Yanick Xavier Lukic

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Lukic

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Yanick Xavier

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0000-0002-2576-6569

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Publications 1 - 10 of 13

The Impact of a Gameful Breathing Training Visualization on Intrinsic Experiential Value, Perceived Effectiveness, and Engagement Intentions: Between-subject Online Experiment
Lukic, Yanick Xavier; Klein, Shari; Brügger, Victoria; et al. (2021)
JMIR Preprints
Background: Slow-paced breathing has been shown to be positively associated with psychological and physiological health. In practice, however, there is little long-term engagement with breathing training, as shown by the usage statistics of breathing training apps. New research suggests that a gameful smartphone-delivered breathing training may address this challenge. Objective: This study assesses the impact of breathing training, that is guided by a gameful visualization, on perceived experiential and instrumental values, and the intention to engage in such a training. Methods: A between-subject online experiment with 170 participants was conducted and one-way MANOVA and t test analyses were used to test for any difference in intrinsic experiential value, perceived effectiveness, and the intention to engage in either a breathing training with a gameful or a nongameful guidance visualization. Moreover, prior experience in gaming and meditation practices were assessed as moderator variables for a preliminary analysis. Results: The intrinsic experiential value for the gameful visualization was found to be significantly higher compared to the nongameful visualization (P=.002), while there was no difference in either perceived effectiveness (P=.75) or the intention to engage (P=.55). The preliminary analysis of the influence of meditation and gaming experience on the outcomes indicates that people with more meditation experience yielded higher intrinsic experiential values from using the gameful visualization than when using the nongameful visualization (P=.01). This analysis did not find any additional evidence of gaming time or meditation impacting the outcomes. Conclusions: The gameful visualization was found to increase the intrinsic experiential value of the breathing training without decreasing the perceived effectiveness. However, there were no differences in intentions to engage in both breathing trainings. Gaming and meditation experiences seem to have no or only a small positive moderating effect on the relationship between the gameful visualization and the intrinsic experiential value. Future longitudinal field studies are required to assess the impact of gameful breathing training on actual behavior, that is, long-term engagement, and outcomes.
Breathe to Play - Design and Evaluation of a Microphone-Based Breathing Detection Algorithm and Gameful Breathing Training App
Lukic, Yanick Xavier (2023)
The Impact of a Gameful Breathing Training Visualization on Intrinsic Experiential Value, Perceived Effectiveness, and Engagement Intentions: Between-Subject Online Experiment
Lukic, Yanick Xavier; Klein, Shari Shirin; Brügger, Victoria; et al. (2021)
JMIR Serious Games
Background: Slow-paced breathing has been shown to be positively associated with psychological and physiological health. In practice, however, there is little long-term engagement with breathing training, as shown by the usage statistics of breathing training apps. New research suggests that gameful smartphone-delivered breathing training may address this challenge. Objective: This study assesses the impact of breathing training, guided by a gameful visualization, on perceived experiential and instrumental values and the intention to engage in such training. Methods: A between-subject online experiment with 170 participants was conducted, and one-way multiple analysis of variance and two-tailed t test analyses were used to test for any difference in intrinsic experiential value, perceived effectiveness, and the intention to engage in either a breathing training with a gameful or a nongameful guidance visualization. Moreover, prior experience in gaming and meditation practices were assessed as moderator variables for a preliminary analysis. Results: The intrinsic experiential value for the gameful visualization was found to be significantly higher compared to the nongameful visualization (P=.001), but there was no difference in either perceived effectiveness (P=.50) or the intention to engage (P=.44). The preliminary analysis of the influence of meditation and gaming experience on the outcomes indicates that people with more meditation experience yielded higher intrinsic experiential values from using the gameful visualization than people with no or little meditation experience (P=.03). This analysis did not find any additional evidence of gaming time or meditation experience impacting the outcomes. Conclusions: The gameful visualization was found to increase the intrinsic experiential value of the breathing training without decreasing the perceived effectiveness. However, there were no differences in intentions to engage in both breathing training conditions. Furthermore, gaming and meditation experiences seem to have no or only a small positive moderating effect on the relationship between the gameful visualization and the intrinsic experiential value. Future longitudinal field studies are required to assess the impact of gameful breathing training on actual behavior, that is, long-term engagement and outcomes.
