Work

Encouraging Breath: Increasing Out‑of‑Session DMHI Engagement using a Shape‑Changing Biofeedback Physicalization within a Longitudinal RCT

Year: 2026

Type: conference-paper

Study designs: Randomized Controlled Trial, Clinical Trial

Abstract: Out-of-session or “homework” engagement is a primary limiting factor in clinical mental health outcomes. Despite weekly practitioner contact, adherence to prescribed Digital Mental Health Interventions (DMHIs) typically drops by 96.1% within two weeks. We evaluate Ankor, a handheld shape-changing biofeedback physicalization, as an adjunct to standard audio-guided mindfulness. In a longitudinal randomized controlled study (N=69), participants were assigned to Ankor+audio or audio-only control across six weekly 15-minute laboratory sessions, with optional DMHI use between sessions. Relative to control, Ankor yielded a 351% increase in total DMHI practice initiations and, by week 2, maintained 29.4% active users versus 2.9% in control, indicating substantially higher out-of-session engagement and reduced early disengagement. These findings demonstrate the capacity of shape-changing biofeedback physicalizations to extend adherence to DMHIs, highlighting kinaesthetic interactions as a promising design pathway for sustaining engagement in mental health interventions.

Source: CHI Conference on Human Factors in Computing Systems

DOI: 10.1145/3772318.3790933

Authors: Alexz Farrall, Adwait Sharma, Ben Ainsworth, Pamela Jacobsen, Jason Alexander

Institutions: ADA University, University of Bath, University of Southampton

Language: English

Topic: Digital Mental Health Interventions

Subfield: Applied Psychology

Field: Psychology

Domain: Social Sciences

SDG: Good health and well-being

Open Access status: hybrid

Funders: European Commission, Engineering and Physical Sciences Research Council