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The International Journal of Behavioral... Dec 2021This systematic review aimed to evaluate AI chatbot characteristics, functions, and core conversational capacities and investigate whether AI chatbot interventions were... (Review)
Review
BACKGROUND
This systematic review aimed to evaluate AI chatbot characteristics, functions, and core conversational capacities and investigate whether AI chatbot interventions were effective in changing physical activity, healthy eating, weight management behaviors, and other related health outcomes.
METHODS
In collaboration with a medical librarian, six electronic bibliographic databases (PubMed, EMBASE, ACM Digital Library, Web of Science, PsycINFO, and IEEE) were searched to identify relevant studies. Only randomized controlled trials or quasi-experimental studies were included. Studies were screened by two independent reviewers, and any discrepancy was resolved by a third reviewer. The National Institutes of Health quality assessment tools were used to assess risk of bias in individual studies. We applied the AI Chatbot Behavior Change Model to characterize components of chatbot interventions, including chatbot characteristics, persuasive and relational capacity, and evaluation of outcomes.
RESULTS
The database search retrieved 1692 citations, and 9 studies met the inclusion criteria. Of the 9 studies, 4 were randomized controlled trials and 5 were quasi-experimental studies. Five out of the seven studies suggest chatbot interventions are promising strategies in increasing physical activity. In contrast, the number of studies focusing on changing diet and weight status was limited. Outcome assessments, however, were reported inconsistently across the studies. Eighty-nine and thirty-three percent of the studies specified a name and gender (i.e., woman) of the chatbot, respectively. Over half (56%) of the studies used a constrained chatbot (i.e., rule-based), while the remaining studies used unconstrained chatbots that resemble human-to-human communication.
CONCLUSION
Chatbots may improve physical activity, but we were not able to make definitive conclusions regarding the efficacy of chatbot interventions on physical activity, diet, and weight management/loss. Application of AI chatbots is an emerging field of research in lifestyle modification programs and is expected to grow exponentially. Thus, standardization of designing and reporting chatbot interventions is warranted in the near future.
SYSTEMATIC REVIEW REGISTRATION
International Prospective Register of Systematic Reviews (PROSPERO): CRD42020216761 .
Topics: Artificial Intelligence; Diet, Healthy; Exercise; Female; Humans; Weight Loss
PubMed: 34895247
DOI: 10.1186/s12966-021-01224-6 -
The Cochrane Database of Systematic... Jul 2021Infectious diseases are a major cause of illness and death among older adults. Vaccines can prevent infectious diseases, including against seasonal influenza,...
BACKGROUND
Infectious diseases are a major cause of illness and death among older adults. Vaccines can prevent infectious diseases, including against seasonal influenza, pneumococcal diseases, herpes zoster and COVID-19. However, the uptake of vaccination among older adults varies across settings and groups. Communication with healthcare workers can play an important role in older people's decisions to vaccinate. To support an informed decision about vaccination, healthcare workers should be able to identify the older person's knowledge gaps, needs and concerns. They should also be able to share and discuss information about the person's disease risk and disease severity; the vaccine's effectiveness and safety; and practical information about how the person can access vaccines. Therefore, healthcare workers need good communication skills and to actively keep up-to-date with the latest evidence. An understanding of their perceptions and experiences of this communication can help us train and support healthcare workers and design good communication strategies.
OBJECTIVES
To explore healthcare workers' perceptions and experiences of communicating with older adults about vaccination.
SEARCH METHODS
We searched MEDLINE, CINAHL and Scopus on 21 March 2020. We also searched Epistemonikos for related reviews, searched grey literature sources, and carried out reference checking and citation searching to identify additional studies. We searched for studies in any language.
SELECTION CRITERIA
We included qualitative studies and mixed-methods studies with an identifiable qualitative component. We included studies that explored the perceptions and experiences of healthcare workers and other health system staff towards communication with adults over the age of 50 years or their informal caregivers about vaccination.