A Playful Smartphone-based Self-regulation Training for the Prevention and Treatment of Child and Adolescent Obesity: Technical Feasibility and Perceptions of Young Patients
Kowatsch, Tobias; Shih, Iris; Lukic, Yanick Xavier; et al. (2021)
CEUR Workshop Proceedings ~ Joint Proceedings of the ACM IUI 2021 Workshops co-located with 26th ACM Conference on Intelligent User Interfaces (ACM IUI 2021), College Station, United States, April 13-17, 2021.
Effective interventions for the prevention and treatment of child and adolescent obesity play an important role in reducing the global health and economic burden of non-communicable diseases. Although multi-component interventions targeting various health behaviors are deemed promising, evidence for their effectiveness is still limited. Self-regulation seems to be a relevant working mechanism in this regard. Therefore, we propose a playful, smartphone-based self-regulation training that also utilizes the health benefits of a slow-paced breathing exercise. The mobile app uses the microphone of the smartphone to detect breathing sounds (e.g. inhalation, exhalation) and translates these sounds into a visual biofeedback on the smartphone screen. The design and evaluation of a very first prototype is described in this interdisciplinary work of obesity experts, clinical psychologists, young patients, and computer scientists. The apps' breathing detection module uses a random forest tree for quasi real-time classification of the incoming audio samples and biofeedback generation. A study with 11 obese children and adolescents was conducted to assess the prototype. Results indicate overall positive evaluations and suggestions for improvement. Implications and limitations are discussed, and an outlook on future work is provided.
Physiological Responses and User Feedback on a Gameful Breathing Training App: Within-Subject Experiment
Lukic, Yanick Xavier; Shih, Chen-Hsuan Iris; Hernández Reguera, Álvaro; et al. (2021)
JMIR Serious Games
Background: Slow-paced breathing training (6 breaths per minute [BPM]) improves physiological and psychological well-being by inducing relaxation characterized by increased heart rate variability (HRV). However, classic breathing training has a limited target group, and retention rates are very low. Although a gameful approach may help overcome these challenges, it is crucial to enable breathing training in a scalable context (eg, smartphone only) and ensure that they remain effective. However, despite the health benefits, no validated mobile gameful breathing training featuring a biofeedback component based on breathing seems to exist. Objective: This study aims to describe the design choices and their implementation in a concrete mobile gameful breathing training app. Furthermore, it aims to deliver an initial validation of the efficacy of the resulting app. Methods: Previous work was used to derive informed design choices, which, in turn, were applied to build the gameful breathing training app Breeze. In a pretest (n=3), design weaknesses in Breeze were identified, and Breeze was adjusted accordingly. The app was then evaluated in a pilot study (n=16). To ascertain that the effectiveness was maintained, recordings of breathing rates and HRV-derived measures (eg, root mean square of the successive differences [RMSSDs]) were collected. We compared 3 stages: baseline, standard breathing training deployed on a smartphone, and Breeze. Results: Overall, 5 design choices were made: use of cool colors, natural settings, tightly incorporated game elements, game mechanics reflecting physiological measures, and a light narrative and progression model. Breeze was effective, as it resulted in a slow-paced breathing rate of 6 BPM, which, in turn, resulted in significantly increased HRV measures compared with baseline (P<.001 for RMSSD). In general, the app was perceived positively by the participants. However, some criticized the somewhat weaker clarity of the breathing instructions when compared with a standard breathing training app. Conclusions: The implemented breathing training app Breeze maintained its efficacy despite the use of game elements. Moreover, the app was positively perceived by participants although there was room for improvement.
Breeze, ein spielerisches Biofeedback Atemtraining für das Smartphone: Physiologische Reaktionen und subjektive Einschätzungen aus einem Labor- und Online-Experiment
Lukic, Yanick Xavier; Klein, Shari; Shih, Iris; et al. (2021)
