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Ashton LM, Adam MT, Whatnall M, Rollo ME, Burrows TL, Hansen V, Collins CE. Exploring the design and utility of an integrated web-based chatbot for young adults to support healthy eating: a qualitative study. Int J Behav Nutr Phys Act 2023; 20:119. [PMID: 37794368 PMCID: PMC10548711 DOI: 10.1186/s12966-023-01511-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 09/01/2023] [Indexed: 10/06/2023] Open
Abstract
BACKGROUND There is a lack of understanding of the potential utility of a chatbot integrated into a website to support healthy eating among young adults. Therefore, the aim was to interview key informants regarding potential utility and design of a chatbot to: (1) increase young adults' return rates and engagement with a purpose-built healthy eating website and, (2) improve young adults' diet quality. METHODS Eighteen qualitative, semi-structured interviews were conducted across three stakeholder groups: (i) experts in dietary behaviour change in young adults (n = 6), (ii) young adult users of a healthy eating website (n = 7), and (iii) experts in chatbot design (n = 5). Interview questions were guided by a behaviour change framework and a template analysis was conducted using NVivo. RESULTS Interviewees identified three potential roles of a chatbot for supporting healthy eating in young adults; R1: improving healthy eating knowledge and facilitating discovery, R2: reducing time barriers related to healthy eating, R3: providing support and social engagement. To support R1, the following features were suggested: F1: chatbot generated recommendations and F2: triage to website information or externally (e.g., another website) to address current user needs. For R2, suggested features included F3: nudge or behavioural prompts at critical moments and F4: assist users to navigate healthy eating websites. Finally, to support R3 interviewees recommended the following features: F5: enhance interactivity, F6: offer useful anonymous support, F7: facilitate user connection with content in meaningful ways and F8: outreach adjuncts to website (e.g., emails). Additional 'general' chatbot features included authenticity, personalisation and effective and strategic development, while the preferred chatbot style and language included tailoring (e.g., age and gender), with a positive and professional tone. Finally, the preferred chatbot message subjects included training (e.g., would you like to see a video to make this recipe?), enablement (e.g., healthy eating doesn't need to be expensive, we've created a budget meal plan, want to see?) and education or informative approaches (e.g., "Did you know bananas are high in potassium which can aid in reducing blood pressure?"). CONCLUSION Findings can guide chatbot designers and nutrition behaviour change researchers on potential chatbot roles, features, style and language and messaging in order to support healthy eating knowledge and behaviours in young adults.
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Affiliation(s)
- Lee M Ashton
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, 2308, Callaghan, NSW, Australia
- School of Education, College of Human and Social Futures, University of Newcastle, 2308, Callaghan, NSW, Australia
- Active Living Research Program, Hunter Medical Research Institute, 2305, New Lambton Heights, NSW, Australia
| | - Marc Tp Adam
- Food and Nutrition Research Program, Hunter Medical Research Institute, 2305, New Lambton Heights, NSW, Australia
- School of Information and Physical Sciences, College of Engineering, Science and Environment, University of Newcastle, 2308, Callaghan, NSW, Australia
| | - Megan Whatnall
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, 2308, Callaghan, NSW, Australia
- Food and Nutrition Research Program, Hunter Medical Research Institute, 2305, New Lambton Heights, NSW, Australia
| | - Megan E Rollo
- Curtin School of Population Health, Faculty of Health Sciences, Curtin University, 6845, Perth, WA, Australia
| | - Tracy L Burrows
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, 2308, Callaghan, NSW, Australia
- Food and Nutrition Research Program, Hunter Medical Research Institute, 2305, New Lambton Heights, NSW, Australia
| | - Vibeke Hansen
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, 2308, Callaghan, NSW, Australia
| | - Clare E Collins
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, 2308, Callaghan, NSW, Australia.
- Food and Nutrition Research Program, Hunter Medical Research Institute, 2305, New Lambton Heights, NSW, Australia.
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Marks E, Moghaddam N, De Boos D, Malins S. A systematic review of the barriers and facilitators to adherence to
mindfulness‐based
cognitive therapy for those with chronic conditions. Br J Health Psychol 2022; 28:338-365. [PMID: 36310447 DOI: 10.1111/bjhp.12628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 09/20/2022] [Accepted: 09/29/2022] [Indexed: 11/30/2022]
Abstract
PURPOSE Mindfulness-Based Cognitive Therapy (MBCT) can improve the lives of those with a chronic condition and psychological distress, however, high drop-out rates limit benefits. MBCT might be a candidate treatment for this population if nonadherence can be overcome. This review explores the existing literature on the barriers and facilitators to adherence to MBCT for those with chronic conditions. METHOD Databases MEDLINE, PsycINFO, CINAHL and Scopus were searched between 28th May and 11th June 2021. We included empirical papers that identified barriers and/or facilitators to MBCT adherence in patients with chronic conditions-excluding non-English and grey literature. Papers were screened and duplicates removed. Extracted data included: setting, design, aim, sample-size, population and identified barriers/facilitators to MBCT adherence. The Mixed Methods Appraisal Tool (MMAT) was adapted and used to appraise the quality of studies RESULTS: Twenty papers were eligible for review. Synthesis identified six themes (in prevalence order): (1) Practical Factors (e.g., time and other commitments), (2) Motivation (e.g., change-readiness), (3) Patient clinical and demographic characteristics (e.g., current physical health), (4) Connection with Others (facilitators and group members), (5) Credibility (perception of the intervention) and (6) Content difficulty (intervention accessibility). Findings highlight potential adaptations to implementation (e.g., clear treatment rationale, preference matching, and eliciting and responding to individual concerns or obstructive assumptions) that could address barriers and harness facilitators. CONCLUSION This review contributes a higher order understanding of factors that may support/obstruct client adherence to MBCT with implications for future implementation in research and practice. Future research should prioritize open exploration of barriers/facilitators.
