Efficacy of the Mindfulness Meditation Mobile App “Calm” to Reduce Stress Among College Students: Randomized Controlled Trial (Preprint)

BACKGROUND College 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. OBJECTIVE We 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. METHODS This 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. RESULTS A 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. CONCLUSIONS Calm 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. CLINICALTRIAL ClinicalTrials.gov NCT03891810; https://clinicaltrials.gov/ct2/show/NCT03891810

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Randomised controlled trial of the new short-term online emotion focused training for self-compassion and self-protection in a nonclinical sample

Current Psychology ◽

10.1007/s12144-018-9933-4 ◽

2018 ◽

Vol 40 (1) ◽

pp. 333-343 ◽

Cited By ~ 1

Author(s):

Júlia Halamová ◽

Martin Kanovský ◽

Karolína Varšová ◽

Nuriye Kupeli

Keyword(s):

Mental Health Professionals ◽

Controlled Trial ◽

Intervention Group ◽

Clinical Population ◽

Control Group ◽

Short Term ◽

Post Intervention ◽

Self Compassion ◽

Self Protection

AbstractThe Emotion Focused Training for Self-Compassion and Self-Protection (EFT-SCP) is an intervention developed to increase skills of self-compassion and protective anger with the aim to decrease self-criticism. This novel intervention was developed on the basis of the latest findings on self-criticism from Emotion-focused therapy and previous programs cultivating compassion (namely Compassion Mind Training and Mindful Self-Compassion Program). According to existing research, simply cultivating self-compassion is not always sufficient in reducing self-criticism. Therefore, the EFT-SCP was designed to build self-compassion whilst developing protective anger to combat self-criticism. Our goal was to investigate the efficacy of this new, short-term, online EFT-SCP program in a non-clinical population. A randomized control trial was conducted with pre- and post-intervention measurements and two-month follow-up of self-compassion and self-criticism/reassurance. Convenience sampling was used to recruit participants through a snowballing technique on social media. A total of 123 participants were randomly allocated to the EFT-SCP intervention or to a control condition. The intervention group were instructed through emails to complete an EFT-SCP task every day for 14 consecutive days. The control group did not complete any tasks. Out of 123 participants, 31 from intervention group and 20 from control group completed all measurements. There was a significant effect of the EFT-SCP on increasing self-compassion and self-reassurance scores as reported at two-month follow-up. The EFT-SCP was also effective at reducing self-uncompassionate responding and self-criticism (specifically Hated self) with changes evident at two months post-intervention. These findings are encouraging and suggest that interventions designed to enhance self-compassion and decrease self-criticism can be delivered to broader populations without the direct contact with mental health professionals.

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A Randomized Control Trial of a Brief Self-Compassion Intervention for Perfectionism, Anxiety, Depression, and Body Image

Frontiers in Psychology ◽

10.3389/fpsyg.2021.751294 ◽

2021 ◽

Vol 12 ◽

Author(s):

Vivian Woodfin ◽

Helge Molde ◽

Ingrid Dundas ◽

Per-Einar Binder

Keyword(s):

