An Automated Conversational Agent Self-Help Program: Randomized Controlled Trial
BackgroundHealth promotion and growth-based interventions can effectively improve individual well-being; however, significant gaps in access and utilization still exist. ObjectiveThis study aims to develop and test the effectiveness and implementation of a new, wi...
Saved in:
| Main Authors: | , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
JMIR Publications
2024-12-01
|
| Series: | Journal of Medical Internet Research |
| Online Access: | https://www.jmir.org/2024/1/e53829 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1846138938334380032 |
|---|---|
| author | Heather M Foran Christian Kubb Janina Mueller Spencer Poff Megan Ung Margaret Li Eric Michael Smith Akinniyi Akinyemi Melanie Kambadur Franziska Waller Mario Graf Y-Lan Boureau |
| author_facet | Heather M Foran Christian Kubb Janina Mueller Spencer Poff Megan Ung Margaret Li Eric Michael Smith Akinniyi Akinyemi Melanie Kambadur Franziska Waller Mario Graf Y-Lan Boureau |
| author_sort | Heather M Foran |
| collection | DOAJ |
| description |
BackgroundHealth promotion and growth-based interventions can effectively improve individual well-being; however, significant gaps in access and utilization still exist.
ObjectiveThis study aims to develop and test the effectiveness and implementation of a new, widely targeted conversational agent prevention program (Zenny) designed to enhance well-being.
MethodsA total of 1345 individuals in the United States were recruited online and randomly assigned to either (1) a self-help program intervention delivered via an automated conversational agent on WhatsApp or (2) an active control group that had access to evidence-based wellness resources available online. The primary outcomes were well-being (measured using the 5-item World Health Organization Well-being Scale), psychosocial flourishing (assessed with the Flourishing Scale), and positive psychological health (evaluated with the Mental Health Continuum-Short Form). Outcome measures were collected at baseline and again 1 month postassessment. All analyses were conducted using an intention-to-treat approach.
ResultsBoth groups showed significant improvements in well-being (self-help program intervention group effect size: Cohen d=0.26, P<.001; active control group effect size: d=0.24, P<.001), psychosocial flourishing (intervention: d=0.19, P<.001; active control: d=0.18, P<.001), and positive psychological health (intervention: d=0.17, P=.001; active control: d=0.24, P<.001) at postassessment. However, there were no significant differences in effectiveness between the 2 groups (P ranged from .56 to .92). As hypothesized a priori, a greater number of days spent actively engaging with the conversational agent was associated with larger improvements in well-being at postassessment among participants in the intervention group (β=.109, P=.04).
ConclusionsThe findings from this study suggest that the free conversational agent wellness self-help program was as effective as evidence-based web resources. Further research should explore strategies to increase participant engagement over time, as only a portion of participants were actively involved, and higher engagement was linked to greater improvements in well-being. Long-term follow-up studies are also necessary to assess whether these effects remain stable over time.
Trial RegistrationClinicalTrials.gov NCT06208566; https://clinicaltrials.gov/ct2/show/NCT06208566; OSF Registries osf.io/ahe2r; https://doi.org/10.17605/osf.io/ahe2r |
| format | Article |
| id | doaj-art-f202906e55c24407a07cf42a40fc03a5 |
| institution | Kabale University |
| issn | 1438-8871 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | JMIR Publications |
| record_format | Article |
| series | Journal of Medical Internet Research |
| spelling | doaj-art-f202906e55c24407a07cf42a40fc03a52024-12-06T15:45:41ZengJMIR PublicationsJournal of Medical Internet Research1438-88712024-12-0126e5382910.2196/53829An Automated Conversational Agent Self-Help Program: Randomized Controlled TrialHeather M Foranhttps://orcid.org/0000-0001-6659-5500Christian Kubbhttps://orcid.org/0000-0002-9514-1281Janina Muellerhttps://orcid.org/0000-0002-5005-2218Spencer Poffhttps://orcid.org/0009-0001-6189-8366Megan Unghttps://orcid.org/0000-0003-3063-3207Margaret Lihttps://orcid.org/0009-0008-3512-5563Eric Michael Smithhttps://orcid.org/0009-0005-3076-1948Akinniyi Akinyemihttps://orcid.org/0009-0004-2361-8476Melanie Kambadurhttps://orcid.org/0009-0008-7481-6850Franziska Wallerhttps://orcid.org/0000-0002-4576-4325Mario Grafhttps://orcid.org/0000-0001-6443-1342Y-Lan Boureauhttps://orcid.org/0009-0008-3990-5778 BackgroundHealth promotion and growth-based interventions can effectively improve individual well-being; however, significant gaps in access and utilization still exist. ObjectiveThis study aims to develop and test the effectiveness and implementation of a new, widely targeted conversational agent prevention program (Zenny) designed to enhance well-being. MethodsA total of 1345 individuals in the United States were