Hintergrund: Langsames Atmen hat eine positive Wirkung auf die Herzfunktion und auf das psychische Wohlbefinden. Daher werden entsprechende Atemübungen oft bei chronischen Krankheiten empfohlen; sie werden allerdings aus verschiedenen Gründen nur von bestimmten Personengruppen ausgeübt und haben somit eine eingeschränkte Reichweite und Wirkung. Ziel: Die Breeze App verfolgt das Ziel, die Reichweite von Atemübungen mit einem spielerischen und skalierbaren Biofeedback-Ansatz zu erhöhen. Methode: Grundlage der Atemübung Breeze ist die Erkennung der Atmung mit dem Mikrofon des Smartphones, um damit beim Ausatmen «Rückenwind» für ein virtuelles Segelboot zu erzeugen und es somit zu beschleunigen. Entspricht der Atmungs-Zyklus einem validierten Muster (z.B. 4s Einatmung, 2s Ausatmung und 4s Pause), kann mit dem Segelboot, welches in Echtzeit auf dem Bildschirm des Smartphones dargestellt wird, die grösste Reisedistanz zurückgelegt werden. Es wurden Labor- und Online-Experimente durchgeführt, um Breeze hinsichtlich physiologischer Effekte und subjektiver Einschätzungen bei erwachsenen Personen zu evaluieren. Ergebnisse: Im Labor (N=16) konnte gezeigt werden, dass Breeze nicht nur zu einer Steigerung der Herzfrequenzvariabilität geführt hat (p<.001), sondern auch gegenüber einer validierten Atemübung ohne spielerischen Ansatz von 14 (87.5%) Personen präferiert wurde. Ein Online-Experiment mit Teilnehmenden, welche im Schnitt nur wenig bis gar keine Erfahrung mit Atemübungen hatten, zeigte darüber hinaus, dass die wahrgenommene Entspannung durch Breeze (N=88) mit der einer validierten Atemübung (N=82) vergleichbar ist und 51 (58.0%) Personen Breeze im Alltag nutzen würden. Zusammenfassung: Breeze hat mit seinem spielerischen Ansatz das Potential, die Reichweite von Atemübungen zu erhöhen, was insbesondere für das Selbstmanagement bei chronischen Krankheiten relevant sein kann.
Long-term usage of the gamified breathing training Breeze and its effect on momentary relaxation in people with cancer: A cohort study
Bischof, Anja Yvonne; Budig, Tobias; Schläpfer, Sonja; et al. (2024)
JMIR Preprints
Background: People with cancer often experience stress. Digital health interventions (DHIs) can help individuals increase momentary relaxation. Breeze is a gamified breathing training that can be embedded into DHIs. Its effectiveness in controlled cross-sectional studies was shown. However, adherence to Breeze and its effect on momentary relaxation in longitudinal interventional studies has yet to be investigated. Objective: This work aims to assess the use of Breeze and its effect on momentary relaxation in people with cancer. Methods: Breeze was one of seven relaxation techniques included in the CanRelax 2.0 app, designed specifically for individuals diagnosed with cancer. Participants could select any of the seven techniques to promote momentary relaxation. The intervention was designed to last 10 weeks. However, participants were allowed to use the CanRelax 2.0 app after that period. Participants were adults diagnosed with cancer in the last five years recruited across Switzerland, Germany, and Austria. Momentary relaxation was measured pre- and post-exercise using an 11-point visual analog scale, while Breeze was assessed through objective usage metrics. Statistical analyses included linear mixed-effects models and effect size calculations. Results: Out of 352 participants, 118 (33.5%) used Breeze at least once. The 118 participants engaged in 754 breathing sessions with Breeze. Momentary relaxation was assessed and calculated for 249 (33.0%) Breeze sessions. The use of Breeze remained stable even after the formal intervention period. Participants also followed the pre-defined breathing rates of Breeze. On average, a small effect on momentary relaxation was observed for 2-minute breathing sessions (d = .20), while a large effect (d = .74) resulted from breathing sessions >=4 minutes. Conclusions: This study shows the potential of Breeze to reduce acute stress in individuals with a chronic condition, such as cancer. By combining gamification with evidence-based breathing techniques, Breeze fosters sustained user engagement and momentary relaxation. Future research aims to assess the impact of Breeze on other populations and chronic conditions. Clinical Trial: German Clinical Trials Register DRKS00027546; registered on 23 February 2022
Development of a digital biomarker and intervention for subclinical depression: study protocol for a longitudinal waitlist control study
Teepe, Gisbert W.; Lukic, Yanick Xavier; Kleim, Birgit; et al. (2023)
BMC Psychology
Background Depression remains a global health problem, with its prevalence rising worldwide. Digital biomarkers are increasingly investigated to initiate and tailor scalable interventions targeting depression. Due to the steady influx of new cases, focusing on treatment alone will not suffice; academics and practitioners need to focus on the prevention of depression (i.e., addressing subclinical depression). Aim With our study, we aim to (i) develop digital biomarkers for subclinical symptoms of depression, (ii) develop digital biomarkers for severity of subclinical depression, and (iii) investigate the efficacy of a digital intervention in reducing symptoms and severity of subclinical depression. Method Participants will interact with the digital intervention BEDDA consisting of a scripted conversational agent, the slow-paced breathing training Breeze, and actionable advice for different symptoms. The intervention comprises 30 daily interactions to be completed in less than 45 days. We will collect self-reports regarding mood, agitation, anhedonia (proximal outcomes; first objective), self-reports regarding depression severity (primary distal outcome; second and third objective), anxiety severity (secondary distal outcome; second and third objective), stress (secondary distal outcome; second and third objective), voice, and breathing. A subsample of 25% of the participants will use smartwatches to record physiological data (e.g., heart-rate, heart-rate variability), which will be used in the analyses for all three objectives. Discussion Digital voice- and breathing-based biomarkers may improve diagnosis, prevention, and care by enabling an unobtrusive and either complementary or alternative assessment to self-reports. Furthermore, our results may advance our understanding of underlying psychophysiological changes in subclinical depression. Our study also provides further evidence regarding the efficacy of standalone digital health interventions to prevent depression.