DATA COLLECTION AND ANALYSIS
We extracted data using a data extraction form designed for this review. We assessed methodological limitations using a list of predefined criteria. We extracted and assessed data regarding study authors' motivations for carrying out their study. We used a thematic synthesis approach to analyse and synthesise the evidence. We used the GRADE-CERQual (Confidence in the Evidence from Reviews of Qualitative research) approach to assess our confidence in each finding. We examined each review finding to identify factors that may influence intervention implementation and we developed implications for practice.
MAIN RESULTS
We included 11 studies in our review. Most studies explored healthcare workers' views and experiences about vaccination of older adults more broadly but also mentioned communication issues specifically. All studies were from high-income countries. The studies focused on doctors, nurses, pharmacists and others working in hospitals, clinics, pharmacies and nursing homes. These healthcare workers discussed different types of vaccines, including influenza, pneumococcal and herpes zoster vaccines. The review was carried out before COVID-19 vaccines were available. We downgraded our confidence in several of the findings from high confidence to moderate, low or very low confidence. One reason for this was that some findings were based on only small amounts of data. Another reason was that the findings were based on studies from only a few countries, making us unsure about the relevance of these findings to other settings. Healthcare workers reported that older adults asked about vaccination to different extents, ranging from not asking about vaccines at all, to great demand for information (high confidence finding). When the topic of vaccination was discussed, healthcare workers described a lack of information, and presence of misinformation, fears and concerns about vaccines among older adults (moderate confidence). The ways in which healthcare workers discussed vaccines with older adults appeared to be linked to what they saw as the aim of vaccination communication. Healthcare workers differed among themselves in their perceptions of this aim and about their own roles and the roles of older adults in vaccine decisions. Some healthcare workers thought it was important to provide information but emphasised the right and responsibility of older adults to decide for themselves. Others used information to persuade and convince older adults to vaccinate in order to increase 'compliance' and 'improve' vaccination rates, and in some cases to gain financial benefits. Other healthcare workers tailored their approach to what they believed the older adult needed or wanted (moderate confidence). Healthcare workers believed that older adults' decisions could be influenced by several factors, including the nature of the healthcare worker-patient relationship, the healthcare worker's status, and the extent to which healthcare workers led by example (low confidence). Our review also identified factors that are likely to influence how communication between healthcare workers and older adults take place. These included issues tied to healthcare workers' views and experiences regarding the diseases in question and the vaccines; as well as their views and experiences of the organisational and practical implementation of vaccine services.
AUTHORS' CONCLUSIONS
There is little research focusing specifically on healthcare workers' perceptions and experiences of communication with older adults about vaccination. The studies we identified suggest that healthcare workers differed among themselves in their perceptions about the aim of this communication and about the role of older adults in vaccine decisions. Based on these findings and the other findings in our review, we have developed a set of questions or prompts that may help health system planners or programme managers when planning or implementing strategies for vaccination communication between healthcare workers and older adults.
Topics: Age Factors; Aged; Caregivers; Communication; Decision Making; Health Knowledge, Attitudes, Practice; Health Personnel; Herpes Zoster Vaccine; Humans; Influenza Vaccines; Middle Aged; Persuasive Communication; Pneumococcal Vaccines; Professional-Family Relations; Qualitative Research; Vaccination; Vaccines
PubMed: 34282603
DOI: 10.1002/14651858.CD013706.pub2 -
Frontiers in Psychology 2021Persuaders face many message design choices: narrative or non-narrative format, gain-framed or loss-framed appeals, one-sided or two-sided messages, and so on. But a...
Persuaders face many message design choices: narrative or non-narrative format, gain-framed or loss-framed appeals, one-sided or two-sided messages, and so on. But a review of 1,149 studies of 30 such message variations reveals that, although there are statistically significant differences in persuasiveness between message forms, it doesn't make much difference to persuasiveness which option is chosen (as evidenced by small mean effect sizes, that is, small differences in persuasiveness: median mean s of about 0.10); moreover, choosing the on-average-more-effective option does not consistently confer a persuasive advantage (as evidenced by 95% prediction intervals that include both positive and negative values). Strikingly, these results obtain even when multiple moderating conditions are specified. Implications for persuasive message research and practice are discussed.
