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Evaluating a brief smartphone-based stress management intervention with heart rate biofeedback from built-in sensors in a three arm randomized controlled trial

L. Fuhrmann, C. A. Lukas, L. Schindler-Gmelch, M. Berking

Scientific Reports, 2025

166 participants · 6 citations

Abstract

Perceived stress is prevalent in industrial societies, negatively impacting mental health. Smartphone-based stress management interventions provide accessible alternatives to traditional methods, but their efficacy remains modest, potentially due to limited integration of smartphone sensor technology. The primary aim of this study was to evaluate the efficacy of an 18-day smartphone-based stress management intervention, MT-StressLess with integrated heart rate (HR)-based biofeedback using built-in accelerometer sensors, compared to a waitlist control (WLC) condition. Secondary outcomes included emotion regulation skills, depressive symptoms, overall well-being, usbiality and usage data. As exploratory aims, we investigated whether the MT-StressLess version without HR-based biofeedback was also superior to the WLC condition, and whether the version with HR-based biofeedback provided additional benefits compared to the version without. In a three-arm randomized controlled trial, 166 participants were assigned to MT-StressLess with HR-based biofeedback, MT-StressLess, or the WLC condition. Linear mixed-effects models were used to analyze intervention effects over time (baseline, postintervention, and 1-month follow-up). At postintervention, MT-StressLess with HR-based biofeedback showed significantly greater reductions in perceived stress compared to the WLC condition (d = 0.41, 95% CI [0.03, 0.79]), whereas the version without biofeedback did not differ significantly (d =…

How strong is the evidence?

Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 166 participants or records.

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