Breeze: A Gameful Biofeedback Breathing Training for Mental and Physical Well-being
Slow-paced breathing training is an effective method to strengthen cardiac functioning and psychological well-being. It thus addresses two of the most pressing global health challenges: chronic disease and mental illness. Slow-paced breathing training can be self-paced (e.g., during mindfulness meditation), externally-guided by following acoustic, seismic, or visual instructions, or biofeedback-guided where individuals consciously control their heart rate variability or breathing rate by monitoring the bio-signals. In addition to various physiological benefits, biofeedback training, if mastered, can also improve self-efficacy, which is a relevant predictor of health behavior.
There are, however, limitations that hinder both the effectiveness and the reach of slow-paced breathing training. First, biofeedback-guided breathing training is not scalable because it requires trained therapists and additional equipment that senses bio-signals, which is particularly critical in developing countries. Second, the use of interventions that incorporate slow-paced breathing training is less prevalent in males, less-educated individuals, and physically inactive individuals.
To address these limitations, we are developing a mobile application that uses a smartphone’s microphone to continuously detect breathing phases in real-time, i.e., inhalation, exhalation, and pauses. The app is then used to enable a gameful breathing training.The overall vision of this project is to provide a scalable health tool as it relies solely on a smartphone, which is currently available to circa 76% of individuals in high-income countries and to circa 45% of individuals in middle and low-income countries. It should offer the benefits of biofeedback without requiring additional equipment. Moreover, the gameful biofeedback (e.g., a correct slow-paced breathing increases the speed of a sailboat) targets experiential outcomes (e.g., enjoyment) in addition to instrumental outcomes of strengthening cardiac functioning or psychological well-being. This increase in experiential value should then be used to reach those who are less motivated to perform slow-paced breathing training.
Version 1: Targeting obese children in the project Pathmate 2 (2018).
Version 2: Completely new app.
Version 3: Improved guidance elements, better detection, and with added soundscape.
Shih, C. H., Tomita, N., Lukic, Y. X., Reguera, Á. H., Fleisch, E., & Kowatsch, T. (2019) Breeze: Smartphone-based Acoustic Real-time Detection of Breathing Phases for a Gamified Biofeedback Breathing Training. Proceedings of the ACM on Interactive, Mobile, Wearable and Ubiquitous Technologies (IMWUT), 3(4), 1-30. 10.1145/3369835
Shih, I., Nißen, M.K., Büchter, D., Durrer, D., l’Allemand, D., Fleisch, E., Kowatsch, T. (2018) Smartphone-based Biofeedback Breathing Training for Stress Management, Poster presented at the Applied Maschine Learning Days, EPFL, Lausanne, Switzerland. (PDF)
Shih, I., Kowatsch, T., Tinschert, P., Barata, F., Nißen, M.K., Towards The Design of a Smartphone-Based Biofeedback Breathing Training: Identifying Diaphragmatic Breathing Patterns from a Smartphone’s Microphone, Proc. of the 10th Mediterranean Conference on Information Systems (MCIS), Paphos, Cyprus. (PDF)