PubMed: 34267703
DOI: 10.3389/fpsyg.2021.664160 -
Frontiers in Psychology 2021Media multitasking became increasingly popular over the past decade. As this behavior is intensely taxing cognitive resources, it has raised interest and concerns among...
Media multitasking became increasingly popular over the past decade. As this behavior is intensely taxing cognitive resources, it has raised interest and concerns among academics in a variety of fields. Consequently, in recent years, research on how, when, and why people media multitask has strongly emerged, and the consequences of the behavior for a great variety of outcomes (such as working memory, task performance, or socioemotional outcomes) have been explored. While efforts are made to summarize the findings of media multitasking research until date, these meta, and literature studies focused on specific research subdomains. Therefore, the current study adopted a quantitative method to map all studies in the broad field of media multitasking research. The bibliometric and thematic content analyses helped us identifying five major research topics and trends in the overall media multitasking domain. While media multitasking research started by studying its prevalence, appearance, and predictors, early research within the domain was also interested in the impact of this media consumption behavior on individuals' cognitive control and academic performance. Later on in 2007, scholars investigated the implications of media multitasking on the processing of media- and persuasive content, while its impact on socioemotional well-being received attention ever since 2009. Our analyses indicate that research within the field of media multitasking knows a dominant focus on adolescents, television watching, and cognitive depletion. Based on these findings, the paper concludes by discussing directions for future research.
PubMed: 34248735
DOI: 10.3389/fpsyg.2021.623643 -
Journal of Medical Internet Research Mar 2021We systematically reviewed the literature on human coaching to identify different coaching processes as behavioral interventions and methods within those processes. We... (Meta-Analysis)
Meta-Analysis
BACKGROUND
We systematically reviewed the literature on human coaching to identify different coaching processes as behavioral interventions and methods within those processes. We then reviewed how those identified coaching processes and the used methods can be utilized to improve an electronic coaching (eCoaching) process for the promotion of a healthy lifestyle with the support of information and communication technology (ICT).
OBJECTIVE
This study aimed to identify coaching and eCoaching processes as behavioral interventions and the methods behind these processes. Here, we mainly looked at processes (and corresponding models that describe coaching as certain processes) and the methods that were used within the different processes. Several methods will be part of multiple processes. Certain processes (or the corresponding models) will be applicable for both human coaching and eCoaching.
METHODS
We performed a systematic literature review to search the scientific databases EBSCOhost, Scopus, ACM, Nature, SpringerLink, IEEE Xplore, MDPI, Google Scholar, and PubMed for publications that included personal coaching (from 2000 to 2019) and persuasive eCoaching as behavioral interventions for a healthy lifestyle (from 2014 to 2019). The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) framework was used for the evidence-based systematic review and meta-analysis.
RESULTS
The systematic search resulted in 79 publications, including 72 papers and seven books. Of these, 53 were related to behavioral interventions by eCoaching and the remaining 26 were related to human coaching. The most utilized persuasive eCoaching methods were personalization (n=19), interaction and cocreation (n=17), technology adoption for behavior change (n= 17), goal setting and evaluation (n=16), persuasion (n=15), automation (n=14), and lifestyle change (n=14). The most relevant methods for human coaching were behavior (n=23), methodology (n=10), psychology (n=9), and mentoring (n=6). Here, "n" signifies the total number of articles where the respective method was identified. In this study, we focused on different coaching methods to understand the psychology, behavioral science, coaching philosophy, and essential coaching processes for effective coaching. We have discussed how we can integrate the obtained knowledge into the eCoaching process for healthy lifestyle management using ICT. We identified that knowledge, coaching skills, observation, interaction, ethics, trust, efficacy study, coaching experience, pragmatism, intervention, goal setting, and evaluation of coaching processes are relevant for eCoaching.
