Review and Evaluation of Mindfulness-Based iPhone Apps

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.

[1]  E. Langer,et al.  The Construct of Mindfulness , 2000 .

[2]  Andrew Olendzki Mindfulness and Meditation , 2009 .

[3]  A. Haines,et al.  The Effectiveness of Mobile-Health Technologies to Improve Health Care Service Delivery Processes: A Systematic Review and Meta-Analysis , 2013, PLoS medicine.

[4]  R. Ryan,et al.  Mindfulness: Theoretical Foundations and Evidence for its Salutary Effects , 2007 .

[5]  Adam W A Geraghty,et al.  Understanding attrition from international Internet health interventions: a step towards global eHealth. , 2013, Health promotion international.

[6]  M. Slade,et al.  Mental illness and well-being: the central importance of positive psychology and recovery approaches , 2010, BMC health services research.

[7]  David C Mohr,et al.  Continuous evaluation of evolving behavioral intervention technologies. , 2013, American journal of preventive medicine.

[8]  Dianne Cyr,et al.  Design aesthetics leading to m-loyalty in mobile commerce , 2006, Inf. Manag..

[9]  Itai Ivtzan,et al.  Putting the ‘app’ in Happiness: A Randomised Controlled Trial of a Smartphone-Based Mindfulness Intervention to Enhance Wellbeing , 2016 .

[10]  B. Fredrickson,et al.  Deconstructing Mindfulness and Constructing Mental Health: Understanding Mindfulness and its Mechanisms of Action , 2010 .

[11]  J. Kabat-Zinn,et al.  Full catastrophe living : how to cope with stress, pain and illness using mindfulness meditation , 2004 .

[12]  F. Didonna Clinical handbook of mindfulness , 2009 .

[13]  Alan E. Kazdin,et al.  Novel Models for Delivering Mental Health Services and Reducing the Burdens of Mental Illness , 2013 .

[14]  Henepola Gunaratana Mindfulness in Plain English , 1992 .

[15]  Guillaume Fortin,et al.  Mindfulness-based therapy: a comprehensive meta-analysis. , 2013, Clinical psychology review.

[16]  A. Haines,et al.  The Effectiveness of Mobile-Health Technology-Based Health Behaviour Change or Disease Management Interventions for Health Care Consumers: A Systematic Review , 2013, PLoS medicine.

[17]  P. Grossman,et al.  Mindfulness-based stress reduction and health benefits. A meta-analysis. , 2004, Journal of psychosomatic research.

[18]  T. L. Lewis,et al.  mHealth and Mobile Medical Apps: A Framework to Assess Risk and Promote Safer Use , 2014, Journal of medical Internet research.

[19]  Oksana Zelenko,et al.  Mobile App Rating Scale: A New Tool for Assessing the Quality of Health Mobile Apps , 2015, JMIR mHealth and uHealth.

[20]  Alessandro Serretti,et al.  Mindfulness based cognitive therapy for psychiatric disorders: A systematic review and meta-analysis , 2011, Psychiatry Research.

[21]  Sulin Ba,et al.  Digital health communities: The effect of their motivation mechanisms , 2013, Decis. Support Syst..

[22]  G. Parker,et al.  Mobile mental health: Review of the emerging field and proof of concept study , 2011, Journal of mental health.

[23]  Conor Farrington,et al.  mHealth and global mental health: still waiting for the mH2 wedding? , 2014, Globalization and Health.

[24]  P. Dobkin,et al.  Cultivating mindfulness in health care professionals: a review of empirical studies of mindfulness-based stress reduction (MBSR). , 2009, Complementary therapies in clinical practice.

[25]  I. Hickie,et al.  The internet as a setting for mental health service utilisation by young people , 2010, The Medical journal of Australia.

[26]  Brian L. Thompson,et al.  Everyday mindfulness and mindfulness meditation: Overlapping constructs or not? , 2007 .

[27]  Scott R. Bishop,et al.  What Do We Really Know About Mindfulness-Based Stress Reduction? , 2002, Psychosomatic medicine.

[28]  Shian-Ling Keng,et al.  Effects of mindfulness on psychological health: a review of empirical studies. , 2011, Clinical psychology review.

[29]  J. Kabat-Zinn,et al.  Mindfulness-Based Interventions in Context: Past, Present, and Future , 2003 .

[30]  Molly E Waring,et al.  Evaluating and selecting mobile health apps: strategies for healthcare providers and healthcare organizations , 2014, Translational behavioral medicine.

[31]  H. Christensen,et al.  Using e‐health applications to deliver new mental health services , 2010, The Medical journal of Australia.

[32]  Farshad Maghnati,et al.  Exploring the Relationship between Experiential Value and Usage Attitude towards Mobile Apps among the Smartphone Users , 2013 .

[33]  J. Compson,et al.  Traditional and Contemporary Mindfulness: Finding the Middle Path in the Tangle of Concerns , 2015 .

[34]  E. Langer,et al.  Matters of mind: Mindfulness/mindlessness in perspective , 1992, Consciousness and Cognition.