{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T11:09:25Z","timestamp":1789729765737,"version":"4.0.1"},"reference-count":86,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Mhealth Uhealth"],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Meditation apps are increasingly popular but face significant engagement challenges. Most research does not meaningfully capture real-world engagement or associated user characteristics. Engagement patterns and reasons for engaging or disengaging remain relatively unexplored.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n This study aimed to examine Medito app user engagement over the first 30 days after download and how intended use, demographics, user traits, and mental health factors predict engagement.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n A prospective online survey was conducted among 668 Medito app users from 30 countries. Factors assessed included demographic factors (eg, age, sex, education, employment, and country of residence); user factors (eg, number of apps tried, hours of experience, meditation-related adverse events, expectations, readiness to change, and personality); and mental health factors (eg, quality of life, perceived stress, psychological distress, well-being, and satisfaction with life). Detailed engagement data included days of use, meditations completed, app opens, and minutes of use obtained via a data-sharing agreement with Medito. Minutes of use in the first 30 days after download served as the main outcome variable.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n App use was relatively low, with 50% (328\/655) of users engaging for a total of 16 minutes or less in the first month after download (median 16.11, IQR 0\u201074.51 min). Fewer than 20% (124\/655, 18.86%) of users continued using the app after 14 days. Intended use (mean 418.56, SD 472.5) significantly exceeded actual use (mean 70.02\n ,<\/jats:italic>\n SD 176.81;\n d<\/jats:italic>\n =0.710;\n P<\/jats:italic>\n <.001). In terms of user factors, expectation match (ie, extent to which outcomes from the app matched initial expectations; \u03c1\n =<\/jats:italic>\n 0.214;\n P<\/jats:italic>\n =.002), expectations for anxiety (\u03c1=0.102;\n P<\/jats:italic>\n =.01), expectations for attention or focus (\u03c1=0.091;\n P<\/jats:italic>\n =.02), and conscientiousness (\u03c1=0.124;\n P<\/jats:italic>\n =.003) were associated with higher engagement. Neuroticism was negatively associated with engagement (\u03c1=\u22120.103;\n P<\/jats:italic>\n =.010). For mental health factors, satisfaction with life (\u03c1=0.123;\n P<\/jats:italic>\n =.002) and well-being (\u03c1=0.135,\n P<\/jats:italic>\n <.001) were associated with higher engagement, while perceived stress (\u03c1=\u22120.107;\n P<\/jats:italic>\n =.007), psychological distress (\u03c1=\u22120.138,\n P<\/jats:italic>\n <.001)\n ,<\/jats:italic>\n and quality of life (\u03c1=\u22120.100;\n P<\/jats:italic>\n =.011) were associated with lower engagement. Only readiness to change showed unique associations with higher engagement (semipartial\n r<\/jats:italic>\n =0.156;\n P<\/jats:italic>\n <.001). Regression analysis showed that only perceived stress predicted higher engagement (\u03b2=.020;\n P<\/jats:italic>\n =.04). However, when mental health was included as a single component, expectations for anxiety (\u03b2=.015;\n P<\/jats:italic>\n =.049) and readiness to change (\u03b2=.011;\n P<\/jats:italic>\n =.048) predicted greater engagement, and mental ill health predicted lower engagement (\u03b2=\u22120.008;\n P<\/jats:italic>\n =.049).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Overall, app engagement is generally quite low. Acute stress motivated meditation app use, while chronic stress disrupted it. Engagement is optimal when experiences match expectations and users are prepared to make a change. More transparency is necessary in the promotion of meditation apps so that users have a realistic understanding of the time and effort required to achieve benefits.<\/jats:p>\n <\/jats:sec>","DOI":"10.2196\/79366","type":"journal-article","created":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T00:05:07Z","timestamp":1772064307000},"page":"e79366-e79366","source":"Crossref","is-referenced-by-count":2,"title":["Real-World Meditation App Engagement: Longitudinal Study of the Medito Meditation App"],"prefix":"10.2196","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-8558-8857","authenticated-orcid":false,"given":"Julia","family":"Adams","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7838-126X","authenticated-orcid":false,"given":"Jonathan","family":"Davies","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2527-3350","authenticated-orcid":false,"given":"Prai","family":"Wattanatakulchat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4108-5341","authenticated-orcid":false,"given":"Julieta","family":"Galante","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7407-8730","authenticated-orcid":false,"given":"Simon","family":"D'Alfonso","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7371-6550","authenticated-orcid":false,"given":"Nicholas T","family":"Van Dam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2026,6,8]]},"reference":[{"issue":"2","key":"R1","doi-asserted-by":"publisher","first-page":"137","DOI":"10.1016\/S2215-0366(21)00395-3","article-title":"Global, regional, and national burden of 12 mental disorders in 204 countries and territories, 1990\u20132019: a systematic analysis for the Global Burden of Disease Study 2019","volume":"9","author":"Collaborators","journal-title":"Lancet Psychiatry"},{"issue":"6","key":"R2","doi-asserted-by":"publisher","first-page":"444","DOI":"10.1192\/bjp.bp.112.112318","article-title":"Disease burden and mental health system capacity: WHO Atlas study of 117 low- and middle-income countries","volume":"201","author":"McBain","journal-title":"Br J Psychiatry"},{"issue":"2","key":"R3","doi-asserted-by":"publisher","first-page":"87","DOI":"10.1038\/s44159-021-00003-1","article-title":"An overview of and recommendations for more accessible digital mental health services","volume":"1","author":"Lattie","journal-title":"Nat Rev Psychol"},{"issue":"9","key":"R4","doi-asserted-by":"publisher","DOI":"10.2196\/14567","article-title":"Objective user engagement with mental health apps: systematic search and panel-based usage analysis","volume":"21","author":"Baumel","journal-title":"J Med Internet Res"},{"key":"R5","doi-asserted-by":"publisher","DOI":"10.57010\/CAXS3076","article-title":"Too much or not enough of a good thing? 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