A Mindfulness Breast Care App to reduce body image distress and stigma for breast cancer survivors: Development and preliminary quality assessment

Objectives: This study aimed to develop and preliminarily assess the quality of a Mindfulness Breast Care (MBC) App to reduce body image distress and stigma among breast cancer survivors (BCSs). Methods: The development process of the MBC App involved: 1) establishing a research group; 2) determining of the content of the MBC App based on Mindfulness-Based Cognitive Therapy and 3) technical exploitation and maintenance. A mixed-methods study was conducted. We selected ten BCSs by a convenience sampling method. After using the APP for three months, five assessed the quality using the Mobile App Rating Scale: User Version (uMARS) and another five were interviewed for process evaluation. Results: The MBC App was developed with three modules: 1) Library to provide health education information on body image, stigma, mindfulness, recovery and etc; 2) Mindfulness Yoga to offer 12 Hatha yoga videos for daily practice; and 3) Mindfulness Practices to have 12 sessions of mindfulness videoconferences. Based on the uMARS data, the MBC App received high ratings for functionality (4.10 ± 0.34), aesthetics (3.93 ± 0.55), information quality (4.10 ± 0.72), and perceived impact (4.03 ± 0.96), as well as moderate ratings for engagement (3.72 ± 0.94) and subjective quality (3.87 ± 0.77). Participants indicated that the MBC App provided reliable knowledge, information, and emotional support. Recommendations from participants included categorizing knowledge in the Library Module, recording videoconferences of mindfulness practice, and adding discussion sessions in the videoconference. Afterward, we optimized the MBC App to enhance the user experience accordingly. Conclusions: The MBC App offers online mindfulness interventions specifically for BCSs in China. The preliminary quality assessment indicates that the MBC App may be a promising tool for delivering mindfulness interventions to BCSs.