JMIR Publications

ABSTRACT

Background:

Cardiometabolic diseases (CMD) are a group of interrelated conditions, including heart failure and diabetes, that increase the risk of cardiovascular and metabolic complications. The rising number of Australians with CMDs has necessitated new strategies for those managing these conditions, such as digital health interventions. The effectiveness of digital health interventions in supporting people with CMDs is dependent on the extent to which users engage. Engagement with digital health interventions is defined by both the level of usage and the qualitative aspects of the interaction. Augmenting digital health interventions with conversational agents, technologies that interact with people using natural language, may enhance engagement because of their human-like attributes. To date, no systematic review has compiled evidence on how design features influence the engagement of conversational agent-enabled interventions supporting people with CMDs. This review seeks to address this gap, thereby, guiding developers in creating more engaging and effective tools for CMD management.

Objective:

To synthesize evidence pertaining to conversational agent-enabled intervention design features and their impacts on the engagement of people managing cardiometabolic disease.

Methods:

The review will be conducted in accordance with the Cochrane handbook for systematic reviews of interventions and reported in accordance with the Preferred reporting items for systematic reviews and meta-analyses guidelines. Searches will be conducted in Ovid (Medline), Web of Science, and Scopus databases, searches will be run again prior to manuscript submission. Inclusion criteria will consist of; 1) primary research studies, 2) reporting on conversational agent-enabled interventions, 3) that include measures of engagement, 4) in adults with CMD. Data extraction will seek to capture the perspectives of people with CMD on the use of conversational agent-enabled interventions. Joanna Briggs Institute critical appraisal tools will be used to evaluate the overall quality of evidence collected.

Results:

This review was initiated in May 2023 and registered with PROSPERO in June 2023, prior to title and abstract screening. Full text screening of articles was completed in July 2023 and data extraction began August 2023.

Conclusions:

This review will synthesize diverse observations pertaining to conversational agent-enabled intervention design features and their impacts on engagement among people with CMDs. These observations can be used to guide the development of more engaging conversational agent-enabled interventions, thereby, increasing the likelihood of regular intervention use and improved CMD health outcomes. Additionally, this review will identify gaps in the literature, in terms of how engagement is reported, thereby, highlighting areas for future exploration, and supporting researchers in advancing understandings of conversational agent-enabled interventions. Clinical Trial: PROSPERO CRD42023431579