Physiological Responses and User Feedback on a Gameful Breathing Training App: Within-Subject Experiment

Background Slow-paced breathing training (6 breaths per minute [BPM]) improves physiological and psychological well-being by inducing relaxation characterized increased heart rate variability (HRV). However, classic has a limited target group, retention rates are very low. Although gameful approach may help overcome these challenges, it is crucial to enable in scalable context (eg, smartphone only) ensure that they remain effective. despite the health benefits, no validated mobile featuring biofeedback component based on seems exist. Objective This study aims describe design choices their implementation concrete app. Furthermore, deliver an initial validation of efficacy resulting Methods Previous work was used derive informed choices, which, turn, were applied build app Breeze. In pretest (n=3), weaknesses Breeze identified, adjusted accordingly. The then evaluated pilot (n=16). To ascertain effectiveness maintained, recordings HRV-derived measures root mean square successive differences [RMSSDs]) collected. We compared 3 stages: baseline, standard deployed smartphone, Results Overall, 5 made: use cool colors, natural settings, tightly incorporated game elements, mechanics reflecting measures, light narrative progression model. effective, as resulted slow-paced 6 BPM, significantly HRV with baseline (P<.001 for RMSSD). general, perceived positively participants. some criticized somewhat weaker clarity instructions when Conclusions implemented maintained its elements. Moreover, participants although there room improvement.