Dataset Information

Characteristics and Usage Patterns Among 12,151 Paid Subscribers of the Calm Meditation App: Cross-Sectional Survey.

ABSTRACT: BACKGROUND:Meditation has become increasingly popular due to its health benefits; however, barriers to delivering meditation programs in traditional group-based formats limit the accessibility of these benefits. Smartphone-based meditation may increase the availability of these programs to larger, more diverse audiences; however, research on subscriber characteristics and usage patterns in meditation mobile apps is lacking. OBJECTIVE:This study aimed to describe the demographics, clinical characteristics, and usage patterns of a convenience sample of Calm subscribers and explore the relationship between self-reported app usage and changes in health, stress, and sleep. METHODS:Participants were 12,151 paying Calm subscribers (response rate=12.08%, 12,151/100,594) who completed an anonymous Web-based survey with 11 quantitative questions related to user engagement, reasons for starting Calm, and changes after using the app. Demographic characteristics, chronic health diagnoses, and sleep difficulties were also assessed. Chi-square tests were used to examine differences in app usage. Logistic regression models were used to examine demographic and health characteristics that may predict changes in health, stress, and sleep. RESULTS:Respondents were 18-96 years old (mean 48.57 [SD 13.79]), primarily female (79.94%, 8778/10,981), white (81.41%, 8959/11,005), and most reported a chronic health diagnosis (56.86%, 6289/11,061). Mental health diagnoses (41.13%, 4549/11,061) were more common than physical health diagnoses (32.19%, 3560/11,061). Most respondents (76.31%, 8684/11,360) reported difficulties falling or staying asleep. On average, respondents had been using Calm for 11.49 months (SD 10.49), and 60.03% (7281/12,129) used it 5 or more times per week. Meditations (used by 80.02%, 9497/11,841) and Sleep Stories (55.66%, 6591/11,841) were the most popular components. The frequency of using Calm was associated with incremental increases in the likelihood of noticing changes in mental health (?22=136.8; P<.001), physical health (?22=102.8; P<.001), stress (?22=128.1; P<.001), and sleep (?22=141.4; P<.001). Respondents who had used Calm longer were also more likely to notice changes in mental health (OR 1.06 [95% CI 1.05 to 1.06]), physical health (OR 1.01 [95% CI 1.01 to 1.02]), stress (OR 1.04 [95% CI 1.04 to 1.05]), and sleep (OR 1.004 [95% CI 1.00 to 1.01]). Subscribers with sleep difficulties used Calm more frequently (?82=11.5; P=.003), were more likely to use Sleep Stories (?12=1590.2; P<.001), and were more likely to notice changes in their physical health (?12=49.2; P<.001) and sleep (?12=2391.1; P<.001). CONCLUSIONS:Results highlight important demographic characteristics and usage patterns among a self-selected sample of Calm subscribers. Mental health concerns and sleep appear to be top reasons for downloading Calm. Sleep Stories and meditations are the most popular app components. The frequency of using Calm was associated with incremental changes in outcomes. Findings support future randomized controlled trials testing the efficacy of Calm for health, stress, and sleep. Studies should also explore strategies to attract a more diverse sample of subscribers.

SUBMITTER: Huberty J

PROVIDER: S-EPMC6858610 | biostudies-literature | 2019 Nov

REPOSITORIES: biostudies-literature

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Characteristics and Usage Patterns Among 12,151 Paid Subscribers of the Calm Meditation App: Cross-Sectional Survey.

Huberty Jennifer J Vranceanu Ana-Maria AM Carney Colleen C Breus Michael M Gordon Michael M Puzia Megan Elizabeth ME

JMIR mHealth and uHealth 20191103 11

<h4>Background</h4>Meditation has become increasingly popular due to its health benefits; however, barriers to delivering meditation programs in traditional group-based formats limit the accessibility of these benefits. Smartphone-based meditation may increase the availability of these programs to larger, more diverse audiences; however, research on subscriber characteristics and usage patterns in meditation mobile apps is lacking.<h4>Objective</h4>This study aimed to describe the demographics, ...[more]

