Smartphone Monitoring of Participants' Engagement With Home Practice During Mindfulness-Based Stress Reduction: Observational Study.

Background: Standardized mindfulness training courses involve significant at-home assignments of meditation practice. Participants' self-reported completion of these assignments has been correlated with treatment outcomes, but self-reported data are often incomplete and potentially biased. In addition, mindfulness teachers typically suggest that participants set aside a regular practice time, preferably in the morning, but the extent to which participants do this has not been empirically examined.

Objective: This study aimed to analyze patterns of participant engagement with home practice in a mindfulness-based stress reduction course.

Methods: We used a novel smartphone app to provide 25 participants with access to their daily practice assignments during the 8-week course. We analyzed data collected through our smartphone app to determine usage and listening patterns and performed analyses of the regularity and frequency of participant behavior.

Results: We found that participants listened to a median of 3 of the 6 practice sessions per week, and they did not typically set aside a regular daily practice time. Across weekdays, participants practiced most frequently in the morning, but there was considerable variation in participants' practice start times. On weekends, the peak practice time was in the evening.

Conclusions: We suggest that it is feasible to integrate a smartphone-monitoring approach into existing mindfulness interventions. High-frequency smartphone monitoring can provide insights into how and when participants complete their homework, information that is important in supporting treatment engagement.