Multi-Site Feasibility Testing a Meditation App for Youth in the Legal System

The investigators aim to enroll 120 youth (30/site) 13-20 years old who report regular access to an Apple or Android smartphone. Following completion of a baseline survey, participants will be individually randomized at a 1:1 ratio to 1 of 2 smartphone app conditions: (1) Bodhi AIM (Action In Mindfulness), a 30-day meditation app or (2) HIB (Health In Balance), a health promotion control app matched to Bodhi AIM for time and structure. Follow-up assessments will occur at 1 and 6 months. All study activities will be remote.

• Bodhi AIM (Behavioral): Bodhi AIM (Action In Mindfulness) is a smartphone-based app that teaches users to establish a daily meditation practice via a 30-day "path," with each day consisting of a brief audio- or video-guided file. In addition to the 30 daily path files, users have access to a menu of "to go" audio-guided meditation practices that they may access any time to prepare for particular situations (e.g., attending a party).
• HIB (Behavioral): HIB (Health In Balance) is a smartphone-based app that is matched to Bodhi AIM for time and structure, but includes health promotion content (e.g., educational information on substance use) in place of the meditation content featured in Bodhi AIM. Like Bodhi AIM, HIB includes a 30-day "path" of audio and video files, along with a menu of "to go" audio files that users may access any time to review key intervention concepts.

Primary outcomes

• App adherence (binary) [1 month]: Percentage of participants who play at least one file on their study app after baseline.
• App adherence (continuous) [1 month]: Average number of daily app files played over the 1-month intervention period.

Secondary outcomes

• Enrollment [Baseline]: Number of participants enrolled
• Randomization [Baseline]: Percentage of participants randomized to each arm who play at least one app file
• Retention [1 month, 6 months]: Percentage of participants who attend (yes/no) each follow-up visit
• Health questionnaire completion [Baseline, 1 month, 6 months]: Percentage of participants who complete the questionnaire measures of psychological wellbeing (PROMIS Pediatric Bank v1.0 Positive Affect, NIH Toolbox Pediatric Item Bank v3.0 Self-Efficacy CAT) and psychological distress (PROMIS Pediatric Item Bank GenPop v3.0 Anxiety, PROMIS Pediatric Item Bank GenPop v3.0 Depressive Symptoms, PROMIS Pediatric Bank v 1.0 Psychological Stress Experiences) at each time point
• Acceptability of Intervention Measure (AIM) [1 month]: Four-item scale assessing perceived acceptability of the intervention. Items are rated on a 5-point Likert scale and averaged to produce a total score ranging from 1 to 5; with higher scores indicating greater acceptability.
• Intervention Appropriateness Measure (IAM) [1 month]: Four-item scale assessing perceived appropriateness of the intervention. Items are rated on a 5-point Likert scale and averaged to produce a total score ranging from 1 to 5; with higher scores indicating greater appropriateness.
• Feasibility of Intervention Measure (FIM) [1 month]: Four-item scale assessing perceived feasibility of the intervention. Items are rated on a 5-point Likert scale and averaged to produce a total score ranging from 1 to 5; with higher scores indicating greater feasibility.

Other outcomes

• Ecological momentary assessment (EMA) completion [Baseline, 1 month]: Percentage of EMA reports made out of total EMA prompts sent at each EMA burst

Sex: All, ages: 13 Years to 20 Years, accepts healthy volunteers

Inclusion Criteria:

* 13-20 years old
* In probation or related programming (i.e., in legal programming but not detained) in Oregon or New York State
* Have access to an Apple/Android smartphone
* Understand and provide assent/consent
* Have legal guardian permission (if under 18 years old)
* English-speaking, due to norming of instruments

Exclusion Criteria:

\- There are no exclusion criteria.

NIH grants: R01AT012892