Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Jan 10, 2026
Open Peer Review Period: Jan 12, 2026 - Mar 9, 2026
Date Accepted: Aug 21, 2026
(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Warning: This is an author submission that is not peer-reviewed or edited.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.
Efficacy of Virtual Agent-Based Digital Intervention (Echo-App V2.0) for Patients with Alcohol Use Disorder: A Randomized Controlled Trial
ABSTRACT
Background:
Traditional conversational agents have emerged as potential psychological tools in mental health field. While the text-only interactions limit compliance and efficacy. Virtual agents (VAs) show great potential to solve this problem.
Objective:
This study aimed to assess whether the combination of Echo appV2.0, a VA-based digital psychological intervention and TAU (Treatment as usual) yield greater efficacy compared to TAU alone.
Methods:
93 participants were randomized to 4-week Echo-app-v2.0 intervention combined with TAU compared to TAU alone. The primary outcome was change of craving. Secondary outcomes were relapse and change of emotional state, sleep quality, and treatment motivation.
Results:
The intervention group showed significant lower craving at week 8(β = -1.81, 95% CI: [-3.45, -0.16], p = 0.03) and week 16 (β = -1.97, 95% CI: [-3.61, -0.32], p = 0.02). A significant difference in relapse between the two groups at the week 8 follow-up (χ2=4.09, P=0.04). Statistically significant larger improvement in sleep quality was found in the intervention group (β = -3.28, 95% CI: [-5.08, -1.49], p <0.001). Perceived stress decreased significantly over time (β = -2.91, 95% CI: [-5.27, -0.56], p = 0.02). Linear regression showed that group and change in PSS significantly predicted Craving change at week 8(intervention: β = -2.13, 95% CI: [-4.03, -0.24], p = 0.03 ;PSS: β = 0.15, 95% CI: [0.03, 0.26],p = 0.02) and week 16(intervention:β= -2.24, 95% CI: [-4.07, -0.42], p = 0.02；PSS: p = 0.03).Both group (β = 0.12, 95% CI: [0.01, 0.24], p = 0.03) and abstinence frequency (β = 0.27, OR = 1.31, 95% CI: [1.06, 1.63], p = 0.01) significantly predict relapse at week 8.
Conclusions:
Echo app V2.0 has certain therapeutic potential in treating AUD, but further adjustments to the intervention are needed to enhance its long-term efficacy. Clinical Trial: ClinicalTrials.gov Identifier: NCT05675553
Citation
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