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Accepted for/Published in: JMIR Formative Research

Date Submitted: Jul 29, 2024
Open Peer Review Period: Aug 7, 2024 - Oct 2, 2024
Date Accepted: Oct 30, 2024
(closed for review but you can still tweet)

The final, peer-reviewed published version of this preprint can be found here:

Development of a Voice-Activated Virtual Assistant to Improve Insomnia Among Young Adult Cancer Survivors: Mixed Methods Feasibility and Acceptability Study

Groninger H, Arem H, Ayangma L, Gong L, Zhou E, Greenberg D

Development of a Voice-Activated Virtual Assistant to Improve Insomnia Among Young Adult Cancer Survivors: Mixed Methods Feasibility and Acceptability Study

JMIR Form Res 2025;9:e64869

DOI: 10.2196/64869

PMID: 40063947

PMCID: 11933750

Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.

Development of a voice-activated virtual assistant to improve insomnia among young adult cancer survivors: Focus groups findings and device feasibility testing

  • Hunter Groninger; 
  • Hannah Arem; 
  • Lylian Ayangma; 
  • Lisa Gong; 
  • Eric Zhou; 
  • Daniel Greenberg

ABSTRACT

Background:

Up to 75% of young adult cancer survivors (YACS) experience chronic insomnia, negatively affecting physical and emotional health and overall quality of life. Cognitive behavioral therapy for insomnia (CBT-I) is a gold standard intervention to address insomnia. However, widespread uptake of CBT-I remains limited and new strategies of CBT-I delivery are warranted.

Objective:

We wished to understand how YACS experience insomnia, how they might incorporate technology-delivered CBT-I into a daily routine and test the feasibility and acceptability of a novel voice-activated virtual assistant-delivered CBT-I prototype.

Methods:

We conducted four focus groups (6-7 participants per group, N=26 total) to understand the YACS experience of insomnia, their routine use of technology at home, particularly voice-activated virtual assistants such as the Amazon Alexa, and input on how CBT-I might be delivered at home through a smart speaker system. We developed a prototype device to deliver key elements of CBT-I at home along with circadian lighting and monitoring of post-bedtime device use, collected YACS user perspectives on this prototype, and then conducted a single-arm feasibility and acceptability study.

Results:

Twenty-six YACS experiencing insomnia participated in focus groups to share experiences of insomnia during cancer survivorship and to provide input regarding a CBT-I prototype. Common triggers of insomnia included worry about disease management and progression, disease-related pain and other symptoms, choices regarding personal device use, and worry about the impact of poor sleep on daily functioning. Twelve participants completed device prototype testing, exceeding pre-determined feasibility and acceptability benchmarks and providing qualitative data to inform future device refinement.

Conclusions:

YACS were highly engaged with our voice-activated virtual assistant-delivered CBT-I prototype and found it acceptable to use. Following final device development, future studies should evaluate efficacy of this intervention among YACS. Clinical Trial: NCT05875129


 Citation

Please cite as:

Groninger H, Arem H, Ayangma L, Gong L, Zhou E, Greenberg D

Development of a Voice-Activated Virtual Assistant to Improve Insomnia Among Young Adult Cancer Survivors: Mixed Methods Feasibility and Acceptability Study

JMIR Form Res 2025;9:e64869

DOI: 10.2196/64869

PMID: 40063947

PMCID: 11933750

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