Adherence and Engagement With a Cognitive Behavioral Therapy-Based Conversational Agent (Wysa for Chronic Pain) Among Adults With Chronic Pain: Survival Analysis.
Adherence and Engagement With a Cognitive Behavioral Therapy-Based Conversational Agent (Wysa for Chronic Pain) Among Adults With Chronic Pain: Survival Analysis.
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DOI：
10.2196/37302
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发表时间：
2022-05-23
影响因子：
2.2
通讯作者：
Kadaba, Madhura
中科院分区：
文献类型：
--
作者：
Sinha, Chaitali;Cheng, Abby L.;Kadaba, Madhura
关键词：
数字应用程序通常用于支持心理健康和福祉。然而，成功留住和吸引用户完成数字干预是一项挑战，慢性疼痛等合并症进一步降低了用户参与度。数字会话代理（CA）可以通过应用已经在亲自护理设置内实现的参与原则来提高用户参与度。评估用户对人工智能主导的数字心理健康应用程序（Wysa for Chronic Pain）的保留和参与，该应用程序为管理心理健康症状和共存慢性疼痛的个人定制。在这项临床试验的辅助生存分析中，参与者包括51名因慢性肌肉骨骼疼痛而到三级护理中心就诊的成年人，他们认可抑郁或焦虑的共存症状（抑郁或焦虑的患者报告结局测量信息系统评分≥ 55），并开始接受为期8周的Wysa慢性疼痛订阅。研究结果是用户保留率，定义为每周和参与的最后一天重新访问应用程序，以及用户参与度，由用户完成的会话数量定义。在为期8周的研究期间，用户累计平均参与33.3次会议。生存分析描绘了中位用户保留期（即，完成脱离接触的时间）为51天，早晨登记功能的使用与较长的保留期具有显著关系（P =.001）。我们的研究结果表明，为慢性疼痛用户构建的基于CBT的CA的用户保留率和参与度高于标准的行业指标。这些结果对于解决数字健康干预的次优参与问题和改善慢性疼痛护理的可及性具有明确的意义。未来的工作应该利用这些发现为慢性疼痛患者的循证干预措施的设计提供信息，并更广泛地提高数字健康干预措施的用户保留率和参与度。ClinicalTrials.gov
Digital applications are commonly used to support mental health and well-being. However, successfully retaining and engaging users to complete digital interventions is challenging, and comorbidities such as chronic pain further reduce user engagement. Digital conversational agents (CAs) may improve user engagement by applying engagement principles that have been implemented within in-person care settings. To evaluate user retention and engagement with an artificial intelligence–led digital mental health app (Wysa for Chronic Pain) that is customized for individuals managing mental health symptoms and coexisting chronic pain. In this ancillary survival analysis of a clinical trial, participants included 51 adults who presented to a tertiary care center for chronic musculoskeletal pain, who endorsed coexisting symptoms of depression or anxiety (Patient-Reported Outcomes Measurement Information System score of ≥55 for depression or anxiety), and initiated onboarding to an 8-week subscription of Wysa for Chronic Pain. The study outcomes were user retention, defined as revisiting the app each week and on the last day of engagement, and user engagement, defined by the number of sessions the user completed. Users engaged in a cumulative mean of 33.3 sessions during the 8-week study period. The survival analysis depicted a median user retention period (i.e., time to complete disengagement) of 51 days, with the usage of a morning check-in feature having a significant relationship with a longer retention period (P=.001). Our findings suggest that user retention and engagement with a CBT-based CA built for users with chronic pain is higher than standard industry metrics. These results have clear implications for addressing issues of suboptimal engagement of digital health interventions and improving access to care for chronic pain. Future work should use these findings to inform the design of evidence-based interventions for individuals with chronic pain and to enhance user retention and engagement of digital health interventions more broadly. ClinicalTrials.gov NCT04640090; https://clinicaltrials.gov/ct2/show/NCT04640090
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