Body Image ◽

Repeated Measures ◽

Intervention Group ◽

Control Group ◽

Wait List ◽

Wait List Control ◽

Self Compassion ◽

Maladaptive Perfectionism ◽

Anxiety Depression ◽

Adaptive Perfectionism

Objective: Due to a rise in perfectionistic tendencies and growing concerns about the increase in mental health conditions among students this study aimed to examine the effects of a brief intervention in self-compassion on maladaptive perfectionism, anxiety, depression, and body image.Methods: The intervention consisted of four seminars and a silent half-day retreat with short lectures and relevant experiential practices from Mindful Self-Compassion (MSC) and Mindfulness Based Stress Reduction (MBSR). This randomized wait-list control trial was pre-registered at Clinicaltrials.gov (ID: NCT03453437, Unique Protocol ID: UiBMSC2018). University students were randomly assigned to the intervention group and wait-list control group and filled out surveys weekly. A repeated measures analysis of variance (ANOVA) was used to compare the groups pre- and post-treatment. Mixed level modeling was used to analyze changes in all outcome measures over time.Results: Eighty-nine participants completed the intervention. Results of the ANOVA showed significant post-intervention reductions in maladaptive perfectionistic tendencies and symptoms of depression and anxiety, in addition to increased self-compassion and improved body image in the intervention group as compared to the wait-list group. Mixed level modeling showed statistically significant changes in self-compassion, maladaptive perfectionism, adaptive perfectionism, anxiety, and depression but not body image. Only the mixed level modeling showed small but significant changes to adaptive perfectionism, also called strivings. Implications of different changes to maladaptive perfectionism than adaptive perfectionism are discussed.

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The Rural Clinical School of Western Australia Mindfulness Project

International Journal of Whole Person Care ◽

10.26443/ijwpc.v7i1.237 ◽

2020 ◽

Vol 7 (1) ◽

pp. 51

Author(s):

Sarah Moore ◽

Rita Barbour ◽

Hanh Ngo ◽

Craig Sinclair ◽

Richard Chambers ◽

...

Keyword(s):

Medical Students ◽

Training Program ◽

Perceived Stress ◽

Western Australia ◽

Mindfulness Meditation ◽

Mindfulness Training ◽

Face To Face ◽

Self Compassion ◽

Professional Impact

Background: Medical students experience high levels of stress during their training. Literature suggests that mindfulness can reduce stress and increase self-compassion levels in medical students. Most mindfulness training programs are delivered face-to-face and require significant time commitments, which can be difficult to achieve for rurally-based students with heavy academic workloads.Aim: We sought to determine the feasibility and effectiveness of a mindfulness training program delivered online to medical students at a Rural Clinical School.Methods: An 8-week online training program was delivered to third year medical students at the Rural Clinical School of Western Australia in 2016.Using quantitative-qualitative mixed-methods approach, we measured the frequency and duration of the participants’ mindfulness meditation practice, and assessed changes in their perceived stress, self-compassion and compassion levels, as well as personal and professional attitudes and behaviours.Results: 47 students were recruited to the study. 50% of participants were practising at least weekly by the end of the 8-week program, and 32% of responding students reported practising at least weekly 6 months following the intervention. There was a statistically significant reduction in participants’ perceived stress levels and a significant increase in self-compassion at 6 month follow up. Participants reported qualitative insights about the personal and professional impact of mindfulness meditation training as well as barriers to practice.

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Do Mindfulness Meditation Apps Decrease Stress in College Students? (Preprint)

10.2196/preprints.11197 ◽

2018 ◽

Author(s):

Kaitana, M. Dahle ◽

Audrey Hooper ◽

Aaron, J Cheung ◽

Ashley Young ◽

AliceAnn Crandall

Keyword(s):

College Students ◽

Undergraduate Students ◽

Perceived Stress ◽

Stress Reduction ◽

Mindfulness Meditation ◽

Mobile App ◽

Stress Change ◽

Stress Levels ◽

Study Interval ◽

The Impact

BACKGROUND Mindfulness meditation apps have become popular self-help technology tools to manage stress and improve mental health. Mindfulness meditation classes have been associated with decreased stress levels, but the impact of mindfulness meditation apps at reducing stress levels among college students has not been thoroughly examined. OBJECTIVE The objective of this study was to assess how the frequency and duration of mindfulness meditation app use during a two-week interval affected self-reported stress levels. The study analyzed how minutes and days of app use during a 14-day period impacted change in self-reported stress compared to baseline. METHODS A longitudinal sample of 85 undergraduate students were recruited to the study through fliers and in-class announcements. Eligibility requirements ensured that participants had no prior or limited (< 2 hours) experience with mindfulness meditation. Pre- and post-assessment survey questions included perceived stress levels and the frequency and duration of meditation app use during the two-week study interval. Multiple linear regression analyses were used to assess whether there was a relationship between app use and change in stress. RESULTS The mean Perceived Stress Scale scores at time 1 and time 2 significantly differed (P < .001; t = 3.47), such that there was a significant decrease in self-reported stress over the study interval. The number of minutes of mindfulness mobile app use over the 14 days of the study was not predictive of stress change (P = .14), but the number of days practicing mindfulness was a significant predictor of stress change (P = .03). CONCLUSIONS Consistently practicing mindfulness may be more predictive of stress reduction than length of practice, as evidenced by a significant relationship between change in stress and number of days practicing mindfulness meditation, but not number of minutes practiced.