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Affiliation(s)
- Eleanor Marks
- Clinical Psychology University of Lincoln Lincoln UK
| | | | | | - Sam Malins
- Clinical Psychology University of Nottingham Nottingham UK
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Marcoux A, Tessier MH, Grondin F, Reduron L, Jackson PL. Perspectives fondamentale, clinique et sociétale de l’utilisation des personnages virtuels en santé mentale. SANTE MENTALE AU QUEBEC 2021. [DOI: 10.7202/1081509ar] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Avec l’attrait engendré par les avancées en informatique et en intelligence artificielle, les personnages virtuels (c.-à-d. personnages représentés numériquement d’apparence humaine ou non) sont pressentis comme de futurs prestataires de soins en santé mentale. À ce jour, l’utilisation principale de tels personnages est toutefois marginale et se limite à une aide complémentaire à la pratique des cliniciens. Des préoccupations liées à la sécurité et l’efficacité, ainsi qu’un manque de connaissances et de compétences peuvent expliquer cette discordance entre ce que certains s’imaginent être l’utilisation future (voire futuriste) des personnages virtuels et leur utilisation actuelle. Un aperçu des récentes données probantes contribuerait à réduire cette divergence et à mieux saisir les enjeux associés à leur utilisation plus répandue en santé mentale.
Objectif Cet article vise à informer tous les acteurs impliqués, dont les cliniciens, quant au potentiel des personnages virtuels en santé mentale, et de les sensibiliser aux enjeux associés à leur usage.
Méthode Une recension narrative de la littérature a été réalisée afin de synthétiser les informations obtenues de la recherche fondamentale et clinique, et de discuter des considérations sociétales.
Résultats Plusieurs caractéristiques des personnages virtuels provenant de la recherche fondamentale ont le potentiel d’influencer les interactions entre un patient et un clinicien. Elles peuvent être regroupées en deux grandes catégories : les caractéristiques liées à la perception (p. ex. réalisme) et celles liées à l’attribution spontanée d’une catégorie sociale au personnage virtuel par un observateur (p. ex. genre). Selon la recherche clinique, plusieurs interventions ou évaluations utilisant des personnages virtuels ont montré divers degrés d’efficacité en santé mentale, et certains éléments de la relation thérapeutique (p. ex. alliance et empathie) peuvent d’ailleurs être présents lors d’une relation avec un personnage virtuel. De multiples enjeux socioéconomiques et éthiques doivent aussi être discutés en vue d’un développement et d’une utilisation plus accrue qui soient responsables et éthiques. Bien que l’accessibilité et la disponibilité des personnages virtuels constituent un avantage indéniable pour l’offre de services en santé mentale, certaines iniquités demeurent. L’accumulation de données biométriques (p. ex. rythme cardiaque) a également le potentiel d’enrichir le travail des cliniciens, mais aussi de mener au développement de personnages virtuels autonomes à l’aide de l’intelligence artificielle, ce qui pourrait conduire à certains dérapages (p. ex. erreurs de décision clinique). Quelques pistes de recommandations visant à éviter ces effets indésirables sont présentées.
Conclusion L’emploi des personnages virtuels sera de plus en plus répandu en santé mentale en raison de leurs avantages prometteurs. Ainsi, il est souhaitable que tous les acteurs impliqués s’informent sur leur usage dans ce contexte, se sensibilisent aux enjeux spécifiques, participent activement aux discussions quant à leur développement et adoptent des recommandations uniformes en vue d’un usage sécuritaire et éthique en santé mentale.
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Affiliation(s)
- Audrey Marcoux
- École de Psychologie, Université Laval
- Centre Interdisciplinaire de Recherche en Réadaptation et Intégration Sociale (Cirris)
- Centre de recherche CERVO
| | - Marie-Hélène Tessier
- École de Psychologie, Université Laval
- Centre Interdisciplinaire de Recherche en Réadaptation et Intégration Sociale (Cirris)
- Centre de recherche CERVO
| | - Frédéric Grondin
- École de Psychologie, Université Laval
- Centre Interdisciplinaire de Recherche en Réadaptation et Intégration Sociale (Cirris)
- Centre de recherche CERVO
| | | | - Philip L. Jackson
- École de Psychologie, Université Laval
- Centre Interdisciplinaire de Recherche en Réadaptation et Intégration Sociale (Cirris)
- Centre de recherche CERVO
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