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This paper explores whether respiration biosignal feedback and mindfulness skill estimation enhance system usability and skill development. We develop a smartphone's accelerometer-based respiration tracking algorithm, eliminating the need for additional wearables. Unlike existing methods, our approach accurately captures slow breathing patterns typical of mindfulness meditation. Additionally, we introduce the first quantitative framework to estimate mindfulness skills---concentration, sensory clarity, and equanimity---based on accelerometer-derived respiration data. We develop and test our algorithms on 261 mindfulness sessions in both controlled and real-world settings. A user study comparing an experimental group receiving biosignal feedback with a control group using a standard app shows that respiration feedback enhances system usability. Our respiration tracking model achieves a mean absolute error (MAE) of 1.6 breaths per minute, closely aligning with ground truth data, while our mindfulness skill estimation attains F1 scores of 80-84% in tracking skill progression. By integrating respiration tracking and mindfulness estimation into a commercial app, we demonstrate the potential of smartphone sensors to enhance digital mindfulness training.<\/jats:p>","DOI":"10.1145\/3749498","type":"journal-article","created":{"date-parts":[[2025,9,3]],"date-time":"2025-09-03T17:15:45Z","timestamp":1756919745000},"page":"1-32","update-policy":"https:\/\/doi.org\/10.1145\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Mindfulness Meditation and Respiration: Accelerometer-based Respiration Rate and Mindfulness Progress Estimation to Enhance App Engagement and Mindfulness Skills"],"prefix":"10.1145","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8312-7001","authenticated-orcid":false,"given":"Mohammad Nur Hossain","family":"Khan","sequence":"first","affiliation":[{"name":"Worcester Polytechnic Institute, Worcester, Massachusetts, USA"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9604-6120","authenticated-orcid":false,"given":"David","family":"creswell","sequence":"additional","affiliation":[{"name":"Carnegie Mellon University, Pittsburgh, Pennsylvania, USA and Equa Health Inc., Pittsburgh, Pennsylvania, USA"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-6433-2970","authenticated-orcid":false,"given":"Jordan","family":"Albert","sequence":"additional","affiliation":[{"name":"Carnegie Mellon University, Pittsburgh, Pennsylvania, USA and Equa Health Inc., Pittsburgh, Pennsylvania, USA"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-1170-2484","authenticated-orcid":false,"given":"Patrick","family":"O'Connell","sequence":"additional","affiliation":[{"name":"Carnegie Mellon University, Pittsburgh, Pennsylvania, USA and Equa Health Inc., Pittsburgh, Pennsylvania, USA"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-3733-0248","authenticated-orcid":false,"given":"Shawn","family":"Fallon","sequence":"additional","affiliation":[{"name":"Carnegie Mellon University, Pittsburgh, Pennsylvania, USA and Equa Health Inc., Pittsburgh, Pennsylvania, USA"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-0943-3099","authenticated-orcid":false,"given":"Mathew","family":"Polowitz","sequence":"additional","affiliation":[{"name":"Carnegie Mellon University, Pittsburgh, Pennsylvania, USA and Equa Health Inc., Pittsburgh, Pennsylvania, USA"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5930-3899","authenticated-orcid":false,"given":"Xuhai orson","family":"Xu","sequence":"additional","affiliation":[{"name":"Columbia University, New York, new York, USA"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1917-054X","authenticated-orcid":false,"given":"Bashima","family":"islam","sequence":"additional","affiliation":[{"name":"Worcester Polytechnic Institute, Worcester, Massachusetts, USA"}]}],"member":"320","published-online":{"date-parts":[[2025,9,3]]},"reference":[{"key":"e_1_2_1_1_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10916-023-01941-4"},{"key":"e_1_2_1_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/1743-0003-11-87"},{"key":"e_1_2_1_3_1","doi-asserted-by":"publisher","DOI":"10.1109\/BSN56160.2022.9928461"},{"key":"e_1_2_1_4_1","doi-asserted-by":"publisher","DOI":"10.1109\/BSN.2019.8771072"},{"key":"e_1_2_1_5_1","doi-asserted-by":"publisher","DOI":"10.1109\/EMBC46164.2021.9631109"},{"key":"e_1_2_1_6_1","doi-asserted-by":"publisher","DOI":"10.1145\/3544548.3581265"},{"key":"e_1_2_1_7_1","volume-title":"Respiration rate monitoring methods: A review. 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