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  <front>
    <journal-meta />
    <article-meta>
      <title-group>
        <article-title>Adaptive interfaces for personalized digital wellbeing</article-title>
      </title-group>
      <contrib-group>
        <contrib contrib-type="author">
          <string-name>Hannes Bend</string-name>
          <email>hannes@breathing.ai</email>
          <xref ref-type="aff" rid="aff1">1</xref>
        </contrib>
        <contrib contrib-type="author">
          <string-name>Spruha K Reddy</string-name>
          <xref ref-type="aff" rid="aff0">0</xref>
        </contrib>
        <contrib contrib-type="author">
          <string-name>Yina Smith-Danenhower</string-name>
          <email>yina@breathing.ai</email>
          <xref ref-type="aff" rid="aff1">1</xref>
        </contrib>
        <contrib contrib-type="author">
          <string-name>Hoda Mahmoodzadegan</string-name>
          <email>hoda@breathing.ai</email>
          <xref ref-type="aff" rid="aff1">1</xref>
        </contrib>
        <contrib contrib-type="author">
          <string-name>Nathalie Di Domenico</string-name>
          <email>nathalie@breathing.ai</email>
          <xref ref-type="aff" rid="aff1">1</xref>
        </contrib>
        <contrib contrib-type="author">
          <string-name>Kamran Hughes</string-name>
          <email>kamran@breathing.ai</email>
          <xref ref-type="aff" rid="aff1">1</xref>
        </contrib>
        <aff id="aff0">
          <label>0</label>
          <institution>Columbia University</institution>
          ,
          <addr-line>New York, NY</addr-line>
          ,
          <country country="US">USA</country>
        </aff>
        <aff id="aff1">
          <label>1</label>
          <institution>breathing.ai</institution>
          ,
          <addr-line>Brooklyn, NY</addr-line>
          ,
          <country country="US">USA</country>
        </aff>
      </contrib-group>
      <abstract>
        <p>Especially since the start of the COVID-19 pandemic, the majority of humans spend most of their waking life using digital screen devices. The present paper explains how adaptive interfaces could improve digital well-being by customizing the output data and digital environments to each user. line applications have introduced elements directed to help users control breathing and aid The impact of natural environments on hu- in reducing stress and anxiety. man health to support subjective wellbeing In natural environments, a dynamic exchange has recently been studied [1, 2]. With an ex- takes place between one's physiological state panding variety of electronic media and dig- and one's response to and interaction with ital environments, screen time has inevitably the surrounding space, for instance with oxyincreased across all ages. Research suggests gen intake and carbon dioxide output. In curscreen time is negatively associated with the rent digital environments, conversely, users development of cognitive abilities, and posi- can only respond by choosing static elements tively associated with sleep problems, depres- on the screen. Detecting the user's physiosion, and anxiety [3]. logical state while using digital devices, and Studies have explored self-regulated med- understanding how diferent output data imitation techniques that relieve stress, reduce pact the user can inform algorithmic processes burnout, improve emotional awareness, and of adaptive interfaces to customize the outheighten attention [4]. In recent years, on- put data to the user's physiological state - and to adapt and personalize the digital experience to improve well-being during screen usage.</p>
      </abstract>
      <kwd-group>
        <kwd>eol&gt;Virtual reality</kwd>
        <kwd>biofeedback</kwd>
        <kwd>UX</kwd>
        <kwd>design</kwd>
        <kwd>color psychology</kwd>
        <kwd>machine learning</kwd>
        <kwd>digital wellbeing</kwd>
        <kwd>AI</kwd>
        <kwd>adaptive interfaces</kwd>
        <kwd>screen based interactions</kwd>
      </kwd-group>
    </article-meta>
  </front>
  <body>
    <sec id="sec-1">
      <title>1. Introduction</title>
      <p>© 2021 Copyright for this paper by its authors. Use
permitted under Creative Commons License Attribution 4.0
InterCPWrEooUrckReshdoinpgs IhStpN:/c1e6u1r3-w-0s.o7r3g (nCCatEiEoUnUaRlR(C-CWBYSW4..o0o).rrgk)shop Proceedings
1.1. The Use of VR and</p>
      <sec id="sec-1-1">
        <title>Biofeedback Devices</title>
        <p>
          The cross-disciplinary project “Mindful
Technologies” [
          <xref ref-type="bibr" rid="ref5">5</xref>
          ] started in 2014 with
neuroscientific research on visual stimuli and
comparing meditation techniques. The
preliminary findings suggested diferent visuals
impact neurophysiological states individually. It
was also found that diverse meditation
techniques led by the development of a virtual
reality (VR) experience with heart rate
biofeedback had individualized impacts. The VR
experience would display a randomized guided
meditation technique and personalized
visuals to help guide the user to lower their heart
rate. The subsequent digital health project
“SEAing Breath” [
          <xref ref-type="bibr" rid="ref6">6</xref>
          ] initiated in 2016 used VR
devices and breathing biofeedback
prompting the user to learn diaphragmatic
breathing in order to advance in a game-like
educational experience about sea level rise. In past
years, Afective Computing [
          <xref ref-type="bibr" rid="ref7">7</xref>
          ] has been used
to elicit and automatically recognize
diferent emotional states in immersive virtual
environments for applications in architecture,
health, education and videogames.
