TY  - JOUR
AU  - Foran, Heather M
AU  - Kubb, Christian
AU  - Mueller, Janina
AU  - Poff, Spencer
AU  - Ung, Megan
AU  - Li, Margaret
AU  - Smith, Eric Michael
AU  - Akinyemi, Akinniyi
AU  - Kambadur, Melanie
AU  - Waller, Franziska
AU  - Graf, Mario
AU  - Boureau, Y-Lan
PY  - 2024
DA  - 2024/12/6
TI  - An Automated Conversational Agent Self-Help Program: Randomized Controlled Trial
JO  - J Med Internet Res
SP  - e53829
VL  - 26
KW  - well-being
KW  - chatbot
KW  - randomized controlled trial
KW  - prevention
KW  - flourishing
AB  - 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 (β=.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 
SN  - 1438-8871
UR  - https://www.jmir.org/2024/1/e53829
UR  - https://doi.org/10.2196/53829
UR  - http://www.ncbi.nlm.nih.gov/pubmed/39641985
DO  - 10.2196/53829
ID  - info:doi/10.2196/53829
ER  -