MIRROR, MIRROR, ON THE SCREEN: CODESIGN OF A BREATHING RETRAINING AVATAR INTERVENTION

Citation

Maltinsky W, Henton S & Taylor A (2023) MIRROR, MIRROR, ON THE SCREEN: CODESIGN OF A BREATHING RETRAINING AVATAR INTERVENTION. International Conference of Behavioural Science, Vancouver, 23.08.2023-26.08.2023.

Abstract
Background: Breathing pattern disorder (BPD) affects roughly 10% of the UK population with similar estimations worldwide. Symptoms can include air hunger and hyperventilation. Breathing retraining is the most effective treatment however has suboptimal adherence. This study describes the use of the Capability, Opportunity and Motivation (COM-B) framework with co-design to co-develop a digital avatar (twin) to strengthen clinic-based breathing retraining. Method: Intervention development included iterative mixed methods: 1) A targeted scoping review was undertaken to identify effective intervention characteristics. 2) People with BPD participated in workshops exploring BPD and treatment experience and to codesign the avatar 3) A workshop with clinicians discussed treatment procedures and avatar integration. Data was analysed thematically using the COM-B Framework to propose the theoretically informed digital intervention. Results The review revealed limited literature on digital breathing retraining interventions. Current barriers to breathing retraining noted by clinicians and patients was poor self-efficacy and low understanding of diaphragm control. During periods of distress, patients struggled to remember breathing exercises. Patients and clinicians believed avatar use could strengthen association between observable body movement and physiology and may assist self-efficacy, provide positive reinforcement and act as a visual aid to strengthen post-clinic practicing. Clinicians wanted an adaptable system for the wide range of individual needs that could increase understanding and minimise risk of information overload. Conclusions The codesign process along with a theoretical framework was successful in producing a proposal for an individualized digital avatar that may assist in building motivation through strengthening interoceptive awareness and supporting capability.