        </p>
        <p>Augmented Reality (AR) devices were used
for a project in collaboration with breathing
expert Wim Hof in 2018 [8]. Hof’s breathing
technique was clinically studied [9] to
voluntarily influence the sympathetic nervous
system and immune system response. Using AR
and a breathing sensor, the users would
follow a virtually guided breathing technique
and experience a visualization of their
breathing patterns in AR and as audio.</p>
        <p>The use of VR and AR devices paired with
wearables to detect and display the
physiological states to the users requires additional
hardware, and demands more time spent on
screens.</p>
      </sec>
      <sec id="sec-1-2">
        <title>1.2. Physiological Computing</title>
      </sec>
      <sec id="sec-1-3">
        <title>Using</title>
      </sec>
      <sec id="sec-1-4">
        <title>Photoplethysmography</title>
        <p>Physiological computing (PG) [10] uses
physiological data as system inputs in real-time so
software can be changed based on the user’s
physiological state, and
Photoplethysmography (PPG) [11] is a measurement technique
enabling remote vital sign monitoring by
using only cameras integrated in laptops and
phones.</p>
        <p>The project “NEHAN” [12] in 2018 at MIT
(Massachusetts Institute of Technology) used
PG and PPG to detect the user’s heart rate
using the laptop webcam and machine
learning, and to display virtual and audio
environments to the user. The interactions with the
digital environments were analyzed and the
visuals and audio with the lowest heart rate
were displayed to the user.
2. 2020 Survey on</p>
      </sec>
    </sec>
    <sec id="sec-2">
      <title>Screen-time</title>
      <p>Our ongoing research found that 55.7% of screen
users (n=210) report they sometimes or often
adjust screen settings like color, and, 87.1% of
screen users experience symptoms like
mental exhaustion and eye strain while using screens
for a long time, whereas 12.9% don’t
experience any symptoms.</p>
      <p>The majority (88.6%) of screen users adjust
screen settings to improve symptoms during
lengthy periods of screen use. Prototype
testing of Adaptive Interfaces [13] using PPG and
color displays in uncontrolled settings between
2018 and 2020 (n=80) indicated
personalization of colors to each user can lead to an
inimproved education and reduced anxiety [15,
16].</p>
      <sec id="sec-2-1">
        <title>2.3. Color Psychology</title>
        <p>Color and its efects on psychological
functioning have been long intertwined although
research in this area is still at a nascent stage.</p>
        <p>Theory of Color draws associations between
Figure 2: Frequency of Screen Adjustments color categories and emotional response.
Longerwavelength colors were found to instigate a
feeling of warmth whereas shorter wavelength
dividualized reduction in heart rate by up to colors feel relaxing and cool [17].
20% while experiencing the color display. The right combination of colors can
produce a higher level of contrast which in turn
2.1. Adaptive Interfaces for can influence memory retention [18]. Color
Screen-based Interactions is also seen to play a vital role in consumer
psychology which is characterized by
emoRecent development of imaging photoplethys- tional attachment, attention, memory, attitudes,
mography (iPPG) leverages subtle changes in and behaviors [19].
light reflected from the skin to capture car- Research has also indicated that diferent
diac activity. These signals can be recovered screen polarities and background colors can
from many types of commercially available influence reading and comprehension of
graphand low-cost cameras (e.g., webcams and sm- ics on a screen [20] with results showing that
artphones) [14]. participants performed well while looking at</p>
        <p>Continuously detecting physiological data a light mode screen rather than a dark mode
of the user during screen- or audio-based in- screen.
teractions is now becoming possible using (i)
PPG to detect neurological or cardiac
activity such as heart rate, heart rate variability or 3. Conclusion
breathing rate without additional hardware.</p>
        <p>Continuously customizing the output data Recent improvements in webcam quality to
to the users’ physiological state is becoming record for more accurate (i)PPG, faster
propossible with the ongoing research and de- cessing and cloud computing, along with users’
velopment of Adaptive Interfaces. higher comfort levels with webcams during
the COVID-19 pandemic and the increased
2.2. Efect of Virtual presence of stressful screen time, have
enabled the potential for a more personalized</p>
        <p>Environments human-computer interaction. We
hypotheVirtual environments have been optimized to size the research and development of
Adapaid neurobehavioral processes including at- tive Interfaces to customize output data to the
tention and emotion regulation. Technology users’ physiological and neurological state can
is gradually being adopted by organizations result in a stress-reducing interaction within
to train employees to be more productive. A digital environments. With the
personalizapilot study showed that virtual stimulation tion of the user experience, screen settings
and designs can support digital wellbeing as
screen time becomes similar to a more
dynamic interaction as experienced with
natural environments.
tion recognition from brain and
heartbeat dynamics using wearable sensors,</p>
        <p>Scientific reports 8 (2018) 1–15.
