Loneliness, Mindfulness Skills, Program Engagement, Psychological Distress, Usability Satisfaction
Conditions
Keywords
young adults, mental health, well-being, mindfulness skills, psychological distress, stress management
Brief summary
This study will evaluate engagement, usability, and psychological outcomes associated with participation in smartphone-based stress management or mindfulness training program among young adults. The study will compare multiple versions of a digital training program delivered through the Equa mobile application. Participants will be individually randomized to one of several app-based training programs using a stratified randomization procedure. Each program consists of guided daily lessons completed over a 14-day period and is designed to support stress management and well-being through structured skill development activities. Primary objectives include evaluating user satisfaction and usability of the digital platform and assessing changes in mindfulness-related skills and mental distress over time. Participants will: Complete surveys assessing demographics and psychological well-being at baseline, post-intervention, and one-month follow-up. Complete a 14-day smartphone-delivered training program consisting of guided lessons while physiological data are collected using wearable sensors. Some participants may receive additional in-app features designed to support personalized learning or engagement with training lessons. Some participants will complete brief questionnaires before and after selected lessons to assess short-term changes associated with lesson participation.
Detailed description
Investigators will recruit young adults to participate in a study examining usability, engagement, and psychological outcomes associated with smartphone-based stress management or mindfulness training programs. Participants will be informed that the study examines physiological responses during guided digital training lessons. At study entry, participants will complete an online survey assessing demographics, prior meditation and stress-management experience, and psychological well-being. Participants will complete similar questionnaires at post-intervention and one-month follow-up, including measures of user satisfaction and usability of the digital training platform using standardized instruments (e.g., System Usability Scale and Mobile App Rating Scale). Participants will be individually randomized to one of several 14-day app-based training programs delivered through the Equa platform. During training lessons, physiological data (e.g., motion-derived signals) will be collected using smartphone sensors to characterize physiological responses associated with lesson participation. Some participants may receive additional in-app features designed to provide personalized information or feedback related to lesson engagement or training progress. These features are delivered automatically through the application following lesson completion. Physiological and questionnaire measures will allow investigators to evaluate usability, engagement, and changes in mindfulness-related skills and psychological well-being associated with participation in the training programs.
Interventions
BEHAVIORALEqua
Participants will be randomly assigned to a 14-unit smartphone meditation program group that involves completing a 2-10 minute daily guided practice on their phones. Participants complete 14 units of mindfulness meditation curriculum that consists of learning and practicing techniques to improve concentration, sensory clarity, and equanimity (Equa meditation app). Physiological measures will be tracked throughout the duration of lessons.
BEHAVIORALFeature-Enhanced Equa Training Program
Participants will be randomly assigned to complete a 14-unit smartphone-delivered guided training program consisting of brief daily lessons lasting approximately 2-10 minutes. Lessons are delivered through the Equa mobile application and focus on the development and practice of mindfulness skills designed to support concentration, awareness, and emotional well-being. Physiological data will be collected during lesson participation using smartphone sensors to characterize participant responses during guided activities. This program version includes additional in-app features designed to provide personalized visual information following lesson completion.
BEHAVIORALStress Management Training
The CC program, called R\&R, is a well matched and previously validated digital stress management training. R\&R program lessons will focus on the development of three coping effectiveness skills: (a) thoughtful reflection; (b) reappraisal and reframing past and anticipated stressful events; and (c) problem solving, such as analyzing and solving personal problems.
Sponsors
Equa Health
Worcester Polytechnic Institute
National Institute of Mental Health (NIMH)
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
BASIC_SCIENCE
Masking
DOUBLE (Investigator, Outcomes Assessor)
Masking description
A psychometrician and statistician on our team who will remain blind to participant study condition during data collection and analysis. All study investigators/staff will be blinded to condition assignment until randomization occurs; at this time only the participant and the project manager will be aware of participant's study condition. All other study personnel will remain blinded and conduct all remaining study assessments.
Intervention model description
Investigators will evaluate whether differences in digital training program features are associated with changes in user satisfaction, engagement, and psychological outcomes. Participants will be individually randomized using a stratified 2:2:1 allocation sequence to one of several matched 14-day app-based training programs delivered through the Equa platform. Programs are comparable in branding, lesson length, platform navigation, and user experience, and include guided daily lessons focused on stress management and well-being skill development. During lesson participation, physiological data will be collected using smartphone sensors to characterize participant responses during training activities. Some program versions include additional in-app features designed to provide personalized information or feedback following lesson completion. Comparisons across program versions will evaluate usability, engagement, and changes in psychological well-being.
