Digital Prompts to Increase Engagement With the Headspace App and for Stress Regulation Among Parents: Feasibility Study

BackgroundGiven the interrelated health of children and parents, strategies to promote stress regulation are critically important in the family context. However, the uptake of preventive mental health is limited among parents owing to competing family demands. Obj...

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Main Authors: Lisa Militello, Michael Sobolev, Fabian Okeke, Daniel A Adler, Inbal Nahum-Shani
Format: Article
Language:English
Published: JMIR Publications 2022-03-01
Series:JMIR Formative Research
Online Access:https://formative.jmir.org/2022/3/e30606
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author Lisa Militello
Michael Sobolev
Fabian Okeke
Daniel A Adler
Inbal Nahum-Shani
author_facet Lisa Militello
Michael Sobolev
Fabian Okeke
Daniel A Adler
Inbal Nahum-Shani
author_sort Lisa Militello
collection DOAJ
description BackgroundGiven the interrelated health of children and parents, strategies to promote stress regulation are critically important in the family context. However, the uptake of preventive mental health is limited among parents owing to competing family demands. ObjectiveIn this study, we aim to determine whether it is feasible and acceptable to randomize digital prompts designed to engage parents in real-time brief mindfulness activities guided by a commercially available app. MethodsWe conducted a 30-day pilot microrandomized trial among a sample of parents who used Android smartphones. Each day during a parent-specified time frame, participants had a 50% probability of receiving a prompt with a message encouraging them to engage in a mindfulness activity using a commercial app, Headspace. In the 24 hours following randomization, ecological momentary assessments and passively collected smartphone data were used to assess proximal engagement (yes or no) with the app and any mindfulness activity (with or without the app). These data were combined with baseline and exit surveys to determine feasibility and acceptability. ResultsOver 4 months, 83 interested parents were screened, 48 were eligible, 16 were enrolled, and 10 were successfully onboarded. Reasons for nonparticipation included technology barriers, privacy concerns, time constraints, or change of mind. In total, 80% (8/10) of parents who onboarded successfully completed all aspects of the intervention. While it is feasible to randomize prompt delivery, only 60% (6/10) of parents reported that the timing of prompts was helpful despite having control over the delivery window. Across the study period, we observed higher self-reported engagement with Headspace on days with prompts (31/62, 50% of days), as opposed to days without prompts (33/103, 32% of days). This pattern was consistent for most participants in this study (7/8, 87%). The time spent using the app on days with prompts (mean 566, SD 378 seconds) was descriptively higher than on days without prompts (mean 225, SD 276 seconds). App usage was highest during the first week and declined over each of the remaining 3 weeks. However, self-reported engagement in mindfulness activities without the app increased over time. Self-reported engagement with any mindfulness activity was similar on days with (40/62, 65% of days) and without (65/103, 63% of days) prompts. Participants found the Headspace app helpful (10/10, 100%) and would recommend the program to others (9/10, 90%). ConclusionsPreliminary findings suggest that parents are receptive to using mindfulness apps to support stress management, and prompts are likely to increase engagement with the app. However, we identified several implementation challenges in the current trial, specifically a need to optimize prompt timing and frequency as a strategy to engage users in preventive digital mental health.
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spelling doaj.art-261e9c51c252471b992d889ebd595b132023-08-28T21:06:51ZengJMIR PublicationsJMIR Formative Research2561-326X2022-03-0163e3060610.2196/30606Digital Prompts to Increase Engagement With the Headspace App and for Stress Regulation Among Parents: Feasibility StudyLisa Militellohttps://orcid.org/0000-0001-7827-1466Michael Sobolevhttps://orcid.org/0000-0002-8931-7682Fabian Okekehttps://orcid.org/0000-0002-8646-0301Daniel A Adlerhttps://orcid.org/0000-0003-3328-0312Inbal Nahum-Shanihttps://orcid.org/0000-0001-6138-9089 BackgroundGiven the interrelated health of children and parents, strategies to promote stress regulation are critically important in the family context. However, the uptake of preventive mental health is limited among parents owing to competing family demands. ObjectiveIn this study, we aim to determine whether it is feasible and acceptable to randomize digital prompts designed to engage parents in real-time brief mindfulness activities guided by a commercially available app. MethodsWe conducted a 30-day pilot microrandomized trial among a sample of parents who used Android smartphones. Each day during a parent-specified time frame, participants had a 50% probability of receiving a prompt with a message encouraging them to engage in a mindfulness activity using a commercial app, Headspace. In the 24 hours following randomization, ecological momentary assessments and passively collected smartphone data were used to assess proximal engagement (yes or no) with the app and any mindfulness activity (with or without the app). These data were combined with baseline and exit surveys to determine feasibility and acceptability. ResultsOver 4 months, 83 interested parents were screened, 48 were eligible, 16 were enrolled, and 10 were successfully onboarded. Reasons for nonparticipation included technology barriers, privacy concerns, time constraints, or change of mind. In total, 80% (8/10) of parents who onboarded successfully completed all aspects of the intervention. While it is feasible to randomize prompt delivery, only 60% (6/10) of parents reported that the timing of prompts was helpful despite having control over the delivery window. Across the study period, we observed higher self-reported engagement with Headspace on days with prompts (31/62, 50% of days), as opposed to days without prompts (33/103, 32% of days). This pattern was consistent for most participants in this study (7/8, 87%). The time spent using the app on days with prompts (mean 566, SD 378 seconds) was descriptively higher than on days without prompts (mean 225, SD 276 seconds). App usage was highest during the first week and declined over each of the remaining 3 weeks. However, self-reported engagement in mindfulness activities without the app increased over time. Self-reported engagement with any mindfulness activity was similar on days with (40/62, 65% of days) and without (65/103, 63% of days) prompts. Participants found the Headspace app helpful (10/10, 100%) and would recommend the program to others (9/10, 90%). ConclusionsPreliminary findings suggest that parents are receptive to using mindfulness apps to support stress management, and prompts are likely to increase engagement with the app. However, we identified several implementation challenges in the current trial, specifically a need to optimize prompt timing and frequency as a strategy to engage users in preventive digital mental health.https://formative.jmir.org/2022/3/e30606
spellingShingle Lisa Militello
Michael Sobolev
Fabian Okeke
Daniel A Adler
Inbal Nahum-Shani
Digital Prompts to Increase Engagement With the Headspace App and for Stress Regulation Among Parents: Feasibility Study
JMIR Formative Research
title Digital Prompts to Increase Engagement With the Headspace App and for Stress Regulation Among Parents: Feasibility Study
title_full Digital Prompts to Increase Engagement With the Headspace App and for Stress Regulation Among Parents: Feasibility Study
title_fullStr Digital Prompts to Increase Engagement With the Headspace App and for Stress Regulation Among Parents: Feasibility Study
title_full_unstemmed Digital Prompts to Increase Engagement With the Headspace App and for Stress Regulation Among Parents: Feasibility Study
title_short Digital Prompts to Increase Engagement With the Headspace App and for Stress Regulation Among Parents: Feasibility Study
title_sort digital prompts to increase engagement with the headspace app and for stress regulation among parents feasibility study
url https://formative.jmir.org/2022/3/e30606
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