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Record W4415584156 · doi:10.2196/70297

Long-Term Usage of Breeze, a Gamified Breathing Training App, and Its Effect on Momentary Relaxation in People With Cancer: Cohort Study

2025· article· en· W4415584156 on OpenAlexvenueno aff
Anja Yvonne Bischof, Tobias Budig, Sonja Schläpfer, Yanick Xavier Lukic, Fabian Schneider, Prabhakaran Santhanam, Jürgen Barth, Claudia M. Witt, Tobias Kowatsch

Bibliographic record

VenueJMIR Serious Games · 2025
Typearticle
Languageen
FieldMedicine
TopicCancer survivorship and care
Canadian institutionsnot available
Fundersnot available
KeywordsBreathingRelaxation (psychology)Training (meteorology)Cohort studyCohort

Abstract

fetched live from OpenAlex

Background: People with cancer often experience stress. Digital health interventions can help individuals increase momentary relaxation. Breeze is a gamified breathing training that can be embedded into digital health interventions. Its effectiveness in controlled cross-sectional studies has been demonstrated. However, adherence to Breeze and its effect on momentary relaxation in longitudinal interventional studies has yet to be investigated. Objective: This study aimed to assess Breeze across 3 key dimensions: (1) its usage over time compared to other intervention components; (2) the accuracy with which users adhered to the guiding breathing pattern provided by Breeze; and (3) its effect on momentary relaxation, including the impact of the duration of the breathing session delivered by Breeze. Methods: Breeze was 1 of 7 relaxation techniques included in the CanRelax 2.0 app, designed specifically for individuals diagnosed with cancer. Participants could select any of the 7 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 5 years recruited across Switzerland, Germany, and Austria. Adherence to the intended breathing pattern was measured using a Pearson correlation coefficient. Momentary relaxation was measured pre- and post-exercise using an 11-point visual analog scale. Statistical analyses included linear mixed effects models and calculations of effect sizes. We further analyzed the relationship between session duration and the magnitude of momentary relaxation and compared Breeze's efficacy and time efficiency to the other available techniques. Results: Of 279 participants, 118 (42.3%) 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 declined initially but remained stable even after 10 weeks. Participants followed the predefined breathing rates of Breeze (r=0.9). On average, a small effect (-0.42; P<.001; d=0.19) on momentary relaxation was observed, with 2-minute breathing sessions (-0.30; P=.02; d=0.13) showing a small effect, whereas a large effect (-1.53; P=.03; d=0.74) was observed for breathing sessions of 4 minutes or longer. Conclusions: This study demonstrates the potential of Breeze to alleviate acute stress in individuals with chronic conditions, such as cancer. By combining gamification with evidence-based breathing techniques, Breeze fosters sustained user engagement and momentary relaxation. Participants adhered well to the guided breathing. While even short breathing sessions of 2 minutes provided modest momentary relaxation, longer durations (≥4 min) were considerably more effective. Future research aims to assess the impact of Breeze on other populations and chronic conditions.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.000
metaresearch head score (Gemma)0.000
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: Observational
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.062
Threshold uncertainty score0.988

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0000.000
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0000.000
Bibliometrics0.0000.000
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.000
Insufficient payload (model declined to judge)0.0000.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.009
GPT teacher head0.289
Teacher spread0.280 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one teacher head, not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designObservational
Domainnot available
GenreEmpirical

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations4
Published2025
Admission routes1
Has abstractyes

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