Accepted for/Published in: JMIR Formative Research
Date Submitted: Mar 18, 2022
Date Accepted: Jul 4, 2022
Design and Formative Evaluation of a Virtual Voice-based Coach for Problem-Solving Treatment: An Observational Study
ABSTRACT
Background:
Artificial Intelligence (AI) has afforded new opportunities for human interactions with technology for the practice of medicine. However, the use of voice-based AI technology for behavioral therapy has not been previously evaluated.
Objective:
We describe the design and user evaluation of LumenTM, voice-only virtual coach, developed as an Alexa skill, that delivers evidence-based, problem-solving treatment (PST) for patients with mild-to-moderate depression and/or anxiety.
Methods:
Participants (N=26) completed two therapy sessions—an introductory (S1) and a problem-solving (S2)—with Lumen. Following each session, participants completed (a) user experience, task-related workload, and work alliance surveys, and (b) semi-structured interviews addressing the benefits, challenges and barriers to Lumen use, and design recommendations. We evaluated the differences in the user experience, task load or work alliance between sessions using paired t tests. Interview transcripts were coded using an inductive thematic analysis to characterize the participant perspectives.
Results:
Participants found Lumen to provide high pragmatic usability and favorable user experience, with marginal task load during interactions for both Lumen sessions. However, participants rated as having experienced higher temporal workload during the problem-solving session, suggesting feeling rushed during their interaction. Based on the qualitative analysis, the following themes were identified: Lumen’s on-demand accessibility and the delivery of a complex PST task with a simplistic structure for achieving therapy goal; themes related to Lumen improvements included streamlining and improved personalization of conversations, slower pacing of conversations, and providing additional context during therapy sessions.
Conclusions:
Lumen offers a cognitively-plausible interactions that can potentially lead to personalized and accessible mental health care, filling a gap in traditional mental health services.
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