title: Mindfulness-based mobile applications: literature review and analysis of current features.
abstract: BACKGROUND
  Interest in mindfulness has increased exponentially, particularly in the fields of psychology and medicine. The trait or state of mindfulness is significantly related to several indicators of psychological health, and mindfulness-based therapies are effective at preventing and treating many chronic diseases. Interest in mobile applications for health promotion and disease self-management is also growing. Despite the explosion of interest, research on both the design and potential uses of mindfulness-based mobile applications (MBMAs) is scarce.
  
  
  OBJECTIVE
  Our main objective was to study the features and functionalities of current MBMAs and compare them to current evidence-based literature in the health and clinical setting.
  
  
  METHODS
  We searched online vendor markets, scientific journal databases, and grey literature related to MBMAs. We included mobile applications that featured a mindfulness-based component related to training or daily practice of mindfulness techniques. We excluded opinion-based articles from the literature.
  
  
  RESULTS
  The literature search resulted in 11 eligible matches, two of which completely met our selection criteria-a pilot study designed to evaluate the feasibility of a MBMA to train the practice of "walking meditation," and an exploratory study of an application consisting of mood reporting scales and mindfulness-based mobile therapies. The online market search eventually analyzed 50 available MBMAs. Of these, 8% (4/50) did not work, thus we only gathered information about language, downloads, or prices. The most common operating system was Android. Of the analyzed apps, 30% (15/50) have both a free and paid version. MBMAs were devoted to daily meditation practice (27/46, 59%), mindfulness training (6/46, 13%), assessments or tests (5/46, 11%), attention focus (4/46, 9%), and mixed objectives (4/46, 9%). We found 108 different resources, of which the most used were reminders, alarms, or bells (21/108, 19.4%), statistics tools (17/108, 15.7%), audio tracks (15/108, 13.9%), and educational texts (11/108, 10.2%). Daily, weekly, monthly statistics, or reports were provided by 37% (17/46) of the apps. 28% (13/46) of them permitted access to a social network. No information about sensors was available. The analyzed applications seemed not to use any external sensor. English was the only language of 78% (39/50) of the apps, and only 8% (4/50) provided information in Spanish. 20% (9/46) of the apps have interfaces that are difficult to use. No specific apps exist for professionals or, at least, for both profiles (users and professionals). We did not find any evaluations of health outcomes resulting from the use of MBMAs.
  
  
  CONCLUSIONS
  While a wide selection of MBMAs seem to be available to interested people, this study still shows an almost complete lack of evidence supporting the usefulness of those applications. We found no randomized clinical trials evaluating the impact of these applications on mindfulness training or health indicators, and the potential for mobile mindfulness applications remains largely unexplored.
authors.affiliation: EduQTech R&D&I Group, Department of Electronics and Communications Engineering, Universidad Zaragoza, Teruel, Teruel, Spain.
authors.forename: Inmaculada
authors.initials: I
authors.lastname: Plaza
authors.forename: Marcelo Marcos Piva
authors.initials: MM
authors.lastname: Demarzo
authors.forename: Paola
authors.initials: P
authors.lastname: Herrera-Mercadal
authors.forename: Javier
authors.initials: J
authors.lastname: García-Campayo
keywords: evidence-based medicine; health informatics; mHealth; mindfulness; mobile health; personalized education; social networks
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