Is there an app for that?: an exploratory randomized controlled trial of app-based mindfulness training for women with breast cancer
Health apps are widely used and accepted by consumers. However, the clinical benefit of many commercially available health apps is unknown. The current project evaluated a commercially available mindfulness training app, Headspace®, with regard to quality of life (QOL), among women with breast cancer. App-based mindfulness training (AMT) intervention uptake, with respect to participants' health literacy, eHealth literacy, and perception of the app's usability, were also evaluated. Using a randomized controlled trial study design, QOL was evaluated among ( N = 95) women with a recent (< 5 years) breast cancer diagnosis. Participants were randomly assigned to 1) AMT or 2) waitlist control (WC). Participants assigned to AMT piloted the Headspace® app for 8-weeks and participants assigned to WC received the app at completion of 4-week follow-up. Participants completed web-based assessments at 4 observation points: baseline, week 5, week 9, and 4-week follow-up. Overall findings reveal higher QOL over time among participants assigned to AMT, compared to WC. Although the degree of change in mindfulness did not appear to be statistically significant, a post hoc analysis using a subset of the sample revealed detectable improvement in mindfulness among AMT compared to WC. Overall, participants' eHealth literacy, and perceived app usability were not associated with app utilization. Further, app usability did not appear to be associated with mindfulness at 4-week follow-up. Delivering mindfulness training using an app-based approach may be feasible for women with breast cancer. However, these findings may not extend to other mindfulness training apps. Additional research is needed to evaluate AMT in other settings, with a larger sample. Findings from this exploratory study may have implications for the delivery of future app-based interventions targeted toward this clinical population.