Augmenting Virtual Mindfulness Group With a Mindfulness App in Integrated Primary Care: Development, Feasibility, and Acceptability

Abstract

As the body of support for the usefulness of mindfulness-based practices within therapeutic intervention has grown, so has demand. To increase access to this evidence-based care, skill-building groups as well as mobile apps that deliver mindfulness training have been developed. However, evaluations of app-augmented group mindfulness interventions are lacking. This pilot study developed and implemented a protocol augmenting a virtual Veterans Affairs–Compassionate Awareness Learning Module (VA-CALM) group with the Mindfulness Coach app in a Mid-Atlantic VA health system. The 6-week app-augmented group was implemented across four cycles (n = 18) within the system’s Integrated Primary Care setting. Qualitative feedback was collected and used to improve the integrative protocol iteratively across group cycles. Feedback indicated participants found the app supported skill growth and that the group context enhanced app engagement, while others found it difficult to navigate the app and build new habits. Quantitative outcomes indicated improvements in stress, health-related quality of life, and the mindfulness skill of nonreactivity. App usage among group members ranged from none to frequent. Groups in combination with apps may be a feasible and acceptable way to support mindfulness skill growth and application to daily life for some veterans. Further study should focus on patient-level factors that are relevant to engagement and efficacy of app-augmented protocols, as well as whether engagement predicts clinical improvement.