Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Oct 23, 2024
Open Peer Review Period: Nov 4, 2024 - Dec 30, 2024
Date Accepted: Jul 11, 2025
(closed for review but you can still tweet)
Warning: This is an author submission that is not peer-reviewed or edited.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.
Engagement with Conversational Agent-Enabled Interventions in Cardiometabolic Disease Self-Management: A Systematic Review
ABSTRACT
Background:
Well-designed conversational agents can improve healthcare capacity to meet the dynamic and complex needs of people self-managing cardiometabolic diseases (CMD). However, a lack of empirical evidence on conversational agent-enabled intervention design features and their impact on engagement make it challenging to comprehensively evaluate effectiveness. This review synthesizes evidence on conversational agent-enabled intervention design features and how they impact on engagement, to inform the development of more engaging conversational agent-enabled interventions that effectively help people with CMD to self-manage their condition.
Objective:
To synthesize evidence pertaining to conversational agent-enabled intervention design features and their impact on engagement of people self-managing cardiometabolic disease.
Methods:
Searches were conducted in Ovid (Medline), Web of Science, and Scopus databases. Inclusion criteria were; Primary research studies; Reporting on conversational agent-enabled interventions; That included measures of engagement; In adults with CMD. Data extraction captured perspectives of people with CMD on various design features of conversational agent-enabled interventions.
Results:
Of 1366 studies identified for screening, 20 were included in the review. 18 of these were qualitative or quasi-experimental evaluations of conversational agent-enabled intervention prototypes. Five domains of design features that impact user engagement with conversational agent-enabled interventions emerged; Communication style, Functionality; Accessibility; Visual appearance; and Personality.
Conclusions:
Across all five domains, integrating redundancy and anthropomorphism were identified as effective strategies for improving engagement by increasing user autonomy and investment. Future research should adopt design strategies that are inclusive and adaptive to the diverse needs of users and aligned with the unique considerations relevant to conversational agent-enabled interventions. Clinical Trial: PROSPERO CRD42023431579
Citation
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Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.