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Acceptability of an embodied conversational agent for type 2 diabetes self-management education and support via a smartphone app: mixed methods study

Baptista, Shaira, Wadley, Greg, Bird, Dominique, Oldenburg, Brian and Speight, Jane 2020, Acceptability of an embodied conversational agent for type 2 diabetes self-management education and support via a smartphone app: mixed methods study, JMIR mHealth and uHealth, vol. 8, no. 7, pp. 1-12, doi: 10.2196/17038.

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Title Acceptability of an embodied conversational agent for type 2 diabetes self-management education and support via a smartphone app: mixed methods study
Author(s) Baptista, Shaira
Wadley, Greg
Bird, Dominique
Oldenburg, Brian
Speight, JaneORCID iD for Speight, Jane orcid.org/0000-0002-1204-6896
Journal name JMIR mHealth and uHealth
Volume number 8
Issue number 7
Article ID e17038
Start page 1
End page 12
Total pages 12
Publisher JMIR Publications
Place of publication Toronto, Ont.
Publication date 2020-07
ISSN 2291-5222
2291-5222
Keyword(s) Science & Technology
Life Sciences & Biomedicine
Health Care Sciences & Services
Medical Informatics
embodied conversational agent
type 2 diabetes
mobile apps
mHealth
smartphone
self-management
mobile phone
Summary Background Embodied conversational agents (ECAs) are increasingly used in health care apps; however, their acceptability in type 2 diabetes (T2D) self-management apps has not yet been investigated. Objective This study aimed to evaluate the acceptability of the ECA (Laura) used to deliver diabetes self-management education and support in the My Diabetes Coach (MDC) app. Methods A sequential mixed methods design was applied. Adults with T2D allocated to the intervention arm of the MDC trial used the MDC app over a period of 12 months. At 6 months, they completed questions assessing their interaction with, and attitudes toward, the ECA. In-depth qualitative interviews were conducted with a subsample of the participants from the intervention arm to explore their experiences of using the ECA. The interview questions included the participants’ perceptions of Laura, including their initial impression of her (and how this changed over time), her personality, and human character. The quantitative and qualitative data were interpreted using integrated synthesis. Results Of the 93 intervention participants, 44 (47%) were women; the mean (SD) age of the participants was 55 (SD 10) years and the baseline glycated hemoglobin A1c level was 7.3% (SD 1.5%). Overall, 66 of the 93 participants (71%) provided survey responses. Of these, most described Laura as being helpful (57/66, 86%), friendly (57/66, 86%), competent (56/66, 85%), trustworthy (48/66, 73%), and likable (40/66, 61%). Some described Laura as not real (18/66, 27%), boring (26/66, 39%), and annoying (20/66, 30%). Participants reported that interacting with Laura made them feel more motivated (29/66, 44%), comfortable (24/66, 36%), confident (14/66, 21%), happy (11/66, 17%), and hopeful (8/66, 12%). Furthermore, 20% (13/66) of the participants were frustrated by their interaction with Laura, and 17% (11/66) of the participants reported that interacting with Laura made them feel guilty. A total of 4 themes emerged from the qualitative data (N=19): (1) perceived role: a friendly coach rather than a health professional; (2) perceived support: emotional and motivational support; (3) embodiment preference acceptability of a human-like character; and (4) room for improvement: need for greater congruence between Laura’s words and actions. Conclusions These findings suggest that an ECA is an acceptable means to deliver T2D self-management education and support. A human-like character providing ongoing, friendly, nonjudgmental, emotional, and motivational support is well received. Nevertheless, the ECA can be improved by increasing congruence between its verbal and nonverbal communication and accommodating user preferences. Trial Registration Australian New Zealand Clinical Trials Registry CTRN12614001229662; https://tinyurl.com/yxshn6pd
Language eng
DOI 10.2196/17038
Indigenous content off
Field of Research 1117 Public Health and Health Services
HERDC Research category C1 Refereed article in a scholarly journal
Free to Read? Yes
Persistent URL http://hdl.handle.net/10536/DRO/DU:30141748

Document type: Journal Article
Collections: Faculty of Health
School of Psychology
Open Access Collection
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Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.