PMID: 31682582

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Project description:BackgroundOver 30% of Americans report regular sleep disturbance, and consumers are increasingly seeking strategies to improve sleep. Self-guided mindfulness mobile apps may help individuals improve their sleep. Despite the recent proliferation of sleep content within commercially available mindfulness apps, there is little research on how consumers are using these apps for sleep.ObjectiveWe conducted a cross-sectional survey among subscribers to Calm, a popular, consumer-based, mindfulness-based meditation app, and described and compared how good sleepers, poor sleepers, and those with self-reported insomnia use the app for sleep.MethodsParticipants who were paying subscribers of Calm and had used a sleep component of Calm in the last 90 days were invited to complete an investigator-developed survey that included questions about sleep disturbance and the use of Calm for sleep. Based on self-reports of sleep disturbances and of insomnia diagnosis, participants were categorized as "good sleepers," "poor sleepers," or "those with insomnia diagnosis." Chi-square tests compared reasons for downloading the app and usage patterns across participants with and without sleep disturbance.ResultsThere was a total of 9868 survey respondents. Approximately 10% of participants (1008/9868, 10.21%) were good sleepers, 78% were poor sleepers (7565/9868, 77.66%), and 11% reported a diagnosis of insomnia (1039/9868, 10.53%). The sample was mostly White (8185/9797, 83.55%), non-Hispanic (8929/9423, 94.76%), and female (8166/9578, 85.26%). The most common reasons for sleep disturbances were racing thoughts (7084/8604, 82.33%), followed by stress or anxiety (6307/8604, 73.30%). Poor sleepers and those with insomnia were more likely than good sleepers to have downloaded Calm to improve sleep (χ22=1548.8, P<.001), reduce depression or anxiety (χ22=15.5, P<.001), or improve overall health (χ22=57.6, P<.001). Respondents with insomnia used Calm most often (mean 5.417 days/week, SD 1.936), followed by poor sleepers (mean 5.043 days/week, SD 2.027; F2=21.544, P<.001). The most common time to use Calm was while lying down to sleep (7607/9686, 78.54%), and bedtime use was more common among poor sleepers and those with insomnia (χ22=382.7, P<.001). Compared to good and poor sleepers, those with insomnia were more likely to use Calm after waking up at night (χ22=410.3, P<.001). Most participants tried to use Calm on a regular basis (5031/8597, 58.52%), but regular nighttime use was most common among those with insomnia (646/977, 66.1%), followed by poor sleepers (4040/6930, 58.30%; χ22=109.3, P<.001).ConclusionsOf the paying subscribers to Calm who have used one of the sleep components, approximately 90% have sleep difficulties, and 77% started using Calm primarily for sleep. These descriptive data point to areas of focus for continued refinement of app features and content, followed by prospective trials testing efficacy of consumer-based meditation mobile apps for improving sleep.

Project description:BACKGROUND:There is a need for tools to decrease cancer patients' and survivors' long-term symptom burden. Complementary strategies, such as meditation, can accompany pharmacologic therapy to improve symptoms. Although support programs with targeted content have wider reach, higher adherence, and greater impact, there are no consumer-based meditation apps designed specifically for cancer. OBJECTIVE:This study aimed to gather information to advise the development of a cancer-specific meditation app in a small convenience sample of cancer patients and survivors who currently use the Calm app. METHODS:Adult cancer patients and survivors who are Calm users (N=82) were recruited through the Daily Calm Facebook page. Participants completed a Web-based survey related to Calm app use and satisfaction, interest in and ideas for a cancer-specific Calm app, and demographic characteristics. Open-ended responses were inductively coded. RESULTS:Participants were aged between 18 and 72 years (mean 48.60 years, SD 15.20), mostly female (77/82, 94%), white (65/79, 82%), and non-Hispanic (70/75, 93%), and reported using Calm at least 5 times per week (49/82, 60%). Although rates of satisfaction with current Calm components were high (65/82, 79%; and 51/81, 63%), only 49% (40/82) of participants used guided meditations that they felt specifically helped with their cancer-related symptoms and survivorship, and 40% (33/82) would prefer more cancer-related content, with guided meditations for cancer-specific anxieties (eg, fear of recurrence; n=15) and coping with strong emotions (n=12) being the most common suggestions. A majority of participants (51/82, 62%) reported that they would be interested in becoming a member of a Calm cancer community (eg, in-app discussion boards: 41/46, 89%; and social media communities: 35/42, 83%). Almost half of the participants (37/82, 45%) reported that they would benefit from features that tracked symptoms in concurrence with app usage, but respondents were divided on whether this information should be shared with health care providers through the app (49/82, 60% would share). CONCLUSIONS:Responses suggest ways in which the current Calm app could be adapted to better fit cancer patients' and survivors' needs and preferences, including adding more cancer-specific content, increasing the amount of content focusing on coping with strong emotions, developing communities for Calm users who are cancer patients and survivors, and including features that track cancer-related symptoms. Given differences in opinions about which features were desirable or would be useful, there is a clear need for future cancer-specific apps to be customizable (eg, ability to turn different features on or off). Although future research should address these topics in larger, more diverse samples, these data will serve as a starting point for the development of cancer-specific meditation app and provide a framework for evaluating their effects.

