JMIR Publications

ABSTRACT

Background:

This systematic literature review aims to provide a better understanding of the current methods on VCAs delivering interventions for the prevention and management of chronic and mental conditions.

Objective:

This systematic literature review aims to provide a better understanding of the current methods on VCAs delivering interventions for the prevention and management of chronic and mental conditions.

Methods:

We conducted a systematic literature review using PubMed Medline, EMBASE, PsycINFO, Scopus, and Web of Science databases. We included primary research involving the prevention and/or management of chronic or mental conditions through a VCA and reporting an empirical evaluation of the system in terms of system accuracy and/or in terms of technology acceptance. Two independent reviewers conducted screening and data extraction and measured their agreement with Cohen’s kappa. A narrative approach was applied to synthesize the selected records.

Results:

Twelve out of 7’170 articles met the inclusion criteria. All studies were non-experimental. The VCAs provided behavioral support (N=5), health monitoring services (N=3), or both (N=4). The interventions were delivered via smartphone (N=5), tablet (N=2), or smart speakers (N=3). In two cases, no device was specified. Three VCAs targeted cancer, while two VCAs each targeted diabetes and heart failure. The other VCAs targeted hearing-impairment, asthma, Parkinson's disease, dementia and autism, “intellectual disability”, and depression. The majority of the studies (N=7) assessed technology acceptance but only a minority (N=3) used validated instruments. Half of the studies (N=6) reported either performance measures on speech recognition or on the ability of VCA’s to respond to health-related queries. Only a minority of the studies (N=2) reported behavioral measure or a measure of attitudes towards intervention-related health behavior. Moreover, only a minority of studies (N=4) reported controlling for participant’s previous experience with technology. Finally, risk bias varied markedly.

Conclusions:

The heterogeneity in the methods, the limited number of studies identified, and the high risk of bias, show that research on VCAs for chronic and mental conditions is still in its infancy. Although results in system accuracy and technology acceptance are encouraging, there still is a need to establish more conclusive evidence on the efficacy of VCAs for the prevention and management of chronic and mental conditions, both in absolute terms and in comparison to standard healthcare. Clinical Trial: -