Eligibility
Sex/Gender
ALL
Age
18 Years to 30 Years
Healthy volunteers
No
Inclusion criteria
* Ages 18-30 years of Age * Fluent in English * Psychological distress * Interested in completing smartphone guided training sessions remotely for 14 days * Willing and able to wear physiological monitoring equipment * Willing to be randomized to one of three conditions * Located in the United States
Exclusion criteria
* Currently pregnant * Current or previous diagnosis with psychosis or schizophrenia
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Equa Program Engagement | Throughout the 21 day training period | In order to evaluate differential engagement over the 21 day training period, we will sum total lessons (out of 14) and total minutes of training across lessons as primary outcome variables. One-way ANOVAs will compare conditions at post-treatment on each of these two engagement outcomes. ANOVA provides a simple and compelling tool but we will extend ANOVA results using survival analysis on lessons completed to detect training condition differences in the time points at which engagement significantly drops off. |
| Symptoms of Depression | From baseline to 6 weeks after (1-month follow-up) | Mental distress will be measured over the past two weeks using the PHQ-8 to measure depression. The PHQ-8 allows participants respond to a questionnaire asking about how often they have been bothered by any of the listed problems over the last 2 weeks. Zero is equivalent to not at all and 3 indicates nearly every day. |
| Loneliness | From baseline to 6 weeks after (1-month follow-up) | Loneliness will be measured using the UCLA 3-item Loneliness Scale. The UCLA Loneliness Scale allows participants indicate how often they feel the way described in each of the 3 statements using a 4-point scale that ranges from 1 never to 4 always. The scoring is continuous. |
| Anxiety | From baseline to 6 weeks after (1-month follow-up) | Mental distress will be measured over the past two weeks using the GAD-7 to measure anxiety. The GAD-7 allows participants to respond to a questionnaire asking about how often they have been bothered by any of the listed problems over the last 2 weeks. Zero is equivalent to not at all and 3 indicates nearly every day. |
| Perceived Stress | From baseline to 6 weeks after (1-month follow-up) | Mental distress will be measured over the past month using the Perceived Stress Scale to measure stress. The Perceived Stress Scale measures the degree to which situations in one's life are appraised as stressful during the last month. Zero is equivalent to never and 4 indicates very often. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| User Satisfaction | From enrollment to the end of treatment at up to week 6 | At post-treatment and follow-up, participants will complete measures of Equa user satisfaction using the 10-item SUS (and as a secondary user satisfaction measure, the 20-item MARS). Participants respond to the usability of a system by indicating the degree to which they agree or disagree with 10 statements using a 5-point scale that ranges from 1=strongly disagree to 5= strongly agree. |
| Mean trait mindfulness as assessed by the Toronto Mindfulness Scale-Trait | From enrollment to the end of treatment at up to week 6 | Participants respond to a questionnaire asking to what degree they agree with statements regarding curiosity and decentering. Zero is equivalent to not at all and four indicates very much. The sum of the items is taken for each of the two different aspects of mindfulness the TMS trait measures. A higher score indicates greater mindfulness and a lower score indicates lower mindfulness. |
| State Trait Mindfulness Scores | Throughout the intervention (up to 3 weeks) | State mindfulness will be measured using two items from the Toronto Mindfulness Scale State (one from curiosity and one from decentering) following lessons within the app. The survey will use a 5-point Likert scale, 0 equal to not at all, and 4 equal to very much. |
| Self-efficacy for practicing meditation or stress management | From baseline to 6-weeks (1 month follow-up) | To test our mechanistic account, we will also evaluate self-efficacy for practicing meditation or stress management by creating an adapted measure from the Self-Efficacy for Exercise Scale. |
| Concentration, Sensory Clarity, and Equanimity | From enrollment to the end of treatment at up to week 6 | Participants rate their average level of concentration, sensory clarity, and equanimity in every day life over the past two weeks. Scale: 1 (Low, Poor) - 5 (High, Excellent) |
| Physical Pain | From baseline to 6 weeks after (1-month follow-up) | Physical pain felt in the past 2-weeks will be captured using "From 0 no pain to 10 worst pain imaginable, how much pain, on average, have you experienced?". Zero is equivalent to no pain and 10 indicates the worst possible pain. |
| Extended Equa Program Engagement | Throughout the 51 day intervention plus follow-up period. | In order to evaluate differential engagement over the 21 day training period plus the 31 day follow up period, we will sum total lessons (out of 14) and total minutes of training across lessons as secondary outcome variables. One-way ANOVAs will compare conditions at end of follow-up period on each of these two engagement outcomes. ANOVA provides a simple and compelling tool but we will extend ANOVA results using survival analysis on lessons completed to detect training condition differences in the time points at which engagement significantly drops off. |
Countries
United States
Contacts
CONTACTJuliette A Bonchonsky, BA
CONTACTDavid Creswell, Ph.D.
PRINCIPAL_INVESTIGATORDavid Creswell, Ph.D.
Equa Health
Outcome results
None listed