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Determining the feasibility and effectiveness of brief online mindfulness training for rural medical students: a pilot study

10.21203/rs.2.13728/v2 ◽

2020 ◽

Author(s):

Sarah Jane Moore ◽

Rita Barbour ◽

Hanh Ngo ◽

Craig Sinclair ◽

Richard Chambers ◽

...

Keyword(s):

Medical Students ◽

Training Program ◽

Perceived Stress ◽

Mindfulness Meditation ◽

Online Training ◽

Preliminary Evidence ◽

Mindfulness Training ◽

Self Compassion ◽

Rigorous Research

Abstract Background We sought to determine the feasibility and effectiveness of a mindfulness training program, delivered online to medical students at a Rural Clinical School.Methods An 8-week online training program was delivered to penultimate-year medical students at an Australian Rural Clinical School during 2016. Using a mixed methods approach, we measured the frequency and duration of participants’ mindfulness meditation practice, and assessed changes in their perceived stress, self-compassion and compassion levels, as well as personal and professional attitudes and behaviours.Results 47 participants were recruited to the study. 50% of participants were practising mindfulness meditation at least weekly by the end of the 8-week program, and 32% reported practising at least weekly 4 months following completion of the intervention. There was a statistically significant reduction in participants’ perceived stress levels and a significant increase in self-compassion at 4-month follow-up. Participants reported insights about the personal and professional impact of mindfulness meditation training as well as barriers to practice.Conclusions The results provide preliminary evidence that online training in mindfulness meditation can be associated with reduced stress and increased self-compassion in rural medical students. More rigorous research is required to establish concrete measures of feasibility of a mindfulness meditation program.

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A Mobile App to Increase Fruit and Vegetable Acceptance Among Finnish and Polish Preschoolers: Randomized Trial

JMIR mhealth and uhealth ◽

10.2196/30352 ◽

2022 ◽

Vol 10 (1) ◽

pp. e30352

Author(s):

Henna Vepsäläinen ◽

Essi Skaffari ◽

Katarzyna Wojtkowska ◽

Julia Barlińska ◽

Satu Kinnunen ◽

...

Keyword(s):

