Accepted for/Published in: JMIR Formative Research
Date Submitted: Sep 2, 2022
Date Accepted: Dec 14, 2022
Comparing the Feasibility and Acceptability of a Virtual Human, Teletherapy, and an e-Manual at Delivering a Stress Management Intervention to Distressed Adult Women: A Pilot Study
ABSTRACT
Background:
Virtual humans (VH), teletherapy, and self-guided e-manuals may increase the accessibility of psychological interventions. However, there is limited research on how these technologies compare in terms of their feasibility and acceptability at delivering stress management interventions.
Objective:
The objectives of this pilot study were to: (1) conduct a preliminary comparison of the feasibility and acceptability of a VH, teletherapy, and an e-manual at delivering one module of Cognitive Behavioral Stress Management (CBSM) including training in CBT and deep breathing; and (2) evaluate the feasibility of the trial methodology in preparation for future research.
Methods:
A pilot RCT was conducted with a parallel, mixed design. A community sample of adult women who self-identified as distressed were randomly allocated to receive one 90-minute session of CBSM by a VH (VH-CBSM), teletherapy (T-CBSM), or an e-manual (E-CBSM) plus homework over two weeks. Data were collected on feasibility (technical issues, missing data), acceptability (completion, engagement, self-report ratings, qualitative responses), therapist rapport and trust.
Results:
38 participants’ data were included in analyses. A VH (n=12), teletherapy (n=12), and an e-manual (n=14) were found to be feasible and acceptable for delivering one session of CBSM based on the overall data (all ps>.05). Rapport (p<.001) and trust (p=.048) were greater with the human teletherapist than with the VH. However, participants commented favourably on the VH conversational agent perceiving it as non-judgemental and lacking social pressure. Participants were found to have a similar degree of satisfaction and willingness to recommend each technology (ps>.396). There was a non-significant trend towards participants feeling more comfortable with using the VH and e-manual from home compared to teletherapy (p=.097). The methodology was feasible, although improvements were identified for a future trial.
Conclusions:
A VH, teletherapy, and a self-guided e-manual were generally feasible and acceptable methods of delivering one session of a stress management intervention to healthy adult women in distress. Findings support creating additional CBSM modules for delivery by these technologies, and conducting a fully-powered RCT to compare the feasibility, acceptability, and effectiveness of the technologies when delivering a full 10-week stress management programme. Clinical Trial: Australia New Zealand Clinical Trials Registry (ANZCTR): ACTRN12620000859987
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