Feasibility of pediatric obesity and prediabetes treatment support through Tess, the AI behavioral coaching chatbot

Stephens, Taylor N.; Joerin, Angela; Rauws, Michiel; Werk, Lloyd N.

doi:10.1093/tbm/ibz043

Cited by 115 publications

(197 citation statements)

References 23 publications

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“…The remaining four studies employed pretest-posttest designs. One feasibility study (n=23) [ 44 ] tested Tess, a behavioral coaching chatbot, in assisting adolescent patients to cope with weight management and prediabetes symptoms. Patients actively engaged with the chatbot, reported experiencing positive progress toward their goals, and deemed the chatbot helpful.…”

Section: Methodsmentioning

confidence: 99%

“…The above-reviewed chatbots showed preliminary evidence supporting the efficacy of using chatbots to deliver physical activity and diet interventions. It is worth noting that four out of seven (57.1%) studies reported chatbots as the only intervention used to deliver behavior change strategies [ 26 , 43 , 44 , 46 ], whereas the other three articles reported chatbots as an auxiliary component complementing other intervention approaches such as messages and conversations delivered by human facilitators [ 41 , 42 , 45 ] ( Multimedia Appendix 1 ). The reviewed chatbots were designed with different theoretical components and varied in their abilities to engage in natural language conversations, relationship building, and emotional understanding.…”

Section: Methodsmentioning

confidence: 99%

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Artificial Intelligence Chatbot Behavior Change Model for Designing Artificial Intelligence Chatbots to Promote Physical Activity and a Healthy Diet: Viewpoint

Zhang¹,

Oh²,

Lange³

et al. 2020

J Med Internet Res

193

116

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Background Chatbots empowered by artificial intelligence (AI) can increasingly engage in natural conversations and build relationships with users. Applying AI chatbots to lifestyle modification programs is one of the promising areas to develop cost-effective and feasible behavior interventions to promote physical activity and a healthy diet. Objective The purposes of this perspective paper are to present a brief literature review of chatbot use in promoting physical activity and a healthy diet, describe the AI chatbot behavior change model our research team developed based on extensive interdisciplinary research, and discuss ethical principles and considerations. Methods We conducted a preliminary search of studies reporting chatbots for improving physical activity and/or diet in four databases in July 2020. We summarized the characteristics of the chatbot studies and reviewed recent developments in human-AI communication research and innovations in natural language processing. Based on the identified gaps and opportunities, as well as our own clinical and research experience and findings, we propose an AI chatbot behavior change model. Results Our review found a lack of understanding around theoretical guidance and practical recommendations on designing AI chatbots for lifestyle modification programs. The proposed AI chatbot behavior change model consists of the following four components to provide such guidance: (1) designing chatbot characteristics and understanding user background; (2) building relational capacity; (3) building persuasive conversational capacity; and (4) evaluating mechanisms and outcomes. The rationale and evidence supporting the design and evaluation choices for this model are presented in this paper. Conclusions As AI chatbots become increasingly integrated into various digital communications, our proposed theoretical framework is the first step to conceptualize the scope of utilization in health behavior change domains and to synthesize all possible dimensions of chatbot features to inform intervention design and evaluation. There is a need for more interdisciplinary work to continue developing AI techniques to improve a chatbot’s relational and persuasive capacities to change physical activity and diet behaviors with strong ethical principles.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Artificial Intelligence Chatbot Behavior Change Model for Designing Artificial Intelligence Chatbots to Promote Physical Activity and a Healthy Diet: Viewpoint

Zhang¹,

Oh²,

Lange³

et al. 2020

J Med Internet Res

193

116

View full text Add to dashboard Cite

show abstract

“…Additionally, a growing number of publications have addressed the utilization of behavioral intervention technologies (52), such as smartphone applications (53,54), artificial intelligence (55), virtual reality (56), chatbots (57,58), and even video games utilizing CBT for depression (59) and anxiety (60). It may be difficult to predict which psychotherapy will be most published but most likely, in the long term, psychotherapies that are more suitable for being digitized may prevail.…”

