Exploring the relationship between usage of a digital mindfulness app and perceived stress among caregivers of persons living with dementia

OBJECTIVES: Mindfulness digital health interventions (DHIs) can support stress management among caregivers of persons living with dementia (PLWD), yet few studies investigate dose‐response relationships. METHOD: This study is a secondary analysis of a feasibility randomized controlled trial of Healthy Minds Program for Caregivers (HMP‐C), a mindfulness DHI to reduce stress among caregivers of PLWD, against an educational podcast control (Wellness App [WA]). Ninety participants were randomized to HMP‐C (n = 46) or WA (n = 44). Participants were instructed to use HMP‐C or WA 10 min per day. This study characterizes the association between app usage and baseline‐post‐test reductions in perceived stress (PSS‐10) using linear regression. RESULTS: Participants used both apps for 70 min (median) per week (IQR = 55; Range= 4‐179). Every 10 min of HMP‐C usage per week was significantly associated with a decrease in perceived stress by 0.7 (CI = ‐1.2, 0.3). Higher baseline stress and anxiety were related to lowered usage in active control (p ≤ 0.05), but not in HMP‐C. CONCLUSION: These findings suggest that HMP‐C usage is related to reductions in perceived stress and robust to potential usage barriers. Future research is needed to identify the optimal dose of DHI mindfulness, which balances feasibility and targeted outcomes.