CONCLUSIONS
This systematic literature review selected processes, associated methods, strengths, and limitations for behavioral interventions from established coaching models. The identified methods of coaching point toward integrating human psychology in eCoaching to develop effective intervention plans for healthy lifestyle management and overcome the existing limitations of human coaching.
Topics: Behavior Therapy; Communication; Electronics; Humans; Life Style; Mentoring
PubMed: 33759793
DOI: 10.2196/23533 -
Journal of Medical Systems Jun 2020In this extensive review of behavioral digital obesity interventions, we reviewed randomized control trials aimed at weight loss or maintaining weight loss and...
In this extensive review of behavioral digital obesity interventions, we reviewed randomized control trials aimed at weight loss or maintaining weight loss and identifying persuasive categories and principles that drive these interventions. The following databases were searched for long-term obesity interventions: Medline, PsycINFO, Academic Search Complete, CINAHL and Scopus. The inclusion criteria included the following search terms: obesity, overweight, weight reduction, weight loss, obesity management, and diet control. Additional criteria included randomized control trial, ≥ 6 months intervention, ≥ 100 participants and must include persuasive technology. Forty-six publications were in the final review. Primary task support was the most frequently utilized persuasive system design (PSD) category and self-monitoring was the most utilized PSD principle. Behavioral obesity interventions that utilized PSD with a behavior change theory more frequently produced statistically significant weight loss findings. Persuasive technology and PSD in digital health play a significant role in the management and improvement of obesity especially when aligned with behavior change theories. Understanding which PSD categories and principles work best for behavioral obesity interventions is critical and future interventions might be more effective if they were based on these specific PSD categories and principles.
Topics: Humans; Internet; Mobile Applications; Motivation; Obesity; Persuasive Communication; Randomized Controlled Trials as Topic; Reminder Systems; Self-Management; Social Support; Telemedicine; Weight Reduction Programs
PubMed: 32500161
DOI: 10.1007/s10916-020-01591-w -
Nutrients Mar 2020Child-targeted food marketing is a significant public health concern, prompting calls for its regulation. Product packaging is a powerful form of food marketing aimed at...
Child-targeted food marketing is a significant public health concern, prompting calls for its regulation. Product packaging is a powerful form of food marketing aimed at children, yet no published studies examine the range of literature on the topic or the "power" of its marketing techniques. This study attempts such a task. Providing a systematic scoping review of the literature on child-targeted food packaging, we assesses the nutritional profile of these foods, the types of foods examined, and the creative strategies used to attract children. Fifty-seven full text articles were reviewed. Results identify high level trends in methodological approaches (content analysis, 38%), outcomes measured (exposure, 44%) and with respect to age. Studies examining the nutritional profile of child-targeted packaged foods use various models, classifying from anywhere from 41% to 97% of products as unhealthy. Content analyses track the prevalence of child-targeted techniques (cartoon characters as the most frequently measured), while other studies assess their effectiveness. Overall, this scoping review offers important insights into the differences between techniques tracked and those measured for effectiveness in existing literature, and identifies gaps for future research around the question of persuasive power-particularly when it comes to children's age and the specific types of techniques examined.
Topics: Advertising; Child; Child Nutritional Physiological Phenomena; Child, Preschool; Diet, Healthy; Food Industry; Food Packaging; Humans; Marketing; Nutritive Value; Pediatric Obesity; Public Health
PubMed: 32235580
DOI: 10.3390/nu12040958 -
Journal of Psychosomatic Research May 2020The apparent absence of any specific underlying diseases challenges patient-provider communication about medically unexplained symptoms (MUS). Previous research focused...
OBJECTIVE
The apparent absence of any specific underlying diseases challenges patient-provider communication about medically unexplained symptoms (MUS). Previous research focused on general communication patterns in these interactions; however, an overview of more detailed interactional and linguistic aspects is lacking. This review aims to gain a detailed understanding of communicative challenges in MUS consultations by synthesizing evidence from conversation and discourse analytic research.
