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Breathe2Relax Evaluation

"A portable stress management tool which provides detailed information on the effects of stress on the body and instructions and practice exercises to help users learn the stress management skill called diaphragmatic breathing." Evaluated: December 2019

The below evaluation is an example of the types of information you may find when using our Model to assess specific apps. This sample evaluation is not intended to enable you to make a decision about choosing these specific apps for actual use, as such a decision is a personal one that you will make based on your own unique preferences, needs, and evaluation. We strongly encourage you to download these apps for yourself and use our Model to conduct your own assessment.

This evaluation was completed December 6th and 7th, 2019, and is based on publicly available information found by our Panel at that time. In June 2020, APA's contacted the app developers and offered to them an opportunity to provide feedback on these assessments. Comments from developers who responded are included here. These comments do not necessarily reflect publicly available information at the time of the original assessment or presently.

Access & Background

On which platforms/operating systems does the app work? Does it also work on desktop?

iOS and Android

Has the app been updated in the last 180 days?

No, last updated May 2019

Does the app identify ownership?

Yes, Defense Health Agency.

Does the app identify funding sources and conflicts of interest?

Yes, the Department of Defense.

Does the app come from a trusted source?

Yes, the government.

Does the app claim to be medical?

No, but provides education about stress and diaphragmatic breathing.

Are there additional or hidden costs?

No

Does the app work offline?

Yes

Does the app work with accessibility features of the iPhone/Android? Is it accessible for those with impaired vision or other disabilities?

No app accessibility settings are apparent within this app to the reviewer.

Privacy & Safety

Is there a transparent privacy policy that is clear and accessible before use?

Yes, upon initial opening of the app. It is difficult to find after this; user might need to look for privacy policy in other sources, such as the app web site.

Does the app collect, use, and/or transmit sensitive data? If yes, does it claim to do so securely?

No, the app does not collect data.

Does the app declare data use and purpose?

The app does not collect data.

Does the app describe use of PHI?

The app does not collect PHI.

Can you opt out of data collection or delete data?

No, the app does not collect data.

Is data maintained in the device or on the web?

Neither, the app does not collect data.

Does the app explain security systems used?

The app does not collect data.

What third parties does the app share data with?

None, the app does not collect data.

If appropriate, is the app equipped to respond to potential harms or safety concerns?

Evidence for the app's ability to respond to potential harms or safety concerns were not found by this reviewer.

Clinical Foundation

Does the app appear to do what it claims to do?

Yes, the app offers breathing exercises to assist with coping skills.

Is there evidence of specific benefit from academic institutions, publications, end user feedback or research studies?

There is preliminary evidence showing support for its use, and it has also been compared to similar apps in peer-reviewed articles.

Does the app have a clinical/recovery foundation relevant to your intended use?

Not explicitly. However appears to be informed by principles of mindfulness and CBT.

Is the app content correct, well-written, and relevant?

Yes, it is simple and straightforward.

What are the relevant sources or references supporting the app use cases?

A peer reviewed article.

Was there an attempt to validate app usability and feasibility?

Not explicitly

Is there evidence of effectiveness/efficacy?

Preliminary evidence is available in a peer reviewed article.

Usability

Does the app seem easy to use?

Yes, it is very straightforward.

What are the main engagement styles of the app?

Video, text and activities

Do the app and its features align with your needs and priorities?

Yes

Is it customizable?

Users can change length of inhale/exhales and background.

Does the app clearly define its functional scope?

Yes, this is an app to practice breathing techniques for stress reduction.

Therapeutic Goal

Can data be easily shared and interpreted in a way that's consistent with the stated purpose of the app?

There is no data to share on the app.

Do you own your data?

The app does not collect data.

Can the app share data with EMR and other data tools (Apple HealthKit, FitBit)?

No, the app does not collect data.

Is the app for individual use or to be used in collaboration with a provider? If intended to be used with a provider, does the app have the ability to export or transfer data?

The app is primarily for individual use.

Does the app lead to any positive behavior change or skill acquisition?

The app is intended for learning and practicing breathing techniques.

Does the app improve therapeutic alliance between patient and provider?

That is not the app's intended purpose.

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