"I've Always Wanted to Find That Peace That Everyone Talks About with Mindfulness": The Development of an Asynchronous Mindfulness-Training Mobile Health Application for Adolescents with Type 1 Diabetes.

Adolescents with type 1 diabetes (T1D) report increased stress and anxiety in comparison to their peers, which may result in out-of-range glycemic outcomes. Complementary therapies such as mindfulness may improve stress and anxiety. However, mindfulness training is mostly delivered in-person for adolescents. As adolescents with T1D are high consumers of technology, with busy schedules that impede their ability to complete in-person training, we designed an mHealth application, Appricate©, to deliver mindfulness-training. The goal of this pilot study was to qualitatively describe the experience of participating in an 8-week mHealth mindfulness-training intervention based on the principles of MBSR, Appricate©, among adolescents with T1D. We conducted semi-structured interviews with 12 adolescents aged 12 to 19 years old who had T1D for >6 months and had completed our 8-week mHealth mindfulness-training intervention. We identified five themes based on participant interviews: (1) initial appeal and attractiveness, (2) usability, (3) engagement, (4) user outcomes, and (5) recommendations. Appricate© was reported as "well made" that was "very easy to use" with engaging lessons. Participants had improved sleep, stress and anxiety management and better ability to manage school and after-school activities after using Appricate©. Participants also recommended additional content and options for personalization.