METHODS
A systematic review of publications using eight databases (PubMed, Embase, CINAHL, PsychINFO, Web of Science, MLA International Bibliography, LLBA and Communication Abstracts). Search terms included 'MUS', 'linguistics' and 'communication'. Additional studies were identified by contacting experts and searching bibliographies. We included linguistic and/or interactional analyses of natural patient-provider interactions about MUS. Two authors independently extracted the data, and quality appraisal was based on internal and external validity.
RESULTS
We identified 18 publications that met the inclusion criteria. The linguistic and interactional features of MUS consultations pertained to three dimensions: 1) symptom recognition, 2) double trouble potential (i.e. patients and providers may have differing views on symptoms and differing knowledge domains), and 3) negotiation and persuasion (in terms of acceptable explanations and subsequent psychological treatment). We describe the recurrent linguistic and interactional features of these interactions.
CONCLUSIONS
Despite the presence of a double trouble potential in MUS consultations, validation of symptoms and subtle persuasive conduct may facilitate agreement on illness models and subsequent (psychological) treatment.
Topics: Communication; Female; Humans; Linguistics; Male; Medically Unexplained Symptoms; Referral and Consultation
PubMed: 32179304
DOI: 10.1016/j.jpsychores.2020.109994 -
Health Communication May 2021African American women (AAW) experience higher burdens of disease and have the highest rate of heart disease, cancer, stroke, and diabetes when compared to females of... (Meta-Analysis)
Meta-Analysis
African American women (AAW) experience higher burdens of disease and have the highest rate of heart disease, cancer, stroke, and diabetes when compared to females of other ethnic groups. Health narratives are a communication strategy that has been used to improve population health outcomes. Narrative storytelling is considered to be effective for improving health outcomes in African Americans because of the strong cultural storytelling background. The purpose of this study was to determine if health narratives have a significant effect on persuasion among AAW, as measured by changes in attitudes, beliefs, intentions, and behaviors. Meta-analysis of health narrative experiments ( = 13) for AAW ( = 2,746) revealed that health narratives have a significant overall effect on persuasion ( = .243; < .01). Sub-group analyses revealed no significant difference between audio-visual and written-based narratives, and no significant difference between general health topics and cancer topics. Narrative communication was effective for promoting health in AAW. These findings imply that narratives can effectively be used as an audio-visual or written-based communication for AAW, and that health topic may not impact outcomes of narrative communication.
Topics: Black or African American; Communication; Female; Humans; Intention; Narration; Persuasive Communication
PubMed: 32122156
DOI: 10.1080/10410236.2020.1731936 -
Current Nutrition Reports Dec 2019This scoping review examines literature from the past 5 years (June 2014 to June 2019) across three databases (PubMed, MEDLINE, and Scopus) to detail how the persuasive...
PURPOSE OF REVIEW
This scoping review examines literature from the past 5 years (June 2014 to June 2019) across three databases (PubMed, MEDLINE, and Scopus) to detail how the persuasive power of child-targeted food marketing content is addressed and evaluated in current research, to document trends and gaps in research, and to identify opportunities for future focus.
RECENT FINDINGS
Eighty relevant studies were identified, with varied approaches related to examining food marketing techniques to children (i.e., experimental, survey, meta-analyses, mixed methods, content analyses, focus groups). Few studies specifically defined power, and studies differed in terms of techniques examined. Spokes-characters were the predominant marketing technique measured; television was the platform most analyzed; and dominant messages focused on health/nutrition, taste appeals, and appeals to fun/pleasure. Mapping the current landscape when it comes to the power of food marketing to children reveals concrete details about particular platforms, methods, and strategies, as well as opportunities for future research-particularly with respect to definitions and techniques monitored, digital platforms, qualitative research, and tracking changes in targeted marketing techniques over time.
Topics: Advertising; Child; Databases, Factual; Diet, Healthy; Food; Food Industry; Humans; Knowledge; Marketing; Persuasive Communication; Publications; Research; Television
PubMed: 31728913
DOI: 10.1007/s13668-019-00292-2