A Biofeedback-Based Mobile App With Serious Games for Young Adults With Anxiety in the United Arab Emirates: Development and Usability Study

Mariam Almeqbaali, Sofia Ouhbi, Mohamed Adel Serhani, Leena Amiri, Reem K. Jan, Nazar Zaki, Ayman Sharaf, Abdulla Al Helali, Eisa Almheiri

Research output: Contribution to journalArticlepeer-review

6 Citations (Scopus)


Background: Following the outbreak of COVID-19, several studies have reported that young adults encountered a rise in anxiety symptoms, which could negatively affect their quality of life. Promising evidence suggests that mobile apps with biofeedback, serious games, breathing exercises, and positive messaging, among other features, are useful for anxiety self-management and treatment. Objective: This study aimed to develop and evaluate the usability of a biofeedback-based app with serious games for young adults with anxiety in the United Arab Emirates (UAE). Methods: This study consists of two phases: Phase I describes the design and development of the app, while Phase II presents the results of a usability evaluation by experts. To elicit the app's requirements during Phase I, we conducted (1) a survey to investigate preferences of young adults in the UAE for mobile games for stress relief; (2) an analysis of serious games for anxiety; and (3) interviews with mental health professionals and young adults in the UAE. In Phase II, five experts tested the usability of the developed app using a set of Nielsen's usability heuristics. Results: A fully functional biofeedback-based app with serious games was co-designed with mental health professionals. The app included 4 games (ie, a biofeedback game, card game, arcade game, and memory game), 2 relaxation techniques (ie, a breathing exercise and yoga videos), and 2 additional features (ie, positive messaging and a mood tracking calendar). The results of Phase II showed that the developed app is efficient, simple, and easy to use. Overall, the app design scored an average of 4 out of 5. Conclusions: The elicitation techniques used in Phase I resulted in the development of an easy-to-use app for the self-management of anxiety. Further research is required to determine the app's usability and effectiveness in the target population.

Original languageEnglish
Article numbere36936
JournalJMIR Serious Games
Issue number3
Publication statusPublished - Jul 1 2022


  • anxiety
  • app
  • biofeedback
  • connected mental health
  • development
  • digital game
  • gamification
  • gaming
  • mHealth
  • mental health
  • mobile health
  • serious game
  • stress
  • stress relief
  • usability
  • user experience
  • user feedback
  • user need
  • user-centered design
  • user-centred design
  • young adult
  • youth

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation
  • Biomedical Engineering
  • Rehabilitation
  • Psychiatry and Mental health


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