Stress-Mentor: Linking Gamification and Behavior Change Theory in a Stress Management Application

Christmann, Corinna A.; Hoffmann, Alexandra; Zolynski, Gregor; Bleser, Gabriele

doi:10.1007/978-3-319-92279-9_52

Cited by 10 publications

(8 citation statements)

References 10 publications

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“…Participants remain dependent on the app during the breathing exercise. However, the protection of the users’ autonomy has been identified as an important factor in a recent stress management app [11]. Therefore, additional blocks with terminal feedback without the visual instruction might be 1 possibility to counteract dependency upon the interface and to trigger transfer learning [31].…”

Section: Discussionmentioning

confidence: 99%

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A Biofeedback App to Instruct Abdominal Breathing (Breathing-Mentor): Pilot Experiment

Faust-Christmann

Taetz

Zolynski

et al. 2019

JMIR Mhealth Uhealth

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BackgroundDeep and slow abdominal breathing is an important skill for the management of stress and pain. However, despite multiple proofs on the effectiveness of biofeedback, most breathing apps remain limited to pacing specific breathing patterns, without sensor feedback on the actual breathing behavior.ObjectiveTo fill this gap, an app named Breathing-Mentor was developed. This app combines effective visualization of the instruction with biofeedback on deep abdominal breathing, based on the mobile phone’s accelerometers. The aim of this pilot study was to investigate users’ feedback and breathing behavior during initial contact with the app.MethodsTo reveal the possible effects of biofeedback, two versions of the mobile app were developed. Both contained the same visual instruction, but only the full version included additional biofeedback. In total, 40 untrained participants were randomly assigned to one of the two versions of the app. They had to follow the app’s instructions as closely as possible for 5 min.ResultsThe group with additional biofeedback showed an increased signal-to-noise ratio for instructed breathing frequency (0.1 Hz) compared with those using visual instruction without biofeedback (F1,37=4.18; P<.048). During this initial contact with the full version, self-reported relaxation effectivity was, however, lower than the group using visual instruction without biofeedback (t37=−2.36; P=.02), probably owing to increased cognitive workload to follow the instruction.ConclusionsThis study supports the feasibility and usefulness of incorporating biofeedback in the Breathing-Mentor app to train abdominal breathing. Immediate effects on relaxation levels should, however, not be expected for untrained users.

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Section: Discussionmentioning

confidence: 99%

“…Moreover, relaxation methods are also commonly integrated in apps for the management of chronic pain [7,8], chronic diseases [9], and anxiety [10]. Through interactive design and gamification, such apps can potentially increase the users’ motivation [11,12]. This could reduce the economic burden for the health care system [13].…”

Section: Introductionmentioning

confidence: 99%

A Biofeedback App to Instruct Abdominal Breathing (Breathing-Mentor): Pilot Experiment

Faust-Christmann

Taetz

Zolynski

et al. 2019

JMIR Mhealth Uhealth

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“…Therefore, Pain-Mentor supports the therapy of patients with chronic pain by teaching evidence-based techniques from multi-modal pain therapy and how they can be applied in everyday life. The app is based on the concept of Stress-Mentor [50], a gamified stress management app. Stress-Mentor includes all 5 suggested theory-based functionalities.…”

Section: Pain-mentormentioning

confidence: 99%

“…In addition to self-monitoring, stress management skills, and educational information, Stress-Mentor includes several other behavior change techniques (see the study by Christmann et al [50] for a detailed list) to support long-term behavior change. The included behavior change techniques are linked to an extensive gamification concept aimed at motivating and engaging the user [50]. As such, the app includes an avatar (a bird-like cartoon animal) that provides feedback by reflecting both the user's diary entries (vicarious reinforcement) [51,52] and progress.…”

Section: Pain-mentormentioning

confidence: 99%

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Toward Gamified Pain Management Apps: Mobile Application Rating Scale–Based Quality Assessment of Pain-Mentor’s First Prototype Through an Expert Study

Hoffmann¹,

Faust-Christmann²,

Zolynski³

et al. 2020

JMIR Form Res

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Background The use of health apps to support the treatment of chronic pain is gaining importance. Most available pain management apps are still lacking in content quality and quantity as their developers neither involve health experts to ensure target group suitability nor use gamification to engage and motivate the user. To close this gap, we aimed to develop a gamified pain management app, Pain-Mentor. Objective To determine whether medical professionals would approve of Pain-Mentor’s concept and content, this study aimed to evaluate the quality of the app’s first prototype with experts from the field of chronic pain management and to discover necessary improvements. Methods A total of 11 health professionals with a background in chronic pain treatment and 2 mobile health experts participated in this study. Each expert first received a detailed presentation of the app. Afterward, they tested Pain-Mentor and then rated its quality using the mobile application rating scale (MARS) in a semistructured interview. Results The experts found the app to be of excellent general (mean 4.54, SD 0.55) and subjective quality (mean 4.57, SD 0.43). The app-specific section was rated as good (mean 4.38, SD 0.75). Overall, the experts approved of the app’s content, namely, pain and stress management techniques, behavior change techniques, and gamification. They believed that the use of gamification in Pain-Mentor positively influences the patients’ motivation and engagement and thus has the potential to promote the learning of pain management techniques. Moreover, applying the MARS in a semistructured interview provided in-depth insight into the ratings and concrete suggestions for improvement. Conclusions The experts rated Pain-Mentor to be of excellent quality. It can be concluded that experts perceived the use of gamification in this pain management app in a positive manner. This showed that combining pain management with gamification did not negatively affect the app’s integrity. This study was therefore a promising first step in the development of Pain-Mentor.

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Gamification of a Stress Management App: Results of a User Study

Hoffmann

Faust-Christmann

Zolynski

et al. 2019

Lecture Notes in Computer Science

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Stress-Mentor: Linking Gamification and Behavior Change Theory in a Stress Management Application

Cited by 10 publications

References 10 publications

A Biofeedback App to Instruct Abdominal Breathing (Breathing-Mentor): Pilot Experiment

A Biofeedback App to Instruct Abdominal Breathing (Breathing-Mentor): Pilot Experiment

Toward Gamified Pain Management Apps: Mobile Application Rating Scale–Based Quality Assessment of Pain-Mentor’s First Prototype Through an Expert Study

Gamification of a Stress Management App: Results of a User Study

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