Randomized Study ◽

Self Regulation ◽

Intervention Group ◽

Mobile App ◽

Analysis Of Covariance ◽

Control Group ◽

Fruit And Vegetable ◽

Multiprofessional Team ◽

Food Education

Background Early childhood education and care (ECEC) centers are ideal venues for food education. As smartphones and tablets are becoming increasingly popular in ECEC centers, technology can be used to deliver such pedagogical content. Evidence suggests that video games can affect fruit and vegetable (FV) consumption among 9- to 12-year-old children, but studies among preschoolers are scarce. Objective This paper describes the development of the Mole’s Veggie Adventures app and its effectiveness in increasing FV acceptance among Finnish and Polish preschoolers aged 3 to 6 years. Methods A multiprofessional team created an app to be used in ECEC centers in groups of 3 to 10 children. The app aimed to increase vegetable acceptance, and it was built using elements that support the development of self-regulation and social skills. Altogether, 7 Finnish and 4 Polish ECEC centers participated in the study. Before randomization, parents reported background factors and their children’s willingness to taste different FVs. The ECEC professionals in the intervention arm were instructed to use the app at least once a week during the 3- to 4-week intervention period. The main outcomes in this unblinded, cluster-randomized study were FV acceptance and relative FV acceptance. The first was calculated as a sum variable describing the children’s willingness to taste 25 different FVs, the second as FV acceptance divided by the number of FVs served. We used analysis of covariance to compare the FV acceptance and relative FV acceptance scores between the intervention and control groups at follow-up. Results A total of 221 children were included in the analysis. At follow-up, the intervention group (115/221, 52%) had higher FV acceptance scores (baseline adjusted difference of mean 7.22; 95% CI 1.41-13.03) than the control group (106/221, 48%). The intervention effect was parallel for relative FV acceptance scores (baseline adjusted difference of mean 0.28; 95% CI 0.05-0.52). Conclusions The Mole’s Veggie Adventures app has the potential to increase FV acceptance among preschoolers and can be a valuable tool in supporting food education in ECEC centers. Furthermore, the app can be feasibly incorporated into preschool routines in countries with different educational environments. Trial Registration ClinicalTrials.gov NCT05173311; https://tinyurl.com/4vfbh283

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Effectiveness of an Internet- and App-Based Intervention for College Students With Elevated Stress: Randomized Controlled Trial (Preprint)

10.2196/preprints.9293 ◽

2017 ◽

Cited By ~ 1

Author(s):

Mathias Harrer ◽

Sophia Helen Adam ◽

Rebecca Jessica Fleischmann ◽

Harald Baumeister ◽

Randy Auerbach ◽

...

Keyword(s):

Mental Health ◽

College Students ◽

Controlled Trial ◽

Intervention Group ◽

Control Group ◽

Waitlist Control ◽

Symptoms Of Depression ◽

Randomized Controlled ◽

Waitlist Control Group

BACKGROUND Mental health problems are highly prevalent among college students. Most students with poor mental health, however, do not receive professional help. Internet-based self-help formats may increase the utilization of treatment. OBJECTIVE The aim of this randomized controlled trial was to evaluate the efficacy of an internet-based, app-supported stress management intervention for college students. METHODS College students (n=150) with elevated levels of stress (Perceived Stress Scale 4-item version, PSS-4 ≥8) were randomly assigned to either an internet- and mobile-based stress intervention group with feedback on demand or a waitlist control group. Self-report data were assessed at baseline, posttreatment (7 weeks), and 3-month follow-up. The primary outcome was perceived stress posttreatment (PSS-4). Secondary outcomes included mental health outcomes, modifiable risk and protective factors, and college-related outcomes. Subgroup analyses were conducted in students with clinically relevant symptoms of depression (Center for Epidemiological Studies’ Depression Scale >17). RESULTS A total of 106 participants (76.8%) indicated that they were first-time help-seekers, and 77.3% (intervention group: 58/75; waitlist control group: 58/75) showed clinically relevant depressive symptoms at baseline. Findings indicated significant effects of the intervention compared with the waitlist control group for stress (d=0.69; 95% CI 0.36-1.02), anxiety (d=0.76; 95% CI 0.43-1.09), depression (d=0.63; 95% CI 0.30-0.96), college-related productivity (d=0.33; 95% CI 0.01-0.65), academic work impairment (d=0.34; 95% CI 0.01-0.66), and other outcomes after 7 weeks (posttreatment). Response rates for stress symptoms were significantly higher for the intervention group (69%, 52/75) compared with the waitlist control group (35%, 26/75, P<.001; number needed to treat=2.89, 95% CI 2.01-5.08) at posttest (7 weeks). Effects were sustained at 3-month follow-up, and similar findings emerged in students with symptoms of depression. CONCLUSIONS Internet- and mobile-based interventions could be an effective and cost-effective approach to reduce consequences of college-related stress and might potentially attract students with clinically relevant depression who would not otherwise seek help. CLINICALTRIAL German Clinical Trial Register DRKS00010212; http://www.drks.de/drks_web/navigate.do? navigationId=trial.HTML&TRIAL_ID=DRKS00010212 (Archived by WebCite at http://www.webcitation.org/6w55Ewhjd)

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Efficacy of a Smartphone App Intervention for Reducing Caregiver Stress: Randomized Controlled Trial (Preprint)

10.2196/preprints.17541 ◽

2019 ◽

Author(s):

Matthew Fuller-Tyszkiewicz ◽

Ben Richardson ◽

Keriann Little ◽

Samantha Teague ◽

Linda Hartley-Clark ◽

...

