# A scalable intervention for stress management practices

> **NIH NIH R41** · LIVOTION LLC · 2024 · $294,312

## Abstract

Roughly 60% of college students meet the criteria for at least one mental health disorder, with anxiety and 
depression being the most common diagnoses. The number of students seeking help for mental health issues 
increased by almost 40% at campus counseling centers between 2009 and 2015 and has continued to rise since 
the onset of the COVID-19 pandemic, yet the demand has not been proportionately matched with increased
funding to support mental health provision on college campuses. Thus, college students require a different 
approach to managing the stress that exacerbates their mental health symptoms. Technology-based breathing 
interventions for stress management, which have been shown to prevent and remediate stress, are growing in 
popularity with the rise of commercially available mobile apps and bio-feedback technologies that do not require 
the help of a professional. However, while such mHealth interventions are now widely available, they often fail 
because they do not lend themselves to use in real-world settings. Most technology-based interventions require 
the use of mobile phones ─ a disruptive and often unwelcome behavior in most educational settings. Existing 
biofeedback devices (e.g., chest straps, clip-ons, inhalers) are similarly contextually inappropriate, making use 
obvious, distracting, and potentially stigmatizing. To overcome these barriers, the PI developed the AIRpen, a
simple, affordable, multi-functional stress management device that is designed to fit into the fabric of users’ lives 
to potentially optimize the delivery, practice, and fidelity of diaphragmatic breathing (DB) interventions in realworld settings. With anecdotal and empirical evidence supporting the device as feasible and acceptable in realworld academic settings (Purdue IRB-2022-423), this Phase I STTR project proposes the following aims: Aim 1. 
Develop and refine the AIRpen intervention to enable the use of the device without oversight by a professional. 
Aim 2: Develop Smart AIRpen prototypes, which are equipped with sensors to measure user adherence in future 
real-world effectiveness studies. Aim 3: Establish the usability and acceptability of the AIRpen intervention with 
a sample of 60 college students (30 in each device group) in a laboratory setting and gather preliminary feedback 
on subject-reported stress using physiological and subjective surveys as a secondary outcome. Aim 4: Establish 
the feasibility of a future real-world research study that will evaluate the usability and acceptability of the AIRpen 
intervention when used during an exam period with a sample of 30 college students. Secondary outcome data 
utilizing subject-reported stress measures will also be collected. Results will support future larger-scale 
effectiveness trials and inform future protocol designs for scaling cost-effective and time-efficient treatments that
broadly support the development of coping skills for stress management.

## Key facts

- **NIH application ID:** 10922374
- **Project number:** 1R41AT012854-01
- **Recipient organization:** LIVOTION LLC
- **Principal Investigator:** Milton Aguirre
- **Activity code:** R41 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $294,312
- **Award type:** 1
- **Project period:** 2024-09-17 → 2026-02-28

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10922374

## Citation

> US National Institutes of Health, RePORTER application 10922374, A scalable intervention for stress management practices (1R41AT012854-01). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10922374. Licensed CC0.

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