[8] H. Bend, Augmented reality (ar)
wim hof + breath biofeedback
and vr film (2018). URL: https:
//www.youtube.com/playlist?list=</p>
        <p>PLxkGuUxHzSsVdyJJ00gL_zawpQRJti.
[9] M. Kox, L. T. van Eijk, J. Zwaag,</p>
        <p>J. van den Wildenberg, F. C. Sweep, J. G.
van der Hoeven, P. Pickkers,
Voluntary activation of the sympathetic
nervous system and attenuation of the
innate immune response in humans,
Proceedings of the National Academy of</p>
        <p>Sciences 111 (2014) 7379–7384.
[10] G. Jacucci, S. Fairclough, E. T. Solovey,</p>
        <p>Physiological computing, Computer 48
(2015) 12–16.
[11] V. Kessler, M. Kächele, S. Meudt,</p>
        <p>F. Schwenker, G. Palm, Machine
learning driven heart rate detection with
camera photoplethysmography in time
domain, in: IAPR Workshop on
Artificial Neural Networks in Pattern
Recognition, Springer, 2016, pp. 324–334.
[12] N. Picard, H. Bend, Mit 2018.
detecting heart rate via webcam,
display of personalized visuals and audio
(2018). URL: https://www.youtube.com/
watch?v=TCUX0mNya5Q.
[13] H. Bend, breathing.ai prototype
testing and interviews nov 9 and 10, 2018,
2018. URL: https://www.youtube.com/
watch?v=mpbWQbkl8_g#t=20m15s.
[14] E. M. Nowara, D. McDuf, A.
Veeraraghavan, Systematic analysis of
video-based pulse measurement from
compressed videos, Biomedical Optics</p>
        <p>Express 12 (2020) 494–508.
[15] M. Marquess, S. P. Johnston, N. L.</p>
        <p>Williams, C. Giordano, B. E. Leiby, M. D.</p>
        <p>Hurwitz, A. P. Dicker, R. B. Den, A pilot
study to determine if the use of a virtual
reality education module reduces
anxiety and increases comprehension in
patients receiving radiation therapy,
Journal of Radiation Oncology 6 (2017) 317–
322.
[16] J. L. Maples-Keller, B. E. Bunnell, S.-J.</p>
        <p>Kim, B. O. Rothbaum, The use of
virtual reality technology in the treatment
of anxiety and other psychiatric
disorders, Harvard review of psychiatry 25
(2017) 103.
[17] L. Wilms, D. Oberfeld, Color and
emotion: efects of hue, saturation, and
brightness, Psychological research 82
(2018) 896–914.
[18] E. Krahn, Decomposing the efect of
color on memory: How red and blue
affect memory diferently, Pridi
Banomyong International College, Thammasat</p>
        <p>University (2018).
[19] M. A. Dzulkifli, M. F. Mustafar, The
influence of colour on memory
performance: A review, The Malaysian
journal of medical sciences: MJMS 20 (2013)
3.
[20] Y.-N. Shih, R.-H. Huang, S.-F. Lu, The
influence of computer screen polarity
and color on the accuracy of workers’
reading of graphics, National Library
of Medicine 45 (2013) 335–42.</p>
      </sec>
    </sec>
  </body>
  <back>
    <ref-list>
      <ref id="ref1">
        <mixed-citation>
          [1]
          <string-name>
            <given-names>M. P.</given-names>
            <surname>White</surname>
          </string-name>
          ,
          <string-name>
            <given-names>S.</given-names>
            <surname>Pahl</surname>
          </string-name>
          ,
          <string-name>
            <given-names>B. W.</given-names>
            <surname>Wheeler</surname>
          </string-name>
          ,
          <string-name>
            <given-names>M. H.</given-names>
            <surname>Depledge</surname>
          </string-name>
          ,
          <string-name>
            <given-names>L. E.</given-names>
            <surname>Fleming</surname>
          </string-name>
          ,
          <article-title>Natural environments and subjective wellbeing: Diferent types of exposure are associated with diferent aspects of wellbeing</article-title>
          ,
          <source>Health &amp; Place</source>
          <volume>45</volume>
          (
          <year>2017</year>
          )
          <fpage>77</fpage>
          -
          <lpage>84</lpage>
          .
