JMIR Publications

ABSTRACT

Background:

Reducing lifestyle risk behaviours among adolescents depends on access to age-appropriate health promotion information. Chatbots – software applications designed to simulate conversations with human users – have the potential to deliver health information to adolescents to improve their lifestyle behaviours and support behaviour change, but research on the feasibility and acceptability of chatbots in the adolescent population is unknown.

Objective:

This systematic scoping review aimed to evaluate the feasibility and acceptability of chatbots in nutrition and physical activity interventions among adolescents. A secondary aim was to consult adolescents to identify features of chatbots that are acceptable and feasible.

Methods:

Six electronic databases were searched from March to April 2022 (MEDLINE, Embase, JBI, CINAHL, ACM library and the IT database Institute of Electrical and Electronics Engineers [IEEE]). Peer- reviewed studies were included that were conducted in the adolescent population (10-19 years) without any chronic disease, except obesity or type 2 diabetes; assessed chatbots used in nutrition and/or physical activity interventions that encouraged individuals to meet dietary or physical activity guidelines and support positive behaviour change. Studies were screened by two independent reviewers, with any queries resolved by a third reviewer. Data was extracted into tables and collated in a narrative summary. Grey literature searches were also undertaken. Results of the scoping review were presented to a diverse youth advisory group (n=16, 13-18 years old) to gain their insights on this topic beyond what is published in the literature.

Results:

The search identified 5,558 articles with five studies describing five chatbots meeting the inclusion criteria. The five chatbots were supported by mobile applications using a combination of the following features: personalised feedback, conversational agents, gamification or monitoring behaviour change. Two studies focused on nutrition, two studies focused on physical activity and one focused on both nutrition and physical activity. Feasibility and acceptability were varied across the five studies, with usage rates above 50% in 3/5 studies. Three studies reported health-related outcomes with only one study showing promising effects of the intervention. Adolescents presented novel concerns around the use of chatbots in nutrition and physical activity interventions including ethical concerns and the use of false or misleading information.

Conclusions:

Very limited research is available on chatbots in adolescent nutrition and physical activity interventions, finding insufficient evidence on the acceptability and feasibility of chatbots in the adolescent population. Similarly, adolescent consultation identified issues in the design features that were not mentioned in the published literature. Therefore, co-design of chatbots with adolescents may help in ensuring that such technology is feasible and acceptable to an adolescent population.