A Feasibility study the of 5Minutes4Myself wellness program app; acceptability, usage and impact on caregivers of children with autism's stress and mindfulness (Preprint)

Abstract

Caregivers of children with autism experience more stress and poorer health outcomes than parents of children with other developmental disabilities or typical development. Yet due to their time intensive caregiving these parents may be unable to attend community-based wellness programming. Innovative programs using interventions delivered in part via mobile applications, that allow caregivers’ participation when and where convenient to them may provide greater access to wellness promotion that leads to stress reduction. The 5Minutes4Myself program was developed with and for caregivers of children with autism; caregivers requested a modification of the initial version of the 5Minutes4Myself program to include a mobile app to delivered mindfulness meditations. This feasibility study examines the usability and use of this newly-designed 5Minutes4Myself companion mobile application and its impact on caregivers’ stress.

This preliminary study assesses: 1) the acceptability of the 5Minutes4Myself wellness app; 2) caregivers’ adoption/use of app delivered caregiver-tailored meditations; and 3) assess the impact of caregiver-tailored mindfulness meditations on caregivers’ levels of mindfulness and perceived stress.

Before and after participation in the 5Minutes4Myself wellness program using the newly designed app with mindfulness content, participants completed the Perceived Stress Scale (PSS) and Five Facet Mindfulness Questionnaire (FFMQ). Weekly usage of app-delivered meditations was collected electronically over 4 months’ time; and app quality and functionality were rated via the Modified System Usability Scale (MSUS). Analyses describe participants’ frequency of use of app-delivered meditations, ratings of app quality and functionality, and investigated changes in participants’ stress and mindfulness post-intervention.

Overall participants rated the app 76.7, indicating above average usability, and on average completed 10.9 minutes of mindfulness meditations per week. Related samples t-test found that group PSS and FFMQ pre-/post-intervention mean scores were not significantly different. However, a visualization of pre- and post-PSS and mindfulness scores suggested there was a group of responders who had decreased stress with increased mindfulness. This was confirmed via an individual change analysis. The effect size of the FFMQ scores suggest there may be treatment effects with a larger sample. A hierarchical multiple regression analysis examined the degree mindfulness impacted perceived stress; 20% of variance in participants’ perceived stress could be attributed to increases in self-rated mindfulness (p = .04) when controlling for pre-intervention stress levels.

Caregivers found the app highly usable and on average used low-dose levels of mindfulness meditations (~10 minutes/week). While not all caregivers had reduced stress post-participation, there was a responder group that benefitted from app-delivered “low-dose” mindfulness, with reductions in self-rated stress closer to population-based levels. Given our findings, increased mindfulness appeared essential for caregivers’ stress reduction.

Trial registration: 2015-1004