@Article{info:doi/10.2196/53829,
author="Foran, Heather M
and Kubb, Christian
and Mueller, Janina
and Poff, Spencer
and Ung, Megan
and Li, Margaret
and Smith, Eric Michael
and Akinyemi, Akinniyi
and Kambadur, Melanie
and Waller, Franziska
and Graf, Mario
and Boureau, Y-Lan",
title="An Automated Conversational Agent Self-Help Program: Randomized Controlled Trial",
journal="J Med Internet Res",
year="2024",
month="Dec",
day="6",
volume="26",
pages="e53829",
keywords="well-being; chatbot; randomized controlled trial; prevention; flourishing",
abstract="Background: Health promotion and growth-based interventions can effectively improve individual well-being; however, significant gaps in access and utilization still exist. Objective: This study aims to develop and test the effectiveness and implementation of a new, widely targeted conversational agent prevention program (Zenny) designed to enhance well-being. Methods: A total of 1345 individuals in the United States were recruited online and randomly assigned to either (1) a self-help program intervention delivered via an automated conversational agent on WhatsApp or (2) an active control group that had access to evidence-based wellness resources available online. The primary outcomes were well-being (measured using the 5-item World Health Organization Well-being Scale), psychosocial flourishing (assessed with the Flourishing Scale), and positive psychological health (evaluated with the Mental Health Continuum-Short Form). Outcome measures were collected at baseline and again 1 month postassessment. All analyses were conducted using an intention-to-treat approach. Results: Both groups showed significant improvements in well-being (self-help program intervention group effect size: Cohen d=0.26, P<.001; active control group effect size: d=0.24, P<.001), psychosocial flourishing (intervention: d=0.19, P<.001; active control: d=0.18, P<.001), and positive psychological health (intervention: d=0.17, P=.001; active control: d=0.24, P<.001) at postassessment. However, there were no significant differences in effectiveness between the 2 groups (P ranged from .56 to .92). As hypothesized a priori, a greater number of days spent actively engaging with the conversational agent was associated with larger improvements in well-being at postassessment among participants in the intervention group ($\beta$=.109, P=.04). Conclusions: The findings from this study suggest that the free conversational agent wellness self-help program was as effective as evidence-based web resources. Further research should explore strategies to increase participant engagement over time, as only a portion of participants were actively involved, and higher engagement was linked to greater improvements in well-being. Long-term follow-up studies are also necessary to assess whether these effects remain stable over time. Trial Registration: ClinicalTrials.gov NCT06208566; https://clinicaltrials.gov/ct2/show/NCT06208566; OSF Registries osf.io/ahe2r; https://doi.org/10.17605/osf.io/ahe2r ",
issn="1438-8871",
doi="10.2196/53829",
url="https://www.jmir.org/2024/1/e53829",
url="https://doi.org/10.2196/53829",
url="http://www.ncbi.nlm.nih.gov/pubmed/39641985"
}