        </mixed-citation>
      </ref>
      <ref id="ref2">
        <mixed-citation>
          [2]
          <string-name>
            <given-names>M. H.</given-names>
            <surname>Depledge</surname>
          </string-name>
          ,
          <string-name>
            <given-names>R. J.</given-names>
            <surname>Stone</surname>
          </string-name>
          ,
          <string-name>
            <given-names>W. J.</given-names>
            <surname>Bird</surname>
          </string-name>
          ,
          <article-title>Can natural and virtual environments be used to promote improved human health and wellbeing?</article-title>
          ,
          <source>Environmental Science &amp; Technology</source>
          <volume>45</volume>
          (
          <year>2011</year>
          )
          <fpage>4660</fpage>
          -
          <lpage>4665</lpage>
          .
        </mixed-citation>
      </ref>
      <ref id="ref3">
        <mixed-citation>
          [3]
          <string-name>
            <given-names>S.</given-names>
            <surname>Domingues-Montanari</surname>
          </string-name>
          ,
          <article-title>Clinical and psychological efects of excessive screen time on children</article-title>
          ,
          <source>Journal of paediatrics and child health 53</source>
          (
          <year>2017</year>
          )
          <fpage>333</fpage>
          -
          <lpage>338</lpage>
          .
        </mixed-citation>
      </ref>
      <ref id="ref4">
        <mixed-citation>
          [4]
          <string-name>
            <given-names>C.</given-names>
            <surname>Heeter</surname>
          </string-name>
          ,
          <string-name>
            <given-names>R.</given-names>
            <surname>Lehto</surname>
          </string-name>
          ,
          <string-name>
            <given-names>M.</given-names>
            <surname>Allbritton</surname>
          </string-name>
          ,
          <string-name>
            <given-names>T.</given-names>
            <surname>Day</surname>
          </string-name>
          ,
          <string-name>
            <given-names>M.</given-names>
            <surname>Wiseman</surname>
          </string-name>
          ,
          <article-title>Efects of a technology-assisted meditation program on healthcare providers' interoceptive awareness, compassion fatigue, and burnout</article-title>
          ,
          <source>Journal of Hospice &amp; Palliative Nursing</source>
          <volume>19</volume>
          (
          <year>2017</year>
          )
          <fpage>314</fpage>
          -
          <lpage>322</lpage>
          .
        </mixed-citation>
      </ref>
      <ref id="ref5">
        <mixed-citation>
          [5]
          <string-name>
            <given-names>H.</given-names>
            <surname>Bend</surname>
          </string-name>
          ,
          <string-name>
            <given-names>S.</given-names>
            <surname>Slater</surname>
          </string-name>
          ,
          <string-name>
            <given-names>B.</given-names>
            <surname>Knapp</surname>
          </string-name>
          , N. Ma,
          <string-name>
            <given-names>R.</given-names>
            <surname>Alexander</surname>
          </string-name>
          ,
          <string-name>
            <given-names>B.</given-names>
            <surname>Shah</surname>
          </string-name>
          ,
          <string-name>
            <given-names>R.</given-names>
            <surname>Jayne</surname>
          </string-name>
          ,
          <article-title>Mindful technologies research and developments in science and art</article-title>
          , AAAI Spring Symposium Series (
          <year>2016</year>
          ).
        </mixed-citation>
      </ref>
      <ref id="ref6">
        <mixed-citation>
          [6]
          <string-name>
            <surname>M.-D. County</surname>
          </string-name>
          , the University of Miami,
          <article-title>Project for the sea level rise public art program, 2018. Retrieved from www</article-title>
          .
          <source>seaingbreath.com.</source>
        </mixed-citation>
      </ref>
      <ref id="ref7">
        <mixed-citation>
          [7]
          <string-name>
            <given-names>J.</given-names>
            <surname>Marin-Morales</surname>
          </string-name>
          ,
          <string-name>
            <given-names>J. L.</given-names>
            <surname>Higuera-Trujillo</surname>
          </string-name>
          ,
          <string-name>
            <given-names>A.</given-names>
            <surname>Greco</surname>
          </string-name>
          ,
          <string-name>
            <given-names>J.</given-names>
            <surname>Guixeres</surname>
          </string-name>
          ,
          <string-name>
            <given-names>C.</given-names>
            <surname>Llinares</surname>
          </string-name>
          ,
          <string-name>
            <given-names>E. P.</given-names>
            <surname>Scilingo</surname>
          </string-name>
          ,
          <string-name>
            <given-names>M.</given-names>
            <surname>Alcañiz</surname>
          </string-name>
          , G. Valenza,
          <article-title>Afective computing in virtual reality: emo-</article-title>
        </mixed-citation>
      </ref>
    </ref-list>
  </back>
</article>