Project description:BackgroundContact tracing apps are considered useful means to monitor SARS-CoV-2 infections during the off-peak stages of the COVID-19 pandemic. Their effectiveness is, however, dependent on the uptake of such COVID-19 apps.ObjectiveWe examined the role of individuals' general health status in their willingness to use a COVID-19 tracing app as well as the roles of socioeconomic characteristics and COVID-19 proximity.MethodsWe drew data from the WageIndicator Foundation Living and Working in Coronavirus Times survey. The survey collected data on labor market status as well as the potential confounders of the relationship between general health and COVID-19 tracing app usage, such as sociodemographics and regular smartphone usage data. The survey also contained information that allowed us to examine the role of COVID-19 proximity, such as whether an individual has contracted SARS-CoV-2, whether an individual has family members and colleagues with COVID-19, and whether an individual exhibits COVID-19 pandemic-induced depressive and anxiety symptoms. We selected data that were collected in Spain, Italy, Germany, and the Netherlands from individuals aged between 18 and 70 years (N=4504). Logistic regressions were used to measure individuals' willingness to use a COVID-19 tracing app.ResultsWe found that the influence that socioeconomic factors have on COVID-19 tracing app usage varied dramatically between the four countries, although individuals experiencing forms of not being employed (ie, recent job loss and inactivity) consistently had a lower willingness to use a contact tracing app (effect size: 24.6%) compared to that of employees (effect size: 33.4%; P<.001). Among the selected COVID-19 proximity indicators, having a close family member with SARS-CoV-2 infection was associated with higher contact tracing app usage (effect size: 36.3% vs 27.1%; P<.001). After accounting for these proximity factors and the country-based variations therein, we found that having a poorer general health status was significantly associated with a much higher likelihood of contact tracing app usage; compared to a self-reported "very good" health status (estimated probability of contact tracing app use: 29.6%), the "good" (estimated probability: +4.6%; 95% CI 1.2%-8.1%) and "fair or bad" (estimated probability: +6.3%; 95% CI 2.3%-10.3%) health statuses were associated with a markedly higher willingness to use a COVID-19 tracing app.ConclusionsCurrent public health policies aim to promote the use of smartphone-based contact tracing apps during the off-peak periods of the COVID-19 pandemic. Campaigns that emphasize the health benefits of COVID-19 tracing apps may contribute the most to the uptake of such apps. Public health campaigns that rely on digital platforms would also benefit from seriously considering the country-specific distribution of privacy concerns.

