A longitudinal, randomized and controlled study of app-delivered mindfulness in the workplace

Abstract

Background: Workplace mindfulness meditation programs are of great interest for improving employee wellbeing and job performance, fueled in part by the apparent effectiveness of mindfulness meditation as well as by the recent proliferation of mobile mindfulness applications (apps) that can be incorporated into a workplace setting. It is critical to examine the facilitators and barriers to engaging with app-delivered mindfulness in the workplace to understand how biological, psychological, and socio-demographic variables impact practice time. Methods: Using a longitudinal and randomized controlled design, we explored facilitators of and barriers to practicing app-delivered mindfulness in the workplace among predominately non-white call center employees. Mindfulness engagement was operationalized as practice time during a prescriptive study period as well as during the entire 1-year duration of the app subscription. In addition, we made preliminary estimates of the impact of app-delivered mindfulness, compared to wait-list open relaxation, on job performance, negative symptoms, well-being, and social connectedness. Results: Employee C-reactive protein levels were positively correlated with subsequent meditation practice time. Employees who reported wanting to use the app to manage stress were most likely to use it, and women practiced significantly more than men. No other psychological resources were significantly correlated with practice time. Employees randomized to mindfulness had a significant increase in self-reported mindfulness scores, but did not have significant improvements in any other psychological or performance domains. Conclusion: Together these data expand what is known about engagement with, and impact of, mindfulness on a population that is under-represented in the research on mindfulness meditation. As mindfulness proliferates beyond the biomedical contexts and populations in which it has been traditionally popular within modern Western contexts, it is crucial to examine its acceptability and gain an understanding of the personality and demographic variables that predict engagement. While it is clear from previous research that engagement with mindfulness varies based on demographic [18, 29] and individual differences [30], a challenge of interpreting these data is understanding causal mechanisms that render meditation accessible and acceptable to some populations and not to others. This is a particularly obfuscating challenge, since previous research points to logistical or practical barriers to meditation practice, including time commitments [28], and lack of access [18]. To overcome this challenge, the current study was designed to provide 1-year subscriptions to a popular mindfulness meditation app and to reduce logistic barriers by providing employees with a break to use the app. In addition, we examined the impact of app-delivered mindfulness on both self-reported and job performance outcomes. The study had two specific aims. First, we designed the study to examine facilitators of and barriers to practicing app-delivered mindfulness in the workplace. To address this aim, we used a biopsychosocial framework toward a holistic and whole-person approach to workplace wellness and lifestyle medicine [31, 32]. We tested the hypothesis that psychological resources and sociodemographic factors would predict engagement with the app. We also tested the hypothesis that biological factors would influence app use. Specifically, we examined whether inflammatory states or self-reported sleep disturbance predicted practice time, since previous research indicates that both of these variables are likely to impact the ability to engage in an intervention [33-35]. Second, we evaluated the impact of app-delivered mindfulness, compared to waitlist open relaxation, on job functioning, daily functioning, well-being, and social connectedness.