although all time points were used to estimate latent intercepts and slopes.

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