The Effectiveness and Exploratory Cost-Effectiveness of Regular Meditation for Improving Quality of Life: Protocol for a Prospective Longitudinal Cohort Study

Background: In recent decades, millions of people globally have taken up Buddhist spiritual and secularized meditation practices, such as mindfulness, with the aim of improving their quality of life and well-being. Practitioners are recommended to continue meditating regularly for the long term; however, the effects of regular meditation practice after introductory instruction remain scientifically underexplored. Objective: This protocol aims to investigate whether regular meditation practice improves quality of life and mental well-being and whether its effects vary between secular and spiritual practitioners. We will also explore the cost-effectiveness of meditation in terms of quality of life and the incidence and functional impact of any adverse effects associated with the practice. Methods: We will conduct a prospective longitudinal cohort study of 600 beginner meditators in Australia, New Zealand, the United States, and the United Kingdom over a 1-year period. Meditation practice frequency and duration will be reported weekly through the ambulatory assessment app Fabla (Emory University), with sampling of the primary outcome of quality of life and secondary outcome of mental well-being at monthly intervals. Practice characteristics, including secular versus spiritual practice, will also be reported monthly, as will the costs of meditation and mental health care and the incidence, severity, and duration of any adverse effects. Potential confounders, including baseline mental health symptoms, social support, and sociodemographics, will be controlled for in linear mixed models. An incremental cost-effectiveness ratio will be calculated, and sensitivity analyses will be conducted. Results: Data collection began on October 28, 2025, after this study was first submitted on October 1, 2025. As of May 14, 2026, 341 participants have completed baseline measures. We expect results to be published in January 2028. Conclusions: Results of this investigation will illuminate the impact of meditation as it is currently practiced in natural contexts, and inform clinicians about whether and how regular meditation may be an effective tool for improving quality of life.