LEAVES (optimizing the mentaL health and resiliencE of older Adults that haVe lost thEir spouSe via blended, online therapy): Proposal for an Online Service Development and Evaluation

Abstract

Background Loss of a spouse is a frequent occurrence in later life. While most older adults successfully process this loss and will return to a normal life, about 10% of the individuals are unable to cope, and progress to prolonged grief (PG). PG, in turn, can result in mental and physical problems including poor sleep, cardiovascular problems, depression, and suicidal tendencies. Objective LEAVES (optimizing the mentaL health and resiliencE of older Adults that haVe lost thEir spouSe via blended, online therapy) is an online bereavement program that will support the prevention and treatment of PG, so that elderly mourners can continue to lead an active, meaningful, and dignified life. LEAVES will cater to secondary end users (eg, family, informal caregivers) by reducing stress. Methods LEAVES will help older adults to process the loss of a spouse in an online environment, which consists of (1) an existing online grief self-help program LIVIA, (2) the Before You Leave program that allows for storing personal memories, (3) a virtual agent platform, and (4) an accessible front-end design. LEAVES can detect persons at risk for complications, reveal negative trends in their emotional life, and act to counter such trends. The service relies on online support whenever possible but is blended with telephone or face-to-face counseling when necessary. Results The project will take place between February 2020 and January 2023 and includes a real-life evaluation in which 315 end users will use the service across 3 countries (the Netherlands, Portugal, and Switzerland). The evaluation of LEAVES will focus on clinical effect, its business case, and technology acceptance. The results will pave the way for smooth integration into existing care paths and reimbursement schemes. Conclusions The LEAVES service aims to soften the mourning process, prevents depression or social isolation, strengthens widow(er)s resilience and well-being, and quickens one’s return to societal participation. International Registered Report Identifier (IRRID) DERR1-10.2196/19344

Consulting the Oracle: A Delphi study for determining parameters for a mental health user profile and personalization strategy for an online service to aid grieving older adults

“…It concludes with writing a farewell letter. The results of this study will inform a re-design of the intervention as part of the AAL LEAVES project ( van Velsen et al, 2020 ). The re-design will enable the resulting intervention, called LEAVES in the remainder of this paper, to a) monitor a users' situation, with the goal to deliver support on-demand in the form of telephone calls or face-to-face meetings, whenever advisable and b) to tailor the therapeutic content based on user characteristics and needs to enhance user adherence and thereby clinical effectiveness.…”

Automatic topic selection for long-term interaction with embodied conversational agents in health coaching: A micro-randomized trial

“…Furthermore, they are always available and their dialogues can be tailored dynamically to the user, for example by elaborating on certain topics of discussion when needed ( Bickmore and Giorgino, 2006 ). In health coaching applications, ECAs can be the main component (e.g., Sebastian and Richards (2017) ; op den Akker et al (2018) ) or they can be part of a broader application (e.g., van Velsen et al (2020) ).…”

Tailoring coaching conversations with virtual health coaches

“…In research, they are incorporated in applications to make those applications more accessible, engaging and effective; for example, as pedagogical agents for children , providing various types of skills training , and for a wide range of health related applications such as coaches or digital healthcare professionals . In some cases, conversational agents are just a component of a broader eHealth application van Velsen et al, 2020), while in other cases they are the intervention's main component (op den Akker et al, 2018;. In all cases, agents are designed to 1 GENERAL INTRODUCTION interact with the user and in this manner hopefully increase engagement with the application itself and ultimately with the application's aim.…”

“…These agents can take on the role of virtual health experts or coaches, and allow users to interact with the application in a natural manner, namely through conversations (dialogues). The agents can be one element in a broader application (L. van Velsen et al, 2020), or they can be the application's main component (op den Akker et al, 2018;.…”

“…Furthermore, they are always available and their dialogues can be tailored dynamically to the user, for example by elaborating on certain topics of discussion when needed . In health coaching applications, ECAs can be the main component (e.g., (op den Akker et al, 2018;) or they can be part of a broader application (e.g., van Velsen et al (2020)).…”