Project description:BackgroundSmartphone fitness apps are considered promising tools for promoting physical activity and health. However, it is unclear which user-perceived factors and app features encourage users to download apps with the intention of being physically active.ObjectiveBuilding on the second version of the Unified Theory of Acceptance and Use of Technology, this study aims to examine the association of the seven determinants of the second version of the Unified Theory of Acceptance and Use of Technology with the app usage intentions of the individuals and their behavioral intentions of being physically active as well as the moderating effects of different smartphone fitness app features (ie, education, motivation, and gamification related) and individual differences (ie, age, gender, and experience) on these intentions.MethodsData from 839 US residents who reported having used at least one smartphone fitness app were collected via a web-based survey. A confirmatory factor analysis was performed, and path modeling was used to test the hypotheses and explore the influence of moderators on structural relationships.ResultsThe determinants explain 76% of the variance in the behavioral intention to use fitness apps. Habit (β=.42; P<.001), performance expectancy (β=.36; P<.001), facilitating conditions (β=.15; P<.001), price value (β=.13; P<.001), and effort expectancy (β=.09; P=.04) were positively related to behavioral intention to use fitness apps, whereas social influence and hedonic motivation were nonsignificant predictors. Behavioral intentions to use fitness apps were positively related to intentions of being physically active (β=.12; P<.001; R2=0.02). Education-related app features moderated the association between performance expectancy and habit and app usage intentions; motivation-related features moderated the association of performance expectancy, facilitating conditions, and habit with usage intentions; and gamification-related features moderated the association between hedonic motivation and usage intentions. Age moderated the association between effort expectancy and usage intentions, and gender moderated the association between performance expectancy and habit and usage intentions. User experience was a nonsignificant moderator. Follow-up tests were used to describe the nature of significant interaction effects.ConclusionsThis study identifies the drivers of the use of fitness apps. Smartphone app features should be designed to increase the likelihood of app usage, and hence physical activity, by supporting users in achieving their goals and facilitating habit formation. Target group-specific preferences for education-, motivation-, and gamification-related app features, as well as age and gender differences, should be considered. Performance expectancy had a high predictive power for intended usage for male (vs female) users who appreciated motivation-related features. Thus, apps targeting these user groups should focus on goal achievement-related features (eg, goal setting and monitoring). Future research could examine the mechanisms of these moderation effects and their long-term influence on physical activity.

Project description:BackgroundCollege students experience high levels of stress. Mindfulness meditation delivered via a mobile app may be an appealing, efficacious way to reduce stress in college students.ObjectiveWe aimed to test the initial efficacy and sustained effects of an 8-week mindfulness meditation mobile app-Calm-compared to a wait-list control on stress, mindfulness, and self-compassion in college students with elevated stress. We also explored the intervention's effect on health behaviors (ie, sleep disturbance, alcohol consumption [binge drinking], physical activity, and healthy eating [fruit and vegetable consumption]) and the feasibility and acceptability of the app.MethodsThis study was a randomized, wait-list, control trial with assessments at baseline, postintervention (8 weeks), and at follow-up (12 weeks). Participants were eligible if they were current full-time undergraduate students and (1) at least 18 years of age, (2) scored ≥14 points on the Perceived Stress Scale, (3) owned a smartphone, (4) were willing to download the Calm app, (5) were willing to be randomized, and (7) were able to read and understand English. Participants were asked to meditate using Calm at least 10 minutes per day. A P value ≤.05 was considered statistically significant.ResultsA total of 88 participants were included in the analysis. The mean age (SD) was 20.41 (2.31) years for the intervention group and 21.85 (6.3) years for the control group. There were significant differences in all outcomes (stress, mindfulness, and self-compassion) between the intervention and control groups after adjustment for covariates postintervention (all P<.04). These effects persisted at follow-up (all P<.03), except for the nonreacting subscale of mindfulness (P=.08). There was a significant interaction between group and time factors in perceived stress (P=.002), mindfulness (P<.001), and self-compassion (P<.001). Bonferroni posthoc tests showed significant within-group mean differences for perceived stress in the intervention group (P<.001), while there were no significant within-group mean differences in the control group (all P>.19). Similar results were found for mindfulness and self-compassion. Effect sizes ranged from moderate (0.59) to large (1.24) across all outcomes. A significant group×time interaction in models of sleep disturbance was found, but no significant effects were found for other health behaviors. The majority of students in the intervention group reported that Calm was helpful to reduce stress and stated they would use Calm in the future. The majority were satisfied using Calm and likely to recommend it to other college students. The intervention group participated in meditation for an average of 38 minutes/week during the intervention and 20 minutes/week during follow-up.ConclusionsCalm is an effective modality to deliver mindfulness meditation in order to reduce stress and improve mindfulness and self-compassion in stressed college students. Our findings provide important information that can be applied to the design of future studies or mental health resources in university programs.Trial registrationClinicalTrials.gov NCT03891810; https://clinicaltrials.gov/ct2/show/NCT03891810.