Keyword(s):

Active Control ◽

Psychological Intervention ◽

Controlled Trial ◽

Intervention Group ◽

Well Being ◽

Self Esteem ◽

Mobile App ◽

Control Group ◽

Self Monitoring

BACKGROUND Caregivers play a pivotal role in maintaining an economically viable health care system, yet they are characterized by low levels of psychological well-being and consistently report unmet needs for psychological support. Mobile app–based (mobile health [mHealth]) interventions present a novel approach to both reducing stress and improving well-being. OBJECTIVE This study aims to evaluate the effectiveness of a self-guided mobile app–based psychological intervention for people providing care to family or friends with a physical or mental disability. METHODS In a randomized, single-blind, controlled trial, 183 caregivers recruited through the web were randomly allocated to either an intervention (n=73) or active control (n=110) condition. The intervention app contained treatment modules combining daily self-monitoring with third-wave (mindfulness-based) cognitive-behavioral therapies, whereas the active control app contained only self-monitoring features. Both programs were completed over a 5-week period. It was hypothesized that intervention app exposure would be associated with decreases in depression, anxiety, and stress, and increases in well-being, self-esteem, optimism, primary and secondary control, and social support. Outcomes were assessed at baseline, postintervention, and 3-4 months postintervention. App quality was also assessed. RESULTS In total, 25% (18/73) of the intervention participants were lost to follow-up at 3 months, and 30.9% (34/110) of the participants from the wait-list control group dropped out before the postintervention survey. The intervention group experienced reductions in stress (b=−2.07; P=.04) and depressive symptoms (b=−1.36; P=.05) from baseline to postintervention. These changes were further enhanced from postintervention to follow-up, with the intervention group continuing to report lower levels of depression (b=−1.82; P=.03) and higher levels of emotional well-being (b=6.13; P<.001), optimism (b=0.78; P=.007), self-esteem (b=−0.84; P=.005), support from family (b=2.15; P=.001), support from significant others (b=2.66; P<.001), and subjective well-being (b=4.82; P<.001). On average, participants completed 2.5 (SD 1.05) out of 5 treatment modules. The overall quality of the app was also rated highly, with a mean score of 3.94 out of a maximum score of 5 (SD 0.58). CONCLUSIONS This study demonstrates that mHealth psychological interventions are an effective treatment option for caregivers experiencing high levels of stress. Recommendations for improving mHealth interventions for caregivers include offering flexibility and customization in the treatment design. CLINICALTRIAL Australian New Zealand Clinical Trial Registry ACTRN12616000996460; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=371170

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Resilience, Insight, Self-Compassion, and Empowerment (RISE): A Randomized Controlled Trial of a Psychoeducational Group Program for Nurses

Journal of the American Psychiatric Nurses Association ◽

10.1177/10783903211033338 ◽

2021 ◽

pp. 107839032110333

Author(s):

Amanda T. Sawyer ◽

Amanda K. Bailey ◽

Jeanette F. Green ◽

Jingwei Sun ◽

Patricia Stearnes Robinson

Keyword(s):

