Can digital health researchers make a difference during the pandemic? Results of the single-arm, chatbot-led Elena+: Care for COVID-19 interventional study

Frontiers in Public Health

Public Health

Tobias Kowatsch¹  Jacqueline Louise Mair²  Pavani Suryapalli³  Elgar Fleisch⁴  Joseph Ollier⁵  Florian von Wangenheim⁶  Alicia Salamanca-Sanabria⁷ 

[1] Centre for Digital Health Interventions, Chair of Information Management, Department of Management, Technology, and Economics, ETH Zurich, Zurich, Switzerland;Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence and Technological Enterprise (CREATE), Singapore, Singapore;Institute for Implementation Science in Health Care, University of Zurich, Zurich, Switzerland;School of Medicine, University of St. Gallen, St. Gallen, Switzerland;Centre for Digital Health Interventions, Chair of Information Management, Department of Management, Technology, and Economics, ETH Zurich, Zurich, Switzerland;Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence and Technological Enterprise (CREATE), Singapore, Singapore;Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore;Centre for Digital Health Interventions, Institute of Technology Management, University of St. Gallen, St. Gallen, Switzerland;Centre for Digital Health Interventions, Institute of Technology Management, University of St. Gallen, St. Gallen, Switzerland;Centre for Digital Health Interventions, Chair of Information Management, Department of Management, Technology, and Economics, ETH Zurich, Zurich, Switzerland;Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence and Technological Enterprise (CREATE), Singapore, Singapore;Mobiliar Lab for Analytics, Chair of Technology Marketing, Department of Management, Technology, and Economics, ETH Zurich, Zurich, Switzerland;Mobiliar Lab for Analytics, Chair of Technology Marketing, Department of Management, Technology, and Economics, ETH Zurich, Zurich, Switzerland;Centre for Digital Health Interventions, Chair of Information Management, Department of Management, Technology, and Economics, ETH Zurich, Zurich, Switzerland;Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence and Technological Enterprise (CREATE), Singapore, Singapore;Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (ASTAR), Singapore, Singapore;

关键词: chatbot;    conversational agent;    COVID-19;    holistic lifestyle intervention;    pandemic lifestyle care;    mental health;    anxiety;    depression;   

DOI  :  10.3389/fpubh.2023.1185702

 received in 2023-03-13, accepted in 2023-07-24,  发布年份 2023

来源: Frontiers

【 摘 要 】

BackgroundThe current paper details findings from Elena+: Care for COVID-19, an app developed to tackle the collateral damage of lockdowns and social distancing, by offering pandemic lifestyle coaching across seven health areas: anxiety, loneliness, mental resources, sleep, diet and nutrition, physical activity, and COVID-19 information.MethodsThe Elena+ app functions as a single-arm interventional study, with participants recruited predominantly via social media. We used paired samples T-tests and within subjects ANOVA to examine changes in health outcome assessments and user experience evaluations over time. To investigate the mediating role of behavioral activation (i.e., users setting behavioral intentions and reporting actual behaviors) we use mixed-effect regression models. Free-text entries were analyzed qualitatively.ResultsResults show strong demand for publicly available lifestyle coaching during the pandemic, with total downloads (N = 7′135) and 55.8% of downloaders opening the app (n = 3,928) with 9.8% completing at least one subtopic (n = 698). Greatest areas of health vulnerability as assessed with screening measures were physical activity with 62% (n = 1,000) and anxiety with 46.5% (n = 760). The app was effective in the treatment of mental health; with a significant decrease in depression between first (14 days), second (28 days), and third (42 days) assessments: F2,38 = 7.01, p = 0.003, with a large effect size (η2G = 0.14), and anxiety between first and second assessments: t54 = 3.7, p = <0.001 with a medium effect size (Cohen d = 0.499). Those that followed the coaching program increased in net promoter score between the first and second assessment: t36 = 2.08, p = 0.045 with a small to medium effect size (Cohen d = 0.342). Mediation analyses showed that while increasing number of subtopics completed increased behavioral activation (i.e., match between behavioral intentions and self-reported actual behaviors), behavioral activation did not mediate the relationship to improvements in health outcome assessments.ConclusionsFindings show that: (i) there is public demand for chatbot led digital coaching, (ii) such tools can be effective in delivering treatment success, and (iii) they are highly valued by their long-term user base. As the current intervention was developed at rapid speed to meet the emergency pandemic context, the future looks bright for other public health focused chatbot-led digital health interventions.

【 授权许可】

Unknown   
Copyright © 2023 Ollier, Suryapalli, Fleisch, Wangenheim, Mair, Salamanca-Sanabria and Kowatsch.