Project description:BACKGROUND:The use of paid social media advertising for targeted study recruitment is an effective strategy in health research and evaluation, specifically to reach diverse youth participants. Although the literature adequately describes the utility of Facebook in recruitment, limited information exists for social media platforms that are more popular with youth, specifically Instagram and Snapchat. OBJECTIVE:This paper outlines a paid advertising approach using Instagram, Snapchat, and Facebook to evaluate a statewide youth marijuana prevention campaign. The objective of this study was to compare recruitment metrics across Instagram, Snapchat, and Facebook for two surveys documenting youth knowledge, attitudes, and behaviors related to retail marijuana in Colorado post legalization. In addition, the study assessed the feasibility of using Instagram and Snapchat as effective additions to Facebook for youth study recruitment. METHODS:A social media recruitment strategy was used to conduct two cross-sectional surveys of youth, aged 13 to 20 years, in Colorado. Geographically targeted ads across 3 social media platforms encouraged the completion of a Web-based self-administered survey. Ad Words and Snap Ads were used to deploy and manage advertising campaigns, including ad design, placement, and analysis. Ad costs and recruitment metrics (ie, impressions, link clicks, and conversion rates) were calculated across the three social media platforms. RESULTS:Over two 1-month periods, 763,613 youth were reached (ie, impressions), 6089 of them clicked survey links (ie, clicks), and 828 eligible youth completed surveys about knowledge, attitudes, and behaviors related to retail marijuana. Instagram converted 36.13% (803/2222) of impressions to clicks (ie, conversion rate) in the first survey and 0.87% (864/98982) in the second survey. Snapchat generated the most impressions and link clicks, but it did so with the lowest conversion rate for both surveys, with a 1.40% (1600/114,200) conversion rate in the first survey and a 0.36% (1818/504700) conversion rate in the second survey. Facebook maintained a consistent conversion rate of roughly 2% across both surveys, despite reductions in budget for the second survey. The cost-per-click ranged between US $0.25 and $0.37 across the three platforms, with Snapchat as both the most cost-effective platform in the first survey and the most expensive platform in the second survey. CONCLUSIONS:Recruitment and enrollment outcomes indicate the use of Instagram and Snapchat, in addition to Facebook, may be a modern, useful, and cost-effective approach to reach youth with surveys on sensitive health topics. As the use of Facebook declines among youth, the use of more popular social media platforms can augment study recruitment for health research and evaluation efforts.

Project description:Adolescence can be a fertile time for relationship issues, with interpersonal conflict being a risk factor for poor mental health. Mobile app interventions may have a significant appeal to young people in assisting with relationship distress. However, currently available apps have not been formally evaluated. Youths' perspectives on engaging with mobile technology to assist with relationships are also unknown.This study aimed to examine adolescents' attitudes toward the concept of a mobile phone app for relationship help and support, and whether they would be likely to use such an intervention.A cross-sectional Web survey consisting of 42 questions, including 13 free responses, was delivered. The proposed app, including character vignettes, was presented, and participants were asked to indicate whether they had experienced the same relationship issues, whether their peers would relate to the issues, and how helpful they found the proposed advice. Participants were also asked to provide their own suggestions for help, which were analyzed using thematic analyses.A total of 150 adolescents (aged 15 to 18) participated. Overall, 60.7% (91/150) were likely to use an app for relationship problems, and this was not associated with demographics or social support (all P values >.05). Likelihood of app usage was found to be influenced by perceived need for help, personal beliefs about app effectiveness, and whether the app is engaging and easy to use. Overall, adolescents were receptive of the proposed content with an average of 99.3% (149/150), rating the strategies provided as somewhat to very helpful.Adolescents were likely to use a mobile phone app for relationship support, and use was not influenced by gender, age, social support, or any other background characteristic. Instead, likely use was influenced by need, personal beliefs, usability, and the appropriateness of app content. App developers must address these factors if the app is to have a wide-scale uptake.

