Usability of an Intelligent Virtual Assistant for Promoting Behavior Change and Self-Care in Older People with Type 2 Diabetes

Balsa, João; Félix, Isa Brito; Cláudio, Ana Paula; Carmo, Maria Beatriz; Silva, Isabel Costa e; Guerreiro, Ana Santos; Guedes, Maria Vilaní Cavalcante; Henriques, Maria Adriana; Guerreiro, Mara Pereira

doi:10.1007/s10916-020-01583-w

Cited by 44 publications

(25 citation statements)

References 36 publications

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“…The scores for acceptability (UC1: NPS +67%; UC2: NPS +45%) and usability (UC1: mean SUS score 79, SD 14; UC2: mean SUS score 68, SD 24) were outstanding. These results are better than most results obtained in existing mHealth tools targeting chronic patients, for example, mHealth tools aiming to improve quality of life in breast cancer survivors such as BENECA (NPS +7%) [31] or Oncokompas (NPS −36%) [32], an Intelligent Virtual Assistant for promoting behavior change and self-care in older people with type 2 diabetes (mean SUS 74, SD 13) [33], or a gait-monitoring mobile phone app for older users (mean SUS 60, SD 11) [34]. Similarly, interventions targeting surgical patients by means of education and communication apps have obtained positive results in terms of acceptability and usability [35,36], comparable with results obtained with automated phone messaging platforms [37,38].…”

Section: Patients' Perspective: Comparison With Previous Workmentioning

confidence: 72%

Implementing Mobile Health–Enabled Integrated Care for Complex Chronic Patients: Patients and Professionals’ Acceptability Study (Preprint)

Batlle¹,

Massip²,

Vargiu³

et al. 2020

Preprint

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BACKGROUND Integrated care (IC) can promote health and social care efficiency through prioritization of preventive patient-centered models and defragmentation of care and collaboration across health tiers, and mobile health (mHealth) can be the cornerstone allowing for the adoption of IC. OBJECTIVE This study aims to assess the acceptability, usability, and satisfaction of an mHealth-enabled IC model for complex chronic patients in both patients and health professionals. METHODS As part of the CONNECARE Horizon 2020 project, a prospective, pragmatic, 2-arm, parallel, hybrid effectiveness-implementation trial was conducted from July 2018 to August 2019 in a rural region of Catalonia, Spain. Home-dwelling patients 55 years and older with chronic conditions and a history of hospitalizations for chronic obstructive pulmonary disease or heart failure (use case [UC] 1), or a scheduled major elective hip or knee arthroplasty (UC2) were recruited. During the 3 months, patients experienced an mHealth-enabled IC model, including a self-management app for patients, a set of integrated sensors, and a web-based platform connecting professionals from different settings or usual care. The Person-Centered Coordinated Care Experience Questionnaire (P3CEQ) and the Nijmegen Continuity Questionnaire (NCQ) assessed person-centeredness and continuity of care. Acceptability was assessed for IC arm patients and staff with the Net Promoter Score (NPS) and the System Usability Scale (SUS). RESULTS The analyses included 77 IC patients, 58 controls who completed the follow-up, and 30 health care professionals. The mean age was 78 (SD 9) years in both study arms. Perception of patient-centeredness was similarly high in both arms (usual care: mean P3CEQ score 16.1, SD 3.3; IC: mean P3CEQ score 16.3, SD 2.4). IC patients reported better continuity of care than controls (usual care: mean NCQ score 3.7, SD 0.9; IC: mean NCQ score 4.0, SD 1; <i>P</i>=.04). The scores for patient acceptability (UC1: NPS +67%; UC2: NPS +45%) and usability (UC1: mean SUS score 79, SD 14; UC2: mean SUS score 68, SD 24) were outstanding. Professionals’ acceptability was low (UC1: NPS −25%; UC2: NPS −35%), whereas usability was average (UC1: mean SUS score 63, SD 20; UC2: mean SUS score 62, SD 19). The actual use of technology was high; 77% (58/75) of patients reported physical activity for at least 60 days, and the ratio of times reported over times prescribed for other sensors ranged from 37% for oxygen saturation to 67% for weight. CONCLUSIONS The mHealth-enabled IC model showed outstanding results from the patients’ perspective in 2 different UCs but lacked maturity and integration with legacy systems to be fully accepted by professionals. This paper provides useful lessons learned through the development and assessment process and may be of use to organizations willing to develop or implement mHealth-enabled IC for older adults.

