Kramer Lean L, van Velsen Lex, Clark Jenna L, Mulder Bob C, de Vet Emely
Consumption and Healthy Lifestyles, Wageningen University & Research, Wageningen, Netherlands.
eHealth cluster, Roessingh Research and Development, Enschede, Netherlands.
JMIR Form Res. 2022 Apr 11;6(4):e33974. doi: 10.2196/33974.
Embodied conversational agents (ECAs) have been proposed as a promising interaction modality for the delivery of programs focused on promoting lifestyle changes. However, it is not understood what factors influence the health effects of ECAs or their use.
We aimed to (1) identify whether ECAs could persuade community-dwelling older adults to change their dietary behavior and whether ECA use could decrease loneliness, (2) test the pathways to these effects, and (3) understand factors influencing the use of ECAs.
A randomized controlled trial was conducted. The intervention group received access to the PACO service for 8 weeks. The waitlist group started PACO use after waiting for 4 weeks. Two primary outcomes (eating behavior and loneliness) were assessed via online questionnaires at intake, upon joining the waitlist, after 4 weeks, and after 8 weeks. The third primary outcome (use) was assessed via data logs. Secondary outcomes were measured at the same time points, via questionnaires or an optional interview.
In total, 32 participants completed the intervention. We found a significant correlation between use in minutes on the one hand, and perceived usefulness (r=0.39, P=.03) and enjoyment on the other (r=0.38, P=.03). However, these did not predict use in the full regression model (F=1.98, P=.16, R=0.12). Additionally, PACO use did not lead to improvement in eating behavior (χ=0.34, P=.85) or a decrease in loneliness (χ=0.02, P=.99).
Our study did not provide any concluding evidence about factors that are linked to the use or health effects of ECAs. Future service design could benefit from either creating a functional design catering to the predominant stage in the precaution adoption process model of the targeted population, or by personalizing the service based on an intake in which the end user's stage is determined.
ClinicalTrials.gov NCT04510883; https://clinicaltrials.gov/ct2/show/NCT04510883.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.2196/22186.
具身对话代理（ECA）已被提议作为一种有前景的交互方式，用于提供专注于促进生活方式改变的项目。然而，尚不清楚哪些因素会影响ECA的健康效果或其使用情况。
我们旨在（1）确定ECA是否能说服社区居住的老年人改变他们的饮食行为，以及使用ECA是否能减少孤独感，（2）测试产生这些效果的途径，以及（3）了解影响ECA使用的因素。
进行了一项随机对照试验。干预组可使用PACO服务8周。等待名单组在等待4周后开始使用PACO。在入组时、加入等待名单时、4周后和8周后，通过在线问卷评估两个主要结局（饮食行为和孤独感）。通过数据日志评估第三个主要结局（使用情况）。在相同时间点，通过问卷或可选访谈测量次要结局。
共有32名参与者完成了干预。我们发现一方面使用时长与感知有用性（r = 0.39，P = 0.03）和愉悦感（r = 0.38，P = 0.03）之间存在显著相关性。然而，在完整回归模型中，这些因素并不能预测使用情况（F = 1.98，P = 0.16，R = 0.12）。此外，使用PACO并未导致饮食行为改善（χ = 0.34，P = 0.85）或孤独感降低（χ = 0.02，P = 0.99）。
我们的研究没有提供任何关于与ECA使用或健康效果相关因素的结论性证据。未来的服务设计可以通过创建适合目标人群预防采用过程模型中主要阶段的功能设计，或者根据确定最终用户阶段的入组情况对服务进行个性化定制而受益。
ClinicalTrials.gov NCT04510883；https://clinicaltrials.gov/ct2/show/NCT04510883。
国际注册报告识别码（IRRID）：RR2 - 10.2196/22186。
