Digital Meditation to Target Employee Stress: A Randomized Clinical Trial

Abstract

Importance: Mindfulness meditation may improve well-being among employees; however, effects of digital meditation programs are poorly understood. Objective: To evaluate the effects of digital meditation vs a waiting list condition on general and work-specific stress and whether greater engagement in the intervention moderates these effects. Design, Setting, and Participants: This randomized clinical trial included a volunteer sample of adults (aged ≥18 years) employed at a large academic medical center who reported mild to moderate stress, had regular access to a web-connected device, and were fluent in English. Exclusion criteria included being a regular meditator. Participants were recruited from May 16, 2018, through September 28, 2019, and completed baseline, 8-week, and 4-month measures assessing stress, job strain, burnout, work engagement, mindfulness, depression, and anxiety. Data were analyzed from March 2023 to October 2024. Intervention: Participants were randomized 1:1 to a digital meditation program or the waiting list control condition. Participants in the intervention group were instructed to complete 10 minutes of meditation per day for 8 weeks. The control group was instructed to continue their normal activities and not add any meditation during the study period. Main Outcomes and Measures: The primary outcome measure was change in Perceived Stress Scale (PSS) score at 8 weeks. Secondary outcome measures included changes in job strain, measured as work effort-reward imbalance. Results: A total of 1458 participants (mean [SD] age, 35.54 [10.30] years; 1178 [80.80%] female) were included. Those randomized to meditation (n = 728) vs waiting list (n = 730) showed improvements in PSS (Cohen d , 0.85; 95% CI, 0.73-0.96) and in all secondary outcome measures (eg, job strain: Cohen d , 0.34; 95% CI, 0.23-0.46) at 8 weeks. These improvements were maintained at 4 months after randomization (PSS: Cohen d , 0.71; 95% CI, 0.59-0.84; job strain: Cohen d , 0.37; 95% CI, 0.25-0.50). Those using the app from 5 to 9.9 min/d vs less than 5 min/d showed greater reduction in stress (mean PSS score difference, −6.58; 95% CI, −7.44 to −5.73). Conclusions and Relevance: The findings suggest that a brief, digital mindfulness-based program is an easily accessible and scalable method for reducing perceptions of stress. Future work should seek to clarify mechanisms by which such interventions contribute to improvements in work-specific well-being. Trial Registration: ClinicalTrials.gov Identifier: NCT03527303