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Section: Patients' Perspective: Comparison With Previous Workmentioning

confidence: 72%

Implementing Mobile Health–Enabled Integrated Care for Complex Chronic Patients: Patients and Professionals’ Acceptability Study (Preprint)

Batlle¹,

Massip²,

Vargiu³

et al. 2020

Preprint

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“…Numerous applications have recently been released that incorporate the use of virtual assistants in the management of diabetes and hypertension [ 28 •, 29 •, 30 •, 31 •, 32 ]; however, the clinical impact of these applications has not been assessed in clinical trials.…”

Section: Current and Potential Uses Of Voice-based Technologies In Cardiovascular Medicinementioning

confidence: 99%

Feasibility of Incorporating Voice Technology and Virtual Assistants in Cardiovascular Care and Clinical Trials

Gouda

Ganni

Chung

et al. 2021

Curr Cardiovasc Risk Rep

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Purpose of Review With the rising cost of cardiovascular clinical trials, there is interest in determining whether new technologies can increase cost effectiveness. This review focuses on current and potential uses of voice-based technologies, including virtual assistants, in cardiovascular clinical trials. Recent Findings Numerous potential uses for voice-based technologies have begun to emerge within cardiovascular medicine. Voice biomarkers, subtle changes in speech parameters, have emerged as a potential tool to diagnose and monitor many cardiovascular conditions, including heart failure, coronary artery disease, and pulmonary hypertension. With the increasing use of virtual assistants, numerous pilot studies have examined whether these devices can supplement initiatives to promote transitional care, physical activity, smoking cessation, and medication adherence with promising initial results. Additionally, these devices have demonstrated the ability to streamline data collection by administering questionnaires accurately and reliably. With the use of these technologies, there are several challenges that must be addressed before wider implementation including respecting patient privacy, maintaining regulatory standards, acceptance by patients and healthcare providers, determining the validity of voice-based biomarkers and endpoints, and increased accessibility. Summary Voice technology represents a novel and promising tool for cardiovascular clinical trials; however, research is still required to understand how it can be best harnessed.

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“…Additionally, knowing the best way to interact with a certain person will also be fundamental to motivate that person to be healthier [16]. In this sense, several studies were also observed using either physical or virtual robots or assistants to directly interact with the elderly person and attempt to persuade him/her to be healthier [8,[17][18][19][20][21][22]. In fact, the authors in [23] explained the importance of intelligent cognitive assistants to support attitude and behavior changes, which are crucial to protect against the deterioration of cognitive and mental health.…”

Section: Introductionmentioning

confidence: 99%

An Intelligent Coaching Prototype for Elderly Care

et al. 2022

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The world ageing problem is prompting new sustainable ways to support elderly people. As such, it is important to promote personalized and intelligent ways to assure the active and healthy ageing of the population. Technological breakthroughs have led to the development of personalized healthcare systems, capable of monitoring and providing feedback on different aspects that can improve the health of the elderly person. Furthermore, defining motivational strategies to persuade the elderly person to be healthier and stay connected to such systems is also fundamental. In this work, a coaching system is presented, especially designed to support elderly people and motivate them to pursue healthier ways of living. To do this, a coaching application is developed using both a cognitive virtual assistant to directly interact with the elderly person and provide feedback on his/her current health condition, and several gamification techniques to motivate the elderly person to stay engaged with the application. Additionally, a set of simulations were performed to validate the proposed system in terms of the support and feedback provided to the user according to his progress, and through interactions with the cognitive assistant.

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Usability of an Intelligent Virtual Assistant for Promoting Behavior Change and Self-Care in Older People with Type 2 Diabetes

Cited by 44 publications

References 36 publications

Implementing Mobile Health–Enabled Integrated Care for Complex Chronic Patients: Patients and Professionals’ Acceptability Study (Preprint)

Implementing Mobile Health–Enabled Integrated Care for Complex Chronic Patients: Patients and Professionals’ Acceptability Study (Preprint)

Feasibility of Incorporating Voice Technology and Virtual Assistants in Cardiovascular Care and Clinical Trials

An Intelligent Coaching Prototype for Elderly Care

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