Randomized Controlled Trial ◽

Perceived Stress ◽

Controlled Trial ◽

Intervention Group ◽

Well Being ◽

Psychoeducational Group ◽

Randomized Controlled ◽

Self Compassion ◽

Mind Set

Background: Nurses tend to be vulnerable to burnout and compassion fatigue due to constant workplace stressors. There is a need to provide advocacy, education, programming, and resources in the areas of positive coping and self-care to reduce burnout symptoms and promote well-being. RISE is an 8-week psychoeducational group intervention for nurses with four themes: resilience, insight, self-compassion, and empowerment. Objectives: This randomized controlled trial examined the effects of RISE on mental well-being. Methods: The sample included 75 registered nurses who work in a hospital-based setting. Outcomes included resilience, insight, self-compassion, empowerment, stress mind-set, perceived stress, and burnout. Independent-samples t tests were conducted to compare outcomes between intervention and wait-list control groups at baseline and 1-month follow-up, as well as at 3-month follow-up. Supplemental analyses included paired-samples t tests and linear mixed models to compare the outcomes of the intervention group participants at baseline to 1-month follow-up, as well as at 3-month and 6-month follow-ups. Results: Participants in the intervention group showed improved levels of insight (i.e., engagement in self-reflection), perceived stress, and burnout (i.e., emotional exhaustion) when compared with the control group and improved levels of resilience, self-compassion, stress mind-set, and perceived stress when compared with their baseline. Conclusions: This study informs how RISE affects nurse well-being and may be an effective intervention for reducing burnout and stress. This type of whole-person intervention can support nurses to improve their well-being and ability to cope amid the complex interplay of factors at the individual, unit, and organizational levels.

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A New Mental Health Mobile App for Well-Being and Stress Reduction in Working Women: Randomized Controlled Trial

Journal of Medical Internet Research ◽

10.2196/14269 ◽

2019 ◽

Vol 21 (11) ◽

pp. e14269 ◽

Cited By ~ 6

Author(s):

Cássia Canha Coelhoso ◽

Patricia Renovato Tobo ◽

Shirley Silva Lacerda ◽

Alex Heitor Lima ◽

Carla Regina Camara Barrichello ◽

...

Keyword(s):

Mental Health ◽

Repeated Measures ◽

Intervention Group ◽

Working Women ◽

Well Being ◽

Mobile App ◽

World Health ◽

Control Group ◽

Work Related

Background Although the availability and use of mobile mental health apps has grown exponentially in recent years, little data are available regarding their efficacy. Objective This study aimed to evaluate the effectiveness of an app developed to promote stress management and well-being among working women compared with a control app. Methods Female employees at a private hospital were invited to participate in the study via mailing lists and intranet ads. A total of 653 individuals self-enrolled through the website. Eligible participants were randomized between control (n=240) and intervention (n=250) groups. The well-being mobile app provides an 8-week program with 4 classes per week (including a brief theoretical portion and a 15-min guided practice). The active control app also provided 4 assessments per week that encouraged participants to self-observe how they were feeling for 20 min. We also used the app to conduct Web-based questionnaires (10-item Perceived Stress Scale and 5-item World Health Organization Well-Being Index) and ask specific questions to assess subjective levels of stress and well-being at baseline (t1), midintervention (t4=4 weeks after t1) and postintervention (t8=8 weeks after t1). Both apps were fully automated without any human involvement. Outcomes from the control and intervention conditions at the 3 time points were analyzed using a repeated measures analysis of variance. Results Among the randomized participants (n=490), 185 participants were excluded at the 4-week follow-up and another 79 at the 8-week follow-up because of noncompliance with the experimental protocol. Participants who did not complete t4 and t8 assessments were equally distributed between groups (t4: control group=34.6% [83/240] and intervention group=40.8% [102/250]; P=.16; t8: control group=29.9% [47/157] and intervention group=21.6% [32/148]; P=.10). Both groups showed a significant increase in general well-being as a function of time (F2,426=5.27; P=.006), but only the intervention group presented a significant increase in work-related well-being (F2,426=8.92; P<.001), as well as a significant reduction in work-related and overall stress (F2,426=5.50; P=.004 and F2,426=8.59; P<.001, respectively). Conclusions The well-being mobile app was effective in reducing employee stress and improving well-being. Trial Registration Clinicaltrials.gov NCT02637414; https://clinicaltrials.gov/ct2/show/NCT02637414.

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