# Mindfulness Meditation and Respiration Biosignal Feedback

> **NIH NIH R44** · EQUA HEALTH, INC. · 2024 · $291,447

## Abstract

PROJECT SUMMARY/ABSTRACT
Young adults (18-30 years) in the US are suffering from unprecedented increases in depressive
symptomatology, anxiety, and loneliness, which are major risk factors for mental illness. Building from our
controlled clinical trials of digital mindfulness meditation training, our company has released an interactive and
data-driven mindfulness meditation application called Equa, which can help reduce the mental distress and
loneliness facing young adults today. There are now 1000s of mindfulness meditation digital apps on the
commercial market, but these apps suffer from poor user engagement over time, and our clinical trials show
that sustained engagement is critical for mental health outcomes. Our overarching goal is to translate our
clinical trials results and evidence-based Equa training platform into a commercial product that helps young
adult users stay engaged with mindfulness training in order to reduce mental distress and loneliness. This
proposal describes new research and development of a respiration biosignal feedback technology, which will
help Equa users better visualize and understand their mindfulness skill development. Building on our
preliminary studies, this fast track SBIR proposal will first validate a new respiration biosignal feedback tool on
Equa in distressed young adults (in Phase I), and then to test whether this new Equa biosignal feedback
improves user engagement and outcomes among distressed young adults (in Phase II). Specifically in Phase I,
we will collect Equa-guided meditation data with respiration tracking in distressed young adults (Study 1 N=80)
in order to optimize deep learning algorithms that link changes in respiration dynamics with pre-post session
changes in mindfulness skills (Phase I performance milestone: 90% prediction accuracy). We will also conduct
usability testing (Study 2 N=60) with the respiration biosignal feedback features on Equa (Phase I milestones:
>85 on System Usability Scale (SUS), and experimentally evaluate if Equa-augmented respiration biosignal
tracking significantly increases user satisfaction relative to Equa with no biosignal tracking). In Phase II, we will
conduct a three arm clinical trial comparing Equa guided meditation training with respiration biosignal feedback
to Equa without respiration biosignal feedback or an active stress management control program in distressed
young adults (N=300). It is predicted that respiration biosignal feedback (relative to the two active comparator
groups) significantly increases user satisfaction and platform engagement, and significantly reduces mental
distress and loneliness at post treatment and one month follow-up. In doing so, this research will position Equa
for dissemination to a large young adult market. The ultimate goal of this fast track proposal is to develop a
more engaging and evidence-based mindfulness meditation product for curbing the growing mental health
crisis in young adults.

## Key facts

- **NIH application ID:** 10919943
- **Project number:** 1R44MH134709-01A1
- **Recipient organization:** EQUA HEALTH, INC.
- **Principal Investigator:** John David Creswell
- **Activity code:** R44 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $291,447
- **Award type:** 1
- **Project period:** 2024-07-15 → 2025-07-14

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10919943

## Citation

> US National Institutes of Health, RePORTER application 10919943, Mindfulness Meditation and Respiration Biosignal Feedback (1R44MH134709-01A1). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10919943. Licensed CC0.

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