Background: The increasing demand for mental health care, a lack of mental health care providers, and unequal access to mental health care services have created a need for innovative approaches to mental health care. Digital device apps, including digital therapeutics, that provide recommendations and feedback for dealing with stress, depression, and other mental health issues can be used to adjust mood and ultimately show promise to help meet this demand. In addition, the recommendations delivered through such apps can also be tailored to an individual’s needs (ie, personalized) and thereby potentially provide greater benefits than traditional “one-size-fits-all” recommendations. Objective: This study aims to characterize individual transitions from one emotional state to another during the prolonged use of a digital app designed to provide a user with guided meditations based on their initial, potentially negative, emotional state. Understanding the factors that mediate such transitions can lead to improved recommendations for specific mindfulness and meditation interventions or activities (MMAs) provided in mental health apps. Methods: We analyzed data collected during the use of the Stop, Breathe & Think (SBT) mindfulness app. The SBT app prompts users to input their emotional state before and immediately after engaging with MMAs recommended by the app. Data were collected from more than 650,000 SBT users engaging in nearly 5 million MMAs. We limited the scope of our analysis to users with 10 or more MMA sessions that included at least 6 basal emotional state evaluations. Using clustering techniques, we grouped emotions recorded by individual users and then applied longitudinal mixed effect models to assess the associations between individual recommended MMAs and transitions from one group of emotions to another. Results: We found that basal emotional states have a strong influence on transitions from one emotional state to another after MMA engagement. We also found that different MMAs impact these transitions, and many were effective in eliciting a healthy transition but only under certain conditions. In addition, we observed gender and age effects on these transitions. Conclusions: We found that the initial emotional state of an SBT app user determines the type of SBT MMAs that will have a favorable effect on their transition from one emotional state to another. Our results have implications for the design and use of guided mental health recommendations for digital device apps.

中文翻译：

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长时间使用正念和冥想应用程序时表征情绪状态转变的现象：观察性研究

背景：对精神卫生保健的需求不断增加，缺乏精神卫生保健提供者，以及获得精神卫生保健服务的机会不平等，因此需要对精神卫生保健采取创新的方法。提供用于处理压力，抑郁和其他精神健康问题的建议和反馈的数字设备应用程序（包括数字疗法）可用于调整情绪，并最终显示出满足这一需求的希望。此外，通过此类应用程序提供的建议还可以根据个人需求（即个性化）进行定制，从而比传统的“千篇一律”建议具有更大的优势。客观的：这项研究旨在表征长时间使用数字应用程序时从一种情绪状态到另一种情绪状态的个体转变，该数字应用程序旨在根据用户最初的潜在负面情绪状态为他们提供指导性冥想。了解介导此类转变的因素可以导致针对心理健康应用程序中提供的特定正念和冥想干预或活动（MMA）的建议得到改进。方法：我们分析了使用Stop，Breathe＆Think（SBT）正念应用程序期间收集的数据。SBT应用程序提示用户在与该应用程序推荐的MMA接触之前和之后输入其情绪状态。数据是从65万SBT用户中收集的，这些用户参与了近500万个MMA。我们将分析的范围限制在具有10个或更多MMA会话（至少包含6个基础情绪状态评估）的用户。使用聚类技术，我们将各个用户记录的情绪进行分组，然后应用纵向混合效果模型来评估各个推荐的MMA以及从一组情绪到另一组情绪之间的关联。结果：我们发现，在MMA参与之后，基础情绪状态对从一种情绪状态过渡到另一种情绪状态具有很大的影响。我们还发现，不同的MMA会影响这些过渡，并且许多MMA仅在特定条件下才能有效引发健康过渡。此外，我们观察到性别和年龄对这些过渡的影响。结论：我们发现，SBT应用程序用户的初始情绪状态决定了SBT MMA的类型，这会对他们从一种情绪状态过渡到另一种情绪状态产生有利影响。我们的结果对数字设备应用程序的指导性心理健康建议的设计和使用具有影响。