recruited online and randomly assigned to either (1) a self-help program intervention delivered via an automated conversational agent on WhatsApp or (2) an active control group that had access to evidence-based wellness resources available online. The primary outcomes were well-being (measured using the 5-item World Health Organization Well-being Scale), psychosocial flourishing (assessed with the Flourishing Scale), and positive psychological health (evaluated with the Mental Health Continuum-Short Form). Outcome measures were collected at baseline and again 1 month postassessment. All analyses were conducted using an intention-to-treat approach. ResultsBoth groups showed significant improvements in well-being (self-help program intervention group effect size: Cohen d=0.26, P<.001; active control group effect size: d=0.24, P<.001), psychosocial flourishing (intervention: d=0.19, P<.001; active control: d=0.18, P<.001), and positive psychological health (intervention: d=0.17, P=.001; active control: d=0.24, P<.001) at postassessment. However, there were no significant differences in effectiveness between the 2 groups (P ranged from .56 to .92). As hypothesized a priori, a greater number of days spent actively engaging with the conversational agent was associated with larger improvements in well-being at postassessment among participants in the intervention group (β=.109, P=.04). ConclusionsThe findings from this study suggest that the free conversational agent wellness self-help program was as effective as evidence-based web resources. Further research should explore strategies to increase participant engagement over time, as only a portion of participants were actively involved, and higher engagement was linked to greater improvements in well-being. Long-term follow-up studies are also necessary to assess whether these effects remain stable over time. Trial RegistrationClinicalTrials.gov NCT06208566; https://clinicaltrials.gov/ct2/show/NCT06208566; OSF Registries osf.io/ahe2r; https://doi.org/10.17605/osf.io/ahe2rhttps://www.jmir.org/2024/1/e53829 |
| spellingShingle | Heather M Foran Christian Kubb Janina Mueller Spencer Poff Megan Ung Margaret Li Eric Michael Smith Akinniyi Akinyemi Melanie Kambadur Franziska Waller Mario Graf Y-Lan Boureau An Automated Conversational Agent Self-Help Program: Randomized Controlled Trial Journal of Medical Internet Research |
| title | An Automated Conversational Agent Self-Help Program: Randomized Controlled Trial |
| title_full | An Automated Conversational Agent Self-Help Program: Randomized Controlled Trial |
| title_fullStr | An Automated Conversational Agent Self-Help Program: Randomized Controlled Trial |
| title_full_unstemmed | An Automated Conversational Agent Self-Help Program: Randomized Controlled Trial |
| title_short | An Automated Conversational Agent Self-Help Program: Randomized Controlled Trial |
| title_sort | automated conversational agent self help program randomized controlled trial |
| url | https://www.jmir.org/2024/1/e53829 |
| work_keys_str_mv | AT heathermforan anautomatedconversationalagentselfhelpprogramrandomizedcontrolledtrial AT christiankubb anautomatedconversationalagentselfhelpprogramrandomizedcontrolledtrial AT janinamueller anautomatedconversationalagentselfhelpprogramrandomizedcontrolledtrial AT spencerpoff anautomatedconversationalagentselfhelpprogramrandomizedcontrolledtrial AT meganung anautomatedconversationalagentselfhelpprogramrandomizedcontrolledtrial AT margaretli anautomatedconversationalagentselfhelpprogramrandomizedcontrolledtrial AT ericmichaelsmith anautomatedconversationalagentselfhelpprogramrandomizedcontrolledtrial AT akinniyiakinyemi anautomatedconversationalagentselfhelpprogramrandomizedcontrolledtrial AT melaniekambadur anautomatedconversationalagentselfhelpprogramrandomizedcontrolledtrial AT franziskawaller anautomatedconversationalagentselfhelpprogramrandomizedcontrolledtrial AT mariograf anautomatedconversationalagentselfhelpprogramrandomizedcontrolledtrial AT ylanboureau anautomatedconversationalagentselfhelpprogramrandomizedcontrolledtrial AT heathermforan automatedconversationalagentselfhelpprogramrandomizedcontrolledtrial AT christiankubb automatedconversationalagentselfhelpprogramrandomizedcontrolledtrial AT janinamueller automatedconversationalagentselfhelpprogramrandomizedcontrolledtrial AT spencerpoff automatedconversationalagentselfhelpprogramrandomizedcontrolledtrial AT meganung automatedconversationalagentselfhelpprogramrandomizedcontrolledtrial AT margaretli automatedconversationalagentselfhelpprogramrandomizedcontrolledtrial AT ericmichaelsmith automatedconversationalagentselfhelpprogramrandomizedcontrolledtrial AT akinniyiakinyemi automatedconversationalagentselfhelpprogramrandomizedcontrolledtrial AT melaniekambadur automatedconversationalagentselfhelpprogramrandomizedcontrolledtrial AT franziskawaller automatedconversationalagentselfhelpprogramrandomizedcontrolledtrial AT mariograf automatedconversationalagentselfhelpprogramrandomizedcontrolledtrial AT ylanboureau automatedconversationalagentselfhelpprogramrandomizedcontrolledtrial |