Breathing as an Input Modality in a Gameful Breathing Training App (Breeze 2): Development and Evaluation Study
Lukic, Yanick Xavier; Teepe, Gisbert Wilhelm; Fleisch, Elgar; et al. (2022)
JMIR Serious Games
Background: Slow-paced breathing training can have positive effects on physiological and psychological well-being. Unfortunately, use statistics indicate that adherence to breathing training apps is low. Recent work suggests that gameful breathing training may help overcome this challenge. Objective: This study aimed to introduce and evaluate the gameful breathing training app Breeze 2 and its novel real-time breathing detection algorithm that enables the interactive components of the app. Methods: We developed the breathing detection algorithm by using deep transfer learning to detect inhalation, exhalation, and nonbreathing sounds (including silence). An additional heuristic prolongs detected exhalations to stabilize the algorithm’s predictions. We evaluated Breeze 2 with 30 participants (women: n=14, 47%; age: mean 29.77, SD 7.33 years). Participants performed breathing training with Breeze 2 in 2 sessions with and without headphones. They answered questions regarding user engagement (User Engagement Scale Short Form [UES-SF]), perceived effectiveness (PE), perceived relaxation effectiveness, and perceived breathing detection accuracy. We used Wilcoxon signed-rank tests to compare the UES-SF, PE, and perceived relaxation effectiveness scores with neutral scores. Furthermore, we correlated perceived breathing detection accuracy with actual multi-class balanced accuracy to determine whether participants could perceive the actual breathing detection performance. We also conducted a repeated-measure ANOVA to investigate breathing detection differences in balanced accuracy with and without the heuristic and when classifying data captured from headphones and smartphone microphones. The analysis controlled for potential between-subject effects of the participants’ sex. Results: Our results show scores that were significantly higher than neutral scores for the UES-SF (W=459; P<.001), PE (W=465; P<.001), and perceived relaxation effectiveness (W=358; P<.001). Perceived breathing detection accuracy correlated significantly with the actual multi-class balanced accuracy (r=0.51; P<.001). Furthermore, we found that the heuristic significantly improved the breathing detection balanced accuracy (F1,25=6.23; P=.02) and that detection performed better on data captured from smartphone microphones than than on data from headphones (F1,25=17.61; P<.001). We did not observe any significant between-subject effects of sex. Breathing detection without the heuristic reached a multi-class balanced accuracy of 74% on the collected audio recordings. Conclusions: Most participants (28/30, 93%) perceived Breeze 2 as engaging and effective. Furthermore, breathing detection worked well for most participants, as indicated by the perceived detection accuracy and actual detection accuracy. In future work, we aim to use the collected breathing sounds to improve breathing detection with regard to its stability and performance. We also plan to use Breeze 2 as an intervention tool in various studies targeting the prevention and management of noncommunicable diseases.
Demonstrating BREEZE-VR: A Gamified Virtual Reality Biofeedback Breathing Training to Strengthen Mental Resilience and Reduce Acute Stress
Kowatsch, Tobias; Ackermann, Lola Jo; Galliker, Helen; et al. (2025)
Workshopband MuC 2025
Noncommunicable diseases (NCDs) pose a significant challenge to public health and the economy, underscoring the need for effective strategies in prevention and management. Evidence shows that slow-paced breathing holds promise in strengthening mental resilience and reducing acute stress, both relevant for addressing the prevention and management of NCDs. Biofeedback can help individuals adopt slow-paced breathing patterns, thereby enhancing the effectiveness of breathing trainings. Gamified immersive environments may further amplify these effects. Against this background, we developed BREEZE-VR, a gamified virtual reality biofeedback breathing training. In this paper, we describe the development of the first prototype of BREEZE-VR and provide a video clip demonstrating its use. During the conference, attendees are invited to try out BREEZE-VR. In our future work, we will evaluate the effectiveness and acceptability of BREEZE-VR in a laboratory study.

Publications 1 - 10 of 13

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