Section: Future Trendsmentioning

confidence: 99%

Publication Trends in Psychotherapy: Bibliometric Analysis of the Past 5 Decades

Soares

Thrall

Stephens

et al. 2020

APT

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Bibliometric analyses are commonly used to document publication trends over time; however, this methodology has not been used to investigate possible trends concerning publishing about psychotherapy brands. In this study, the authors sought to identify the publication trends of peer-reviewed articles about 30 psychotherapy brands. Methods: Analyses were focused on the past 50 years and on each decade from 1970 to 2019. All searches were performed between October 2018 and January 2019 on the EbscoHost platform. Two databases were selected for the searches: PsycINFO and PubMed. Results: In the 28,594 articles reviewed, most published articles concerned cognitive-behavioral therapy (CBT), and five brands accounted for almost 78% of all publications: CBT, psychoanalysis, family systems therapy, behavioral therapy, and cognitive therapy. Three trends were identified across decades: five therapies consistently yielded the largest number of publications, the number of publications focused on therapies with less research support declined from the 1970s to the 1990s, and publications about therapies with more of a research basis increased in the 1990s through the 2010s. Publications on meditation and mindfulness presented the most salient growth area for all psychotherapies across the 5 decades. A few psychotherapy brands have dominated the publishing realm during the past 50 years and across each decade. Conclusions: Possible explanations for these publication trends were considered, including the emergence of the evidence-based therapy movement and various sociohistorical changes. Potential psychotherapy publications trends in the future are discussed.

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“…This includes the randomized controlled trial with Northwestern University, which revealed that Tess interactions led to significantly reduced symptoms of depression by 13%, as measured by the PHQ-9 (p=0.03), and anxiety by 18%, as measured by the GAD-7 (p=0.02)[13]. Research with Nemours Children's Hospital revealed Tess to be a beneficial adjunct to pediatric care as adolescent patients experienced positive progress toward their goals 81% of the time and reported usefulness ratings 96% of the time[18]. Ongoing and upcoming efficacy studies will be completed through research partners such as Palo Alto University, Stanford University, CHADIS (Comprehensive Health and Decision Information System), and Patients-Centered Outcomes Research Institute.2020 Joerin et al Cureus 12(3): e7202.…”

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confidence: 99%

Ethical Artificial Intelligence for Digital Health Organizations

Joerin¹,

Rauws²,

Fulmer³

et al. 2020

Cureus

Self Cite

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This technical report describes the methods undertaken by a US-based Digital Health company (X2AI or X2 for short) to develop an ethical code for startup environments and other organizations delivering emotional artificial intelligence (AI) services, especially for mental health support. With a growing demand worldwide for scalable, affordable, and accessible health care solutions, the use of AI offers tremendous potential to improve emotional wellbeing. To realize this potential, it is imperative that AI service providers prioritize clear and consistent ethical guidelines that align with global considerations regarding user safety and privacy. This report offers a template for an ethical code that can be implemented by other emotional AI services and their affiliates. It includes practical guidelines for integrating support from clients, collaborators, and research partners. It also shows how existing ethical systems can inform the development of AI ethics.

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Feasibility of pediatric obesity and prediabetes treatment support through Tess, the AI behavioral coaching chatbot

Cited by 115 publications

References 23 publications

Artificial Intelligence Chatbot Behavior Change Model for Designing Artificial Intelligence Chatbots to Promote Physical Activity and a Healthy Diet: Viewpoint

Artificial Intelligence Chatbot Behavior Change Model for Designing Artificial Intelligence Chatbots to Promote Physical Activity and a Healthy Diet: Viewpoint

Publication Trends in Psychotherapy: Bibliometric Analysis of the Past 5 Decades

Ethical Artificial Intelligence for Digital Health Organizations

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