Martinengo, Laura;
Jabir, Ahmad Ishqi;
Goh, Westin Wei Tin;
Lo, Nicholas Yong Wai;
Ho, Moon-Ho Ringo;
Kowatsch, Tobias;
Atun, Rifat;
... Tudor Car, Lorainne; + view all
(2022)
Conversational agents in healthcare: a scoping review of their behavior change techniques and underpinning theory.
Journal of Medical Internet Research
, 24
(10)
, Article e39243. 10.2196/39243.
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Abstract
Background: Conversational agents (CAs) are increasingly used in health care to deliver behavior change interventions. Their evaluation often includes categorizing the behavior change techniques (BCTs) using a classification system of which the BCT Taxonomy v1 (BCTTv1) is one of the most common. Previous studies have presented descriptive summaries of behavior change interventions delivered by CAs, but no in-depth study reporting the use of BCTs in these interventions has been published to date. Objective: This review aims to describe behavior change interventions delivered by CAs and to identify the BCTs and theories guiding their design. Methods: We searched PubMed, Embase, Cochrane’s Central Register of Controlled Trials, and the first 10 pages of Google and Google Scholar in April 2021. We included primary, experimental studies evaluating a behavior change intervention delivered by a CA. BCTs coding followed the BCTTv1. Two independent reviewers selected the studies and extracted the data. Descriptive analysis and frequent itemset mining to identify BCT clusters were performed. Results: We included 47 studies reporting on mental health (n=19, 40%), chronic disorders (n=14, 30%), and lifestyle change (n=14, 30%) interventions. There were 20/47 embodied CAs (43%) and 27/47 CAs (57%) represented a female character. Most CAs were rule based (34/47, 72%). Experimental interventions included 63 BCTs, (mean 9 BCTs; range 2-21 BCTs), while comparisons included 32 BCTs (mean 2 BCTs; range 2-17 BCTs). Most interventions included BCTs 4.1 “Instruction on how to perform a behavior” (34/47, 72%), 3.3 “Social support” (emotional; 27/47, 57%), and 1.2 “Problem solving” (24/47, 51%). A total of 12/47 studies (26%) were informed by a behavior change theory, mainly the Transtheoretical Model and the Social Cognitive Theory. Studies using the same behavior change theory included different BCTs. Conclusions: There is a need for the more explicit use of behavior change theories and improved reporting of BCTs in CA interventions to enhance the analysis of intervention effectiveness and improve the reproducibility of research.
| Type: | Article |
|---|---|
| Title: | Conversational agents in healthcare: a scoping review of their behavior change techniques and underpinning theory |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.2196/39243 |
| Publisher version: | https://doi.org/10.2196/39243 |
| Language: | English |
| Additional information: | This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on https://www.jmir.org/, as well as this copyright and license information must be included. |
| UCL classification: | UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences > Clinical, Edu and Hlth Psychology UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences |
| URI: | https://discovery-pp.ucl.ac.uk/id/eprint/10155057 |
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