CRII: SCH: Designing for Supportive Accountability: Using Conversational Agents to Sustain Patient Engagement in Post-Traumatic Stress Disorder

在美国，每年大约有800万成年人患有创伤后应激障碍（PTSD）。它造成了惊人的个人和社会成本，包括更高的死亡风险和重大的国家卫生保健支出。虽然存在基于证据的创伤后应激障碍治疗，但由于后勤问题（例如，成本和缺乏训练有素的专业人员）。为了解决这些问题，最近的研究使用了移动的技术进行干预和治疗。然而，确保参与和遵守这些技术仍然是一个严峻的挑战。该项目旨在通过开发用于治疗内容交付和日常疾病管理的有限状态会话代理（CA）来解决这些参与和依从性问题。这个项目的发现可以导致更有效的方法来保持人们的参与。拟议的对话代理将提供互动的心理教育，评估工具，和个性化的疾病管理策略与创伤后应激障碍患者。它将支持轮流发言和互动，这将导致以两种方式进行积极的信息流动，而不仅仅是被动地提供信息内容。CA的实现将涉及对话管理，处理用户输入的分支，并为给定的上下文提供适当的消息。为了保持纵向用户参与，它将利用支持性问责制模型，特别关注通过个性化，目标设定和情境化支持来保持社会存在和流程问责制。CA将被开发为一个独立的模块，可以集成到一个移动的应用程序中。这将简化系统对患者的部署。该项目将收集真实世界的数据，以确定特定领域的可用性问题和信息需求。它还将进行系统评估，以了解CA和患者参与之间的因果关系。也就是说，它将评估CA的哪些组成部分对患者有效，在什么情况下，以及多长时间。该奖项反映了NSF的法定使命，并通过使用基金会的知识价值和更广泛的影响审查标准进行评估，被认为值得支持。

Approximately 8 million adults in the United States suffer from Post-traumatic stress disorder (PTSD) in a given year. It causes staggering individual and societal costs including higher mortality risk and significant national health care expenditure. While evidence-based PTSD treatments exist, their dissemination is limited due to logistical issues (e.g., cost and lack of trained professionals). To address these issues, recent studies have used mobile technologies for intervention and treatment delivery. However, ensuring engagement and adherence to these technologies remains a serious challenge. This project aims to address these engagement and adherence issues by developing a finite-state conversational agent (CA) for therapeutic content delivery and day-to-day illness management. Findings from this project can lead to more effective methods for keeping people engaged. The proposed conversational agent will provide interactive psychoeducation, assessment tools, and personalized illness management strategies to patients with PTSD. It will support turn-taking and interactivity, which will result in active information flow in both ways rather than just passive delivery of information content. The implementation of the CA will involve dialogue management, handling user input for branching, and delivering appropriate message for a given context. For sustaining longitudinal user engagement, it will leverage the Supportive Accountability model with a specific focus on maintaining social presence and process accountability through personalization, goal setting, and contextualized support. The CA will be developed as a stand-alone module that can be incorporated into a mobile app. This will streamline the deployment of the system to patients. The project will collect real-world data to determine domain specific usability issues and information needs. It will also perform a systematic evaluation to understand the causal pathway between a CA and patient engagement. That is, it will assess what components of a CA work for patients, in what contexts, and for how long. Publications and source code resulting from the project will be publicly available.This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.