Objective Chatbots have potential to deliver interactive self-management interventions but have rarely been studied in the context of hypertension or medication adherence. The objective of this study was to better understand patient information needs and perceptions of chatbots to support hypertension medication self-management. Materials and Methods Mixed methods were used to assess self-management needs and preferences for using chatbots. We purposively sampled adults with hypertension who were prescribed at least one medication. Participants completed questionnaires on sociodemographics, health literacy, self-efficacy, and technology use. Semi-structured interviews were conducted, audio-recorded, and transcribed verbatim. Quantitative data were analyzed using descriptive statistics, and qualitative data were analyzed using applied thematic analysis. Results Thematic saturation was met after interviewing 15 participants. Analysis revealed curiosity toward chatbots, and most perceived them as humanlike. The majority were interested in using a chatbot to help manage medications, refills, communicate with care teams, and for accountability toward self-care tasks. Despite general enthusiasm, there were concerns with chatbots providing too much information, making demands for lifestyle changes, invading privacy, and usability issues with deployment on smartphones. Those with overall positive perceptions toward chatbots were younger and taking fewer medications. Discussion Chatbot-related informational needs were consistent with existing self-management research, and many felt chatbots would be valuable if customizable and compatible with patient portals, pharmacies, or health apps. Conclusion Although most were not familiar with chatbots, patients were interested in interacting with them, but this varied. This research informs future design and functionalities of conversational interfaces to support hypertension self-management.

BACKGROUND Conversational agents have the potential to deliver patient-centered interventions that focus on goal setting, feedback, and education. However, little is known how these agents may be utilized to assist patients with chronic disease self-management. OBJECTIVE The objective of this study was to systematically review the literature to assess how conversational agents have been used to facilitate chronic disease self-management and to identify gaps in the evidence base. METHODS The systematic review utilized Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines across five databases. We included full-text journal articles or conference proceedings that contained primary research findings for text-based conversational agents focused on self-management for chronic diseases in adults. Two reviewers independently extracted information from the included studies, analyzed the data, grouped the studies into themes, and rated the quality of the studies. RESULTS 1,606 studies were identified, and 12 studies met inclusion criteria. There were five randomized controlled trials, five quasi-experimental studies, and two non-experimental studies. Studies were heterogeneous in design and many lacked methodological rigor. Participants mostly reported positive attitudes towards conversational agents, and there were improvements on the Patient Health Questionnaire (P<.05), Generalized Anxiety Disorder Scale (P=.004), Perceived Stress Scale (P=.048), Flourishing Scale (P=.032), and Overall Anxiety Severity and Impairment Scale (P<.05) between the conversational agent intervention and control groups in three randomized controlled trials. Major themes related to user perceptions were personalization, engagement, and social support. The majority of conversational agents were based upon theoretical grounding, but few studies reported using established design principles and no studies used heuristic evaluation. CONCLUSIONS Our findings suggest that conversational agents are acceptable and have the potential to support self-management particularly for mental health conditions. As this is an emerging area of research, efficacy of long-term use of conversational agents for chronic disease self-management is unknown but shows promise. Future studies should assess the characteristics of agents that may be most useful for self-management based on the patient’s clinical and sociodemographic characteristics, motivation, and preferences.

BackgroundConversational interfaces (CIs) in different modalities have been developed for health purposes, such as health behavioral intervention, patient self-management, and clinical decision support. Despite growing research evidence supporting CIs’ potential, CI-related research is still in its infancy. There is a lack of systematic investigation that goes beyond publication review and presents the state of the art from perspectives of funding agencies, academia, and industry by incorporating CI-related public funding and patent activities.ObjectiveThis study aimed to use data systematically extracted from multiple sources (ie, grant, publication, and patent databases) to investigate the development, research, and fund application of health-related CIs and associated stakeholders (ie, countries, organizations, and collaborators).MethodsA multifaceted search query was executed to retrieve records from 9 databases. Bibliometric analysis, social network analysis, and term co-occurrence analysis were conducted on the screened records.ResultsThis review included 42 funded projects, 428 research publications, and 162 patents. The total dollar amount of grants awarded was US $30,297,932, of which US $13,513,473 was awarded by US funding agencies and US $16,784,459 was funded by the Europe Commission. The top 3 funding agencies in the United States were the National Science Foundation, National Institutes of Health, and Agency for Healthcare Research and Quality. Boston Medical Center was awarded the largest combined grant size (US $2,246,437) for 4 projects. The authors of the publications were from 58 countries and 566 organizations; the top 3 most productive organizations were Northeastern University (United States), Universiti Teknologi MARA (Malaysia), and the French National Center for Scientific Research (CNRS; France). US researchers produced 114 publications. Although 82.0% (464/566) of the organizations engaged in interorganizational collaboration, 2 organizational research-collaboration clusters were observed with Northeastern University and CNRS as the central nodes. About 112 organizations from the United States and China filed 87.7% patents. IBM filed most patents (N=17). Only 5 patents were co-owned by different organizations, and there was no across-country collaboration on patenting activity. The terms patient, child, elderly, and robot were frequently discussed in the 3 record types. The terms related to mental and chronic issues were discussed mainly in grants and publications. The terms regarding multimodal interactions were widely mentioned as users’ communication modes with CIs in the identified records.ConclusionsOur findings provided an overview of the countries, organizations, and topic terms in funded projects, as well as the authorship, collaboration, content, and related information of research publications and patents. There is a lack of broad cross-sector partnerships among grant agencies, academia, and industry, particularly in the United States. Our results suggest a need to improve col...

Teacher-related variables have been considered as determining factors in shaping educational system. Teacher professional identity is also very important construct that affect teachers’ teaching practice Moreover, the positive and negative emotions are considered sporadically in Chinese English as a Foreign Language (EFL) educational contexts; however, and there is a paucity of research in investigating the relationship between work engagement as a positive emotion and teacher burnout as a negative workrelated factor. This review also tried to examine how teachers’ professional identity is affected by teachers’ positive and negative emotions in Chinese contexts. Earlier studies have verified that teacher burnout is significantly correlated with professional identity. The earlier investigations showed the mediating role of job resources, such as job satisfaction and obligation, in the correlation between teacher burnout and professional identity. Moreover, studies have shown a significant negative correlation between teacher burnout and work engagement. Some variables, including personal features, instructive environment, work difficulties, job capital, character strengths, self-efficacy, close relationship with school colleagues, and emotional intelligence, mediate the correlation between teacher burnout and work engagement. Finally, this review specified that teachers’ professional identity is regarded as a critical variable in fostering work engagement. Emotional intelligence was also considered a mediating variable that affected the relationship between teacher professional identity and work engagement. Moreover, the study has pedagogical implications and suggestions for different teacher educators, administrators, and advisors. The ideas can improve their awareness of teacher burnout, professional identity, and work engagement in instructive contexts.

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