Project description:BackgroundTimely and effective contact tracing is an essential public health measure for curbing the transmission of COVID-19. App-based contact tracing has the potential to optimize the resources of overstretched public health departments. However, its efficiency is dependent on widespread adoption.ObjectiveThis study aimed to investigate the uptake of the Australian Government's COVIDSafe app among Australians and examine the reasons why some Australians have not downloaded the app.MethodsAn online national survey, with representative quotas for age and gender, was conducted between May 8 and May 11, 2020. Participants were excluded if they were a health care professional or had been tested for COVID-19.ResultsOf the 1802 potential participants contacted, 289 (16.0%) were excluded prior to completing the survey, 13 (0.7%) declined, and 1500 (83.2%) participated in the survey. Of the 1500 survey participants, 37.3% (n=560) had downloaded the COVIDSafe app, 18.7% (n=280) intended to do so, 27.7% (n=416) refused to do so, and 16.3% (n=244) were undecided. Equally proportioned reasons for not downloading the app included privacy (165/660, 25.0%) and technical concerns (159/660, 24.1%). Other reasons included the belief that social distancing was sufficient and the app was unnecessary (111/660, 16.8%), distrust in the government (73/660, 11.1%), and other miscellaneous responses (eg, apathy and following the decisions of others) (73/660, 11.1%). In addition, knowledge about COVIDSafe varied among participants, as some were confused about its purpose and capabilities.ConclusionsFor the COVIDSafe app to be accepted by the public and used correctly, public health messages need to address the concerns of citizens, specifically privacy, data storage, and technical capabilities. Understanding the specific barriers preventing the uptake of contact tracing apps provides the opportunity to design targeted communication strategies aimed at strengthening public health initiatives, such as downloading and correctly using contact tracing apps.

Project description:BackgroundFamilies experiencing high levels of psychological distress are considered a particularly vulnerable population for adverse effects on mental and physical health. Moreover, highly stressed individuals engage less in mental health promoting activities and show low stress management competencies. App-based stress interventions seem promising for the treatment and prevention of stress outcomes and might be a low-threshold solution.ObjectiveThe aim of this study was to identify the requirements for a tailored app to reduce stress in a cohort of highly stressed families that have low stress management skills.MethodsParents (n=1008; age: mean 47.7 years, SD 6.1; female: 599/1008, 59.7%) completed an extensive web-based survey and were subdivided into a target (stressed individuals with low stress competency) and nontarget group according to their reported stress level and stress management competencies. Group differences were analyzed using analysis of variance. In principal component analysis with Kaiser varimax rotation, personally defined stress management goals were grouped into components. Linear regression models were also calculated.ResultsA 3-factor solution cumulatively explained 56% of the variance in personally defined goals of interest for stress management with (1) active strategies (25.61% explained variance), (2) general competency (17.95% explained variance) and (3) passive strategies (12.45% explained variance). The groups differed in age (F1,978=27.67, P<.001), health index (F1,958=246.14, P<.001), personally defined general-competency goal (F1,958=94.16 P<.001), as well as "information acquisition" (F1,971=14.75, P<.001) and "need for stimulation" (F1,981=54.49, P<.001) personality traits. A regression model showed that for the active strategies goals of interest, only app feature information or instructional videos had a significant effect (P=.02). The general competency factor showed none, and the passive strategies factor showed significant effects for 2 app features-suggestions for planning possible activities with the family (P=.01) and diaries for documentation and development of strategies (P=.03).ConclusionsThe results of this survey study highlight the need to develop an app to increase stress management competencies that takes into consideration perceived stress level, stress management skills, personality, and personally defined goals of the user. The content of the app should be tailored to previously detected personality traits, especially selective information acquisition and low need for stimulation. Furthermore, personally defined stress management goals seem to affect interest in some features.

Dataset Information

Characteristics and Usage Patterns Among 12,151 Paid Subscribers of the Calm Meditation App: Cross-Sectional Survey.

Publications

Characteristics and Usage Patterns Among 12,151 Paid Subscribers of the Calm Meditation App: Cross-Sectional Survey.

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