Chatbots to Support Mental Wellbeing of People Living in Rural Areas: Can User Groups Contribute to Co-design?

Potts, Courtney; Ennis, Edel; Bond, RR; Mulvenna, Maurice; McTear, Mike; Boyd, Kyle; Broderick, Thomas; Malcolm, Martin; Kuosmanen, Lauri; Nieminen, Heidi; Vartiainen, Anna-Kaisa; Kostenius, Catrine; Cahill, Brian; Vakaloudis, Alex; McConvey, Gavin; O’Neill, Siobhan

doi:10.1007/s41347-021-00222-6

Cited by 31 publications

(31 citation statements)

References 40 publications

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“…Of the 76 included studies, 69 (91%) exclusively focused on acceptability, acceptance, or adoption among patients, and 3 (4%) focused solely on acceptability, acceptance, or adoption among health care professionals. The remaining 4 (5%) of the 76 studies (the studies by Dupuy et al [ 22 ], Kowatsch et al [ 76 ], LeRouge et al [ 26 ], and Potts et al [ 77 ]) explored and described the influencing factors from both the patient and health care professional perspectives.…”

Section: Resultsmentioning

confidence: 99%

“…The 7 (9%) of the 73 studies dealing with the acceptability, acceptance, and adoption among health care professionals referred to different health care professional groups. In addition to physicians [ 26 , 29 , 116 ], the studies investigated the acceptability, acceptance, and adoption of CAs among physiotherapists [ 76 ], mental health professionals [ 77 ], and (home) care providers [ 22 , 85 ]. In the analysis of the data and description of the results, it was important to distinguish between the perception of health care professionals of the use of CAs for patients and their perception of the use of CAs to support their daily work.…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Factors Influencing the Acceptability, Acceptance, and Adoption of Conversational Agents in Health Care: Integrative Review

Wutz¹,

Hermes²,

Winter³

et al. 2023

J Med Internet Res

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Background Conversational agents (CAs), also known as chatbots, are digital dialog systems that enable people to have a text-based, speech-based, or nonverbal conversation with a computer or another machine based on natural language via an interface. The use of CAs offers new opportunities and various benefits for health care. However, they are not yet ubiquitous in daily practice. Nevertheless, research regarding the implementation of CAs in health care has grown tremendously in recent years. Objective This review aims to present a synthesis of the factors that facilitate or hinder the implementation of CAs from the perspectives of patients and health care professionals. Specifically, it focuses on the early implementation outcomes of acceptability, acceptance, and adoption as cornerstones of later implementation success. Methods We performed an integrative review. To identify relevant literature, a broad literature search was conducted in June 2021 with no date limits and using all fields in PubMed, Cochrane Library, Web of Science, LIVIVO, and PsycