Review and Evaluation of Mindfulness-Based iPhone Apps

Abstract

Background: There is growing evidence for the positive impact of mindfulness on wellbeing. Mindfulness-based mobile apps may have potential as an alternative delivery medium for training. While there are hundreds of such apps, there is little information on their quality.
Objective: This study aimed to conduct a systematic review of mindfulness-based iPhone mobile apps and to evaluate their quality using a recently-developed expert rating scale, the Mobile Application Rating Scale (MARS). It also aimed to describe features of selected high-quality mindfulness apps.
Methods: A search for “mindfulness” was conducted in iTunes and Google Apps Marketplace. Apps that provided mindfulness training and education were included. Those containing only reminders, timers or guided meditation tracks were excluded. An expert rater reviewed and rated app quality using the MARS engagement, functionality, visual aesthetics, information quality and subjective quality subscales. A second rater provided MARS ratings on 30% of the apps for inter-rater reliability purposes.
Results: The “mindfulness” search identified 700 apps. However, 94 were duplicates, 6 were not accessible and 40 were not in English. Of the remaining 560, 23 apps met inclusion criteria and were reviewed. The median MARS score was 3.2 (out of 5.0), which exceeded the minimum acceptable score (3.0). The Headspace app had the highest average score (4.0), followed by Smiling Mind (3.7), iMindfulness (3.5) and Mindfulness Daily (3.5). There was a high level of inter-rater reliability between the two MARS raters.
Conclusions: Though many apps claim to be mindfulness-related, most were guided meditation apps, timers, or reminders. Very few had high ratings on the MARS subscales of visual aesthetics, engagement, functionality or information quality. Little evidence is available on the efficacy of the apps in developing mindfulness.

Full text

Original Paper
Review and Evaluation of Mindfulness-Based iPhone Apps
Madhavan Mani, BTech, MSc (Applied Psychology); David J Kavanagh, PhD; Leanne Hides, PhD (Psych); Stoyan
R Stoyanov, MRes (Psych)
Institute of Health & Biomedical Innovation, School of Psychology and Counselling, Queensland University of Technology, Kelvin Grove, Australia
Corresponding Author:
Madhavan Mani, BTech, MSc (Applied Psychology)
Institute of Health & Biomedical Innovation
School of Psychology and Counselling
Queensland University of Technology
60 Musk Avenue
Kelvin Grove, 4059
Australia
Phone: 61 434190971
Fax: 61 731386030
Email: m.mani@qut.edu.au
Abstract
Background: There is growing evidence for the positive impact of mindfulness on wellbeing. Mindfulness-based mobile apps
may have potential as an alternative delivery medium for training. While there are hundreds of such apps, there is little information
on their quality.
Objective: This study aimed to conduct a systematic review of mindfulness-based iPhone mobile apps and to evaluate their
quality using a recently-developed expert rating scale, the Mobile Application Rating Scale (MARS). It also aimed to describe
features of selected high-quality mindfulness apps.
Methods: A search for “mindfulness” was conducted in iTunes and Google Apps Marketplace. Apps that provided mindfulness
training and education were included. Those containing only reminders, timers or guided meditation tracks were excluded. An
expert rater reviewed and rated app quality using the MARS engagement, functionality, visual aesthetics, information quality
and subjective quality subscales. A second rater provided MARS ratings on 30% of the apps for inter-rater reliability purposes.
Results: The “mindfulness” search identified 700 apps. However, 94 were duplicates, 6 were not accessible and 40 were not
in English. Of the remaining 560, 23 apps met inclusion criteria and were reviewed. The median MARS score was 3.2 (out of
5.0), which exceeded the minimum acceptable score (3.0). The Headspace app had the highest average score (4.0), followed by
Smiling Mind (3.7), iMindfulness (3.5) and Mindfulness Daily (3.5). There was a high level of inter-rater reliability between the
two MARS raters.
Conclusions: Though many apps claim to be mindfulness-related, most were guided meditation apps, timers, or reminders.
Very few had high ratings on the MARS subscales of visual aesthetics, engagement, functionality or information quality. Little
evidence is available on the efficacy of the apps in developing mindfulness.
(JMIR mHealth uHealth 2015;3(3):e82) doi:10.2196/mhealth.4328
KEYWORDS
mindfulness; mindfulness-based mobile apps; mobile health (mHealth); mental health
Introduction
Background
Mindfulness has grown in popularity in the last two decades,
and there is growing evidence for its positive impact on
well-being [1,2]. Many different perspectives of mindfulness
have evolved over this period. An influential definition by Jon
Kabat-Zinn is that mindfulness is “paying attention on purpose,
in the present moment, and non-judgmentally to the unfolding
of experience moment by moment” (p 145 [3]). Mindfulness is
seen as a skill that can be developed through practice. The
benefits of present-centered attention and acceptance of
experience that can be achieved through mindfulness include
enhanced awareness, greater self-regulation, greater openness
and acceptance to experiences, and the development of new
perspectives on the context and content of information [4]. This
contrasts with mindlessness, where an individual’s attention is
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focused on past experiences and concerns about the future rather
than on the present moment [5].
Accordingly, mindfulness has been found to have beneficial
psychological, somatic, behavioral, and interpersonal effects
[6], developing tolerance, acceptance, patience, trust, openness,
gentleness, generosity, empathy, gratitude, and loving-kindness,
each of which is relevant to the personal recovery of people
with mental disorders, as well as to positive well-being in
general [2]. Mindfulness has also been found to reduce
psychological distress and optimize psychological functioning
in young people [7]. There is growing evidence for the efficacy
of mindfulness-based programs in promoting well-being [8],
reducing depression [9], and preventing relapse in depression
[10].
While mindfulness can be an effective tool for improving health
and psychological well-being, finding an effective mindfulness
delivery medium that can reach a wider audience remains a
challenge.
Apps for Mental Health
The global prevalence and burden of mental disorders is
substantial, and delivering mental health services effectively to
millions in need remains a challenge [11]. While Web-based
interventions are gaining empirical support [12], mobile
interventions are still in their infancy [13]. Mobile health
(mHealth) is an emerging field that uses wireless technologies
such as mobile phones and other devices in health practice. The
advent of apps has created new opportunities. Smartphones can
keep the user connected to the Internet at all times. Smartphones
and apps provide computing facility comparable to personal
computers and software with the advantage of mobility.
Smartphone use is growing rapidly [14], and smartphones now
account for 25% of total Web usage. A recent Australian study
[15] reported that 88% of its survey respondents use websites
or apps on their mobile phone and predicted that 92% of
respondents would own a smartphone by October 2015. Global
mobile app downloads are expected to reach 269 billion by 2017
[16]. Smartphone usage by young people is particularly high:
The Australian Communications and Media Authority reported
that in May 2013, 89% of people aged 18-24 years had a
smartphone and 83% of this age group downloaded an app in
the previous 6 months [17]. E-technologies are also
well-accepted by young people as sources of health information.
In a recent survey, 39% of young people reported using the
Internet to seek information about a mental health problem [18].
An implication of this wide acceptance of e-technologies is that
they may offer a medium to improve the well-being of young
people by supporting the development of mindfulness [18,19].
The Apple Store now has a staggering 1.4 million apps, more
than 35,000 of which are health-related [20]. However, little
information is available on the quality or efficacy of these apps
beyond user reviews and star ratings [21]. It is imperative that
health apps contain high-quality information and have positive
effects for users [22].
In particular, while there is growing evidence for the positive
effects of face-to-face mindfulness-based training programs, it
is unclear if mindfulness apps can provide the same benefits.
A search for studies in various databases (ERIC, MEDLINE,
PsycINFO, Web of Science, ProQuest) only identified one
randomized controlled trial [23] examining the efficacy of a
mindfulness training app (Headspace).
The present study conducted a systematic review of
mindfulness-based mobile apps, evaluated the quality of these
apps using an expert rating scale, and described features of the
highest-scoring apps.
Methods
Systematic Search
A systematic search of mindfulness-based mobile apps
accessible from Australia was conducted in June 2014. The
search was conducted using the Google app search function as
well as the search feature in the iTunes app store. The Google
app search included mindfulness, vipassana, mindful,
meditation, and present moment, and excluded hypnosis,
hypnotize, weight, magazine, mindmap, mind map, mind-map,
and binaural. “Mindfulness” was the only search term used in
iTunes, as the search feature was more limited.
Preliminary screening removed irrelevant apps
(music/relaxation, happiness, inspirational cards, games, clocks,
etc), apps not in English, and those that were not readily
accessible. Mindfulness apps that were secular, explicated
mindfulness practice, and also had guided mindfulness training
were included. Apps that only gave reminders, timers, or guided
meditation tracks were excluded, as were apps that cost more
than $10 (on the grounds that they were unlikely to be purchased
by a large number of users). While guided meditation tracks are
a part of mindfulness training, that by itself cannot be justified
as mindfulness training as they lack education about
mindfulness.
The apps were rated and reviewed in iOS 7 with an iPhone 5s.
Each app was tested by at least one author for a minimum of
30 minutes in a real-world setting. The authors were involved
in the development of the MARS [24] and had undertaken
mindfulness training. Two of the authors had delivered
mindfulness training as part of their clinical psychology practice.
Measures/Rating Tool
The MARS [24] was used to rate app quality. It contains 23
items in 3 sections: classification, app quality, and satisfaction.
Each MARS item uses a 5-point scale (1-Inadequate, 2-Poor,
3-Acceptable, 4-Good, 5-Excellent). The classification section
is only for descriptive purposes. The 19-item app quality section
rates apps on four subscales: engagement, functionality,
aesthetics, and information quality. The subjective quality
section contains 4 items evaluating the user’s overall
satisfaction. The MARS is scored by calculating the mean scores
of the app quality subscales and the total mean score. The
subjective quality items are scored separately as individual
items. The MARS has demonstrated excellent internal
consistency (α=0.92) and interrater reliability (ICC=.85) [24].
A second rater reviewed and rated 30% of the apps on the
MARS for interrater reliability purposes.
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Results
Systematic Search
The Google and iTunes searches identified 323 and 377 apps,
respectively (Figure 1). Excluding duplicates, there were 606
apps. However, 10 were not accessible, 40 were in languages
other than English, and 296 were not relevant (ie
music/relaxation, happiness, inspirational cards, games, clocks,
etc). Of the remaining 260 apps, 23 met the inclusion criteria.
Excluded apps comprised those containing timers or reminders
(74), guided meditation tracks for common practice or special
occasions (129; religious practice/pregnancy/eating/exercise),
or information only (37; eBooks/audiobooks/guidelines, without
any tools to practice). Nine of the included apps were free and
the rest cost between $2.49 and $5.99.
Figure 1. Systematic search for mindfulness apps in Apple store.
App Quality
Table 1shows the subscale and overall scores of apps rated with
MARS. It was not possible to rate item 19, which provides a
measure of the evidence base for the apps, as a Google Scholar
search only identified one efficacy study [23] on one of the
included apps (Headspace). Seven apps (30%) were evaluated
by two expert MARS raters, and there was an excellent level
of interrater reliability (two-way mixed ICC=.84; 95% CI
0.79-0.87).
The Headspace app had the highest average MARS total (4.0)
and subscale scores. The next highest were Smiling Mind (3.7),
iMindfulness (3.5) and Mindfulness Daily (3.5). Mindfulness
Trainer scored the lowest (2.6). The median MARS was 3.2,
and all but three of the apps met or beat the minimum
acceptability score of 3.0. Satisfaction (the only totally
subjective subscale) was not included in the overall score.
Features of High-Quality Mindfulness Apps
Features of the reviewed apps are summarized in Tables 2 and
3. All contained guided meditations and mindfulness education.
They also had at least 2 of the following 9 most common types
of guided meditations [25]:
1. Breathing — deep breathing with awareness of the in and
out breathes
2. Body scan — awareness of the body focusing on each of
the body parts, usually starting from the toes and
progressively moving towards the head
3. Sitting meditation — breathing meditation in a sitting
posture, with awareness of the body
4. Walking meditation — practicing mindful walking, raising
awareness of each movement as we walk slowly
5. Loving kindness meditation — a meditation practice to
accept, love and show kindness to oneself and others
6. Thoughts and emotions — acknowledging thoughts and
emotions non-judgmentally, as they come and go
7. Mountain meditation — a guided imagery practice,
imagining oneself as a mountain and feeling stronger
8. Lake meditation — a guided imagery practice, imagining
oneself as a lake, experiencing stillness and peace
9. Three-minute breathing space — a 3-minute guided
meditation, with becoming aware in the first minute,
gathering and focusing attention in the second minute, and
expanding the attention in the third minute.
Almost all apps provided mindful breathing and body-scan
exercises. Only one contained all 9 types of guided meditations
(Mindfulness Trainer) and few contained loving kindness, lake,
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and mountain meditations. Buddhify 2 differed from the rest
by providing guided meditations to practice in different
situations, including exercising, working online, sleeping, and
on your work break. The recording quality, voice used, and pace
of the delivery of guided meditations varied from app to app.
Table 1. MARS Rating.
OverallSatisfactionInformationb
AestheticsFunctionalityEngagementAppa
4.04.04.04.74.83.8Headspacec
1
3.74.03.84.34.53.4Smiling Mindc
2
3.52.53.73.74.83.0iMindfulnessc
3
3.53.33.74.04.03.2Mindfulness Daily4
3.43.83.53.73.83.6Buddhify 25
3.42.83.74.04.03.0Complete Mindfulnessc
6
3.42.53.34.03.53.6Mindfulise7
3.33.53.83.04.03.0ACT Coach8
3.33.03.24.03.53.4Rhythm Free9
3.32.83.54.03.82.8Simply810
3.33.03.33.34.03.2Stop, Breathe & Think11
3.22.53.33.34.03.0Mindfully Me12
3.22.53.53.04.03.0The Meditation App with
Michael Stone
13
3.22.83.53.34.02.6Meditation without bordersc
14
3.22.83.73.03.82.8Mindfulness Coach15
3.22.53.53.03.83.0The Mindfulness Appa
16
3.12.53.52.73.53.2Take a Chillc
17
3.12.53.23.03.83.0iMindfulness
- On The Go
18
3.12.53.22.74.03.0Personal Coach
- Mindfulness
19
3.02.53.32.73.82.8The Breathing Anchor - Andries
J Kroese
20
2.82.03.02.73.52.8Mindfulness by Potential Project21
2.82.53.02.73.82.4Cleveland Clinic -
Stress Free Now
22
2.61.83.02.33.32.2Mindfulness Trainer23
aThe rated versions (Multimedia appendix 1) of the apps may not be available in the App Store at the time of publication, as they may be replaced by
newer versions.
bThe information quality score excluded Item 19 of the MARS.
cRated by two raters for interrater reliability purposes.
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Table 2. Summary of mindfulness-based apps features.
PB Practicea
TrackingMood assessmentsRemindersTimerApp#
✓✓✓✓Headspace1
✓✓✓✓✓Smiling Mind2
✓✓✓iMindfulness3
✓✓✓✓✓Mindfulness Daily4
✓✓Buddhify 25
Complete Mindfulness6
✓✓Mindfulise7
✓ACT Coach8
✓✓✓Rhythm Free9
✓✓✓Simply810
✓✓Stop, Breathe & Think11
✓✓✓Mindfully Me12
✓✓✓The Meditation App with Michael Stone13
✓Meditation without borders14
✓✓✓Mindfulness Coach15
✓✓✓The Mindfulness App16
✓✓✓Take a Chill17
✓✓✓iMindfulness On The Go18
✓✓Personal Coach - Mindfulness19
✓✓✓The Breathing Anchor
- Andries J Kroese
20
✓✓✓Mindfulness by Potential Project21
Cleveland Clinic -
Stress Free Now
22
Mindfulness Trainer23
aProgram-based practice
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Table 3. Summary of mindfulness-based app features.
CostIn-app PurchaseSocial MediaApp communityApp#
Free✓✓✓Headspace1
Free✓Smiling Mind2
$2.49✓iMindfulness3
Free✓✓Mindfulness Daily4
$3.79✓Buddhify 25
$2.49Complete Mindfulness6
$3.79Mindfulise7
FreeACT Coach8
Free✓✓Rhythm Free9
$3.79✓Simply810
Free✓Stop, Breathe & Think11
Free✓Mindfully Me12
$3.79✓The Meditation App with Michael Stone13
$5.99✓Meditation without borders14
FreeMindfulness Coach15
$2.49✓✓The Mindfulness App16
$2.49✓✓Take a Chill17
$2.49✓iMindfulness On The Go18
$2.49Personal Coach
- Mindfulness
19
$2.49The Breathing Anchor
- Andries J Kroese
20
$2.49Mindfulness by Potential Project21
FreeCleveland Clinic - Stress Free Now22
$3.79Mindfulness Trainer23
The majority of apps contained timers and provided reminders.
Seven did not have a timer (ACT Coach, Complete Mindfulness,
Stop, Breathe & Think, Meditation without Borders, MindKind
Now, Cleveland Clinic - Stress Free Now, Mindfulness Trainer)
and nine did not have reminders (ACT Coach, Buddhify 2,
Cleveland Clinic - Stress Free Now, Complete Mindfulness,
Meditation without Borders, Mindfulise, Mindfulness Trainer,
MindKind Now, Stop, Breathe & Think).
Five apps provided progressive/program-based mindfulness
training (Headspace, Smiling Mind, Mindfulness Daily, Simply8
and Meditation without Borders). Headspace provided free
access to a 10-day program, Take 10, which has 10 guided
meditation sessions of approximately 10 minutes each.
Completing a session unlocked the next meditation track.
Smiling Mind had a 10-week program for different age groups.
The introductory session at the start of each week explored
breath, sounds, tastes, etc. The user was advised to practice
mindfulness and relevant take-home activities with the assistance
of the app. Simply8 was a 3-week program with 8 minutes of
guided meditation every day under the themes of calm, clear,
and aware (focusing on one theme each week). Mindfulness
Daily provided short mindfulness exercises for 21 days. The
user can also access guided meditations such as body scan,
kindness, and awareness any time. Meditation without Borders
was a 4-week program advising the users to practice guided
meditations for at least 20 minutes per day.
While most apps provided exclusive texts and videos explaining
the concepts of mindfulness, some apps relied on guided
meditation tracks to educate the user. Take A Chill referred to
relevant websites and did not provide much mindfulness
education within the app. Few apps (eg ACT Coach, Complete
Mindfulness) provided comprehensive text-based education.
Headspace used video infographics to explain the concepts.
Two of the apps (Mindfulness by Potential Project and
iMindfulness) mentioned the 7 attitudes for mindfulness training,
otherwise known as the essential pillars of Mindfulness-Based
Stress Reduction (MBSR) practice [25].
Twelve apps provided an option to share the user’s experience
in social networks such as Facebook and Twitter (Headspace,
Meditacious, Meditation without Borders, Mindfully Me,
Mindfulness Daily, Rhythm Free, Simply8, Smiling Mind, Stop,
Breathe & Think, Take A Chill, The Meditation App with
Michael Stone, The Mindfulness App). Headspace and
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Meditacious also had an app community. Eight apps provided
in-app purchase that included additional guided meditation
tracks (Take a Chill, iMindfulness On The Go, Headspace,
Mindfulness Daily, The Mindfulness App, iMindfulness,
Buddhify 2, and Rhythm Free, which also provided reminders)
Discussion
Principal Findings
Though the search for mindfulness apps identified 606 apps,
excluding duplicates, only 23 provided mindfulness training.
Timers, reminders, meditation, relaxation, or reference apps
can assist in mindfulness practice, but categorizing them as
mindfulness apps is inappropriate [26].
Mindfulness is much more than meditation, a breathing exercise,
or a relaxation technique. Meditation is a practice that aids
development of mindfulness [27,28]. Breathing is used as an
exercise in the practice of mindfulness and relaxation can be an
outcome. Contemplative practices (breathing, sitting, walking
meditations), understanding emergent bodily and mental
experiences, and withdrawing from habitual experiential
avoidance form part of mindfulness training in
mindfulness-based interventions such as MBSR and
Mindfulness-Based Cognitive Therapy [29]. A mindfulness app
should clearly explain the philosophy and practice of
mindfulness and address common misconceptions. An app
without mindfulness education may be beneficial if this
information has been provided as part of face-to-face
mindfulness training. However, a stand-alone mindfulness app
should educate the user on mindfulness. All of the apps included
in the review explain the concept of mindfulness at varying
levels. Some (eg Headspace, Smiling Mind) employed
interesting visual modes of explanation.
Mindfulness is a habit and a mind-training skill that requires
regular practice and sustained effort to be effective [3,30-32].
This is a challenge for both face-to-face and app-based
mindfulness training. Mindfulness apps provide 24/7 access to
mindfulness-based practice. Interactive mobile applications and
aesthetically pleasing and well-designed apps are likely to be
more effective in engaging the user in regular mindfulness
practice [33,34]. Headspace, Mindfulise, Buddhify 2 and
Smiling Mind exceeded the minimum acceptable level score
(3.0) on the MARS engagement subscale. These apps had
high-quality graphics, simple and easy-to-use interfaces, and
soothing voices for the guided meditation tracks. Headspace
used short video infographics that complemented the guided
meditation tracks. Unlike most apps that used a linear menu
style, Buddhify 2 used an interesting collapsible circular menu
to choose the meditation tracks. The low median score of the
reviewed apps on the MARS engagement subscale, highlights
the need to focus on engagement and motivation during the
design process.
Participation in an app community can help motivate users to
engage in healthy activities [35]. A supportive app community
can help users share and discuss their mindfulness experiences
and the challenges of regular practice. This could potentially
complement or substitute for the support provided in face-to-face
mindfulness training. While nearly 50% of the reviewed apps
provided social network sharing, only Headspace and
Meditacious incorporated app community support. Research is
required to determine the impact of sharing in social media and
participating in a supportive app community on the frequency
of mindfulness-based practice.
Assessing the quality of an app, especially a health intervention
app, is an essential step before evaluating its efficacy [36]. The
23 mindfulness apps reviewed in this study had a median
objective quality MARS score of 3.2. This suggests the apps
had an overall acceptable level of quality. However, the low
median engagement and moderate median aesthetics and
information subscale scores highlight potential target areas for
improvement.
Strengths and Limitations
This study is one of the first to review mindfulness-based mobile
apps and evaluate their quality using a new multidimensional
expert rating scale. The MARS provides a reliable measure of
app quality on four objective subscales (engagement,
functionality, visual aesthetics, information quality) and one
subjective scale. Only the objective quality scales are included
in the total app quality score. Expert ratings on 30% of the
reviewed apps had a high level interrater reliability in the current
study. However, while the MARS can be used to provide an
evaluation of the quality of existing apps, this cannot replace
the use of rigorous user-centered design and evidence-based
practice in the design of health behavior apps.
The current review was limited to iPhone iOS apps, indicating
future research is required to review and rate the quality of
mindfulness apps developed for Android and other app
platforms. Future research is also required to assess the quality
of mindfulness training and individual guided meditation tracks
contained in the apps, as there is currently no gold standard for
how mindfulness is best conceptualized or practiced.
Future Research
mHealth is fast becoming an essential component of global
health care [37]. The majority of mHealth apps developed to
date have focused on physical health and lifestyle domains
rather than mental health [38,39]. While an increasing number
of mindfulness apps are being developed, the current evidence
base is limited to one trial examining the efficacy of the
Headspace app [23]. Future research is needed to determine and
compare the efficacy of mindfulness apps in randomized
controlled trials.
Conclusions
Only 4% of the 700 apps identified in our search provided
mindfulness training and education. Though many apps claimed
to be mindfulness apps, most of them were not. While the
reviewed apps scored an acceptable median MARS score, very
few scored high, indicating that the quality of the apps can be
improved. The lack of evidence for the effectiveness of
mindfulness apps needs to be addressed.
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Acknowledgments
This project was funded by the Young and Well Cooperative Research Centre (Young and Well CRC), an Australian-based,
international research center that unites young people with researchers, practitioners, innovators and policy-makers from over 70
partner organizations. Together, we explore the role of technology in young people’s lives and how it can be used to improve the
mental health and well-being of people aged 12 to 25. The Young and Well CRC is established under the Australian Government’s
Cooperative Research Centres Program.
Associate Professor Leanne Hides is supported by an Australian Research Council Future Fellowship.
Conflicts of Interest
None declared.
Multimedia Appendix 1
Mindfulness-based iPhone apps.
[XLSX File (Microsoft Excel File), 80KB - mhealth_v3i3e82_app1.xlsx ]
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Edited by G Eysenbach; submitted 08.02.15; peer-reviewed by R Vilardaga, E Boudreaux; comments to author 16.04.15; revised
version received 09.06.15; accepted 24.06.15; published 19.08.15
Please cite as:
Mani M, Kavanagh DJ, Hides L, Stoyanov SR
Review and Evaluation of Mindfulness-Based iPhone Apps
JMIR mHealth uHealth 2015;3(3):e82
URL: http://mhealth.jmir.org/2015/3/e82/
doi:10.2196/mhealth.4328
PMID:
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