Efficacy of the Mindfulness Meditation Mobile App "Calm" to Reduce Stress Among College Students: Randomized Controlled Trial
- PMID: 31237569
- PMCID: PMC6614998
- DOI: 10.2196/14273
Efficacy of the Mindfulness Meditation Mobile App "Calm" to Reduce Stress Among College Students: Randomized Controlled Trial
Abstract
Background: College students experience high levels of stress. Mindfulness meditation delivered via a mobile app may be an appealing, efficacious way to reduce stress in college students.
Objective: We aimed to test the initial efficacy and sustained effects of an 8-week mindfulness meditation mobile app-Calm-compared to a wait-list control on stress, mindfulness, and self-compassion in college students with elevated stress. We also explored the intervention's effect on health behaviors (ie, sleep disturbance, alcohol consumption [binge drinking], physical activity, and healthy eating [fruit and vegetable consumption]) and the feasibility and acceptability of the app.
Methods: This study was a randomized, wait-list, control trial with assessments at baseline, postintervention (8 weeks), and at follow-up (12 weeks). Participants were eligible if they were current full-time undergraduate students and (1) at least 18 years of age, (2) scored ≥14 points on the Perceived Stress Scale, (3) owned a smartphone, (4) were willing to download the Calm app, (5) were willing to be randomized, and (7) were able to read and understand English. Participants were asked to meditate using Calm at least 10 minutes per day. A P value ≤.05 was considered statistically significant.
Results: A total of 88 participants were included in the analysis. The mean age (SD) was 20.41 (2.31) years for the intervention group and 21.85 (6.3) years for the control group. There were significant differences in all outcomes (stress, mindfulness, and self-compassion) between the intervention and control groups after adjustment for covariates postintervention (all P<.04). These effects persisted at follow-up (all P<.03), except for the nonreacting subscale of mindfulness (P=.08). There was a significant interaction between group and time factors in perceived stress (P=.002), mindfulness (P<.001), and self-compassion (P<.001). Bonferroni posthoc tests showed significant within-group mean differences for perceived stress in the intervention group (P<.001), while there were no significant within-group mean differences in the control group (all P>.19). Similar results were found for mindfulness and self-compassion. Effect sizes ranged from moderate (0.59) to large (1.24) across all outcomes. A significant group×time interaction in models of sleep disturbance was found, but no significant effects were found for other health behaviors. The majority of students in the intervention group reported that Calm was helpful to reduce stress and stated they would use Calm in the future. The majority were satisfied using Calm and likely to recommend it to other college students. The intervention group participated in meditation for an average of 38 minutes/week during the intervention and 20 minutes/week during follow-up.
Conclusions: Calm is an effective modality to deliver mindfulness meditation in order to reduce stress and improve mindfulness and self-compassion in stressed college students. Our findings provide important information that can be applied to the design of future studies or mental health resources in university programs.
Trial registration: ClinicalTrials.gov NCT03891810; https://clinicaltrials.gov/ct2/show/NCT03891810.
Keywords: meditation; mental health; mindfulness; mobile phone; smartphone; technology.
©Jennifer Huberty, Jeni Green, Christine Glissmann, Linda Larkey, Megan Puzia, Chong Lee. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 25.06.2019.
Conflict of interest statement
Conflicts of Interest: JH is currently the Director of Science at Calm (although she was engaged in this role almost 1 year after the design, collection of data, and analysis of results of the study presented in this paper). None of the authors declare any conflicts of interest.
Figures
Similar articles
-
Efficacy and Conflicts of Interest in Randomized Controlled Trials Evaluating Headspace and Calm Apps: Systematic Review.JMIR Ment Health. 2022 Sep 20;9(9):e40924. doi: 10.2196/40924. JMIR Ment Health. 2022. PMID: 36125880 Free PMC article. Review.
-
A Mobile App for Stress Management in Middle-Aged Men and Women (Calm): Feasibility Randomized Controlled Trial.JMIR Form Res. 2022 May 24;6(5):e30294. doi: 10.2196/30294. JMIR Form Res. 2022. PMID: 34989677 Free PMC article.
-
Testing a mindfulness meditation mobile app for the treatment of sleep-related symptoms in adults with sleep disturbance: A randomized controlled trial.PLoS One. 2021 Jan 7;16(1):e0244717. doi: 10.1371/journal.pone.0244717. eCollection 2021. PLoS One. 2021. PMID: 33411779 Free PMC article. Clinical Trial.
-
The Mindfulness App Trial for Weight, Weight-Related Behaviors, and Stress in University Students: Randomized Controlled Trial.JMIR Mhealth Uhealth. 2019 Apr 10;7(4):e12210. doi: 10.2196/12210. JMIR Mhealth Uhealth. 2019. PMID: 30969174 Free PMC article. Clinical Trial.
-
Meditation programs for psychological stress and well-being: a systematic review and meta-analysis.JAMA Intern Med. 2014 Mar;174(3):357-68. doi: 10.1001/jamainternmed.2013.13018. JAMA Intern Med. 2014. PMID: 24395196 Free PMC article. Review.
Cited by
-
Sleep Quality and Interoception Are Associated with Generalized Anxiety in Baccalaureate Nursing Students: A Cross-Sectional Study.Nurs Rep. 2024 May 13;14(2):1184-1192. doi: 10.3390/nursrep14020090. Nurs Rep. 2024. PMID: 38804423 Free PMC article.
-
Effectiveness of mindfulness-based interventions on the well-being of healthcare workers: a systematic review and meta-analysis.Gen Psychiatr. 2024 May 7;37(3):e101115. doi: 10.1136/gpsych-2023-101115. eCollection 2024. Gen Psychiatr. 2024. PMID: 38737894 Free PMC article.
-
Mobile apps to reduce depressive symptoms and alcohol use in youth: A systematic review and meta-analysis: A systematic review.Campbell Syst Rev. 2024 Apr 26;20(2):e1398. doi: 10.1002/cl2.1398. eCollection 2024 Jun. Campbell Syst Rev. 2024. PMID: 38680950 Free PMC article. Review.
-
The impact of mindfulness apps on psychological processes of change: a systematic review.Npj Ment Health Res. 2024 Mar 18;3(1):14. doi: 10.1038/s44184-023-00048-5. Npj Ment Health Res. 2024. PMID: 38609511 Free PMC article. Review.
-
An Artificial Intelligence Platform to Stratify the Risk of Experiencing Sleep Disturbance in University Students After Analyzing Psychological Health, Lifestyle, and Sports: A Multicenter Externally Validated Study.Psychol Res Behav Manag. 2024 Mar 13;17:1057-1071. doi: 10.2147/PRBM.S448698. eCollection 2024. Psychol Res Behav Manag. 2024. PMID: 38505352 Free PMC article.
References
-
- Pierceall EA, Keim MC. Stress and Coping Strategies Among Community College Students. Community College Journal of Research and Practice. 2007 Sep 06;31(9):703–712. doi: 10.1080/10668920600866579. - DOI
-
- Almojali AI, Almalki SA, Alothman AS, Masuadi EM, Alaqeel MK. The prevalence and association of stress with sleep quality among medical students. J Epidemiol Glob Health. 2017 Dec;7(3):169–174. doi: 10.1016/j.jegh.2017.04.005. https://linkinghub.elsevier.com/retrieve/pii/S2210-6006(17)30041-2 S2210-6006(17)30041-2 - DOI - PMC - PubMed
-
- American College Health Association. Hanover, MD: [2019-06-18]. American College Health Association-National College Health Assessment II: Spring 2018 Reference Group Executive Summary https://www.acha.org/documents/ncha/NCHA-II_Spring_2018_Reference_Group_....
-
- American Psychological Association. 2012. [2019-06-18]. Stress by Generation https://www.apa.org/news/press/releases/stress/2012/generations .
-
- Neely ME, Schallert DL, Mohammed SS, Roberts RM, Chen Y. Self-kindness when facing stress: The role of self-compassion, goal regulation, and support in college students’ well-being. Motiv Emot. 2009 Jan 6;33(1):88–97. doi: 10.1007/s11031-008-9119-8. - DOI
Publication types
MeSH terms
Associated data
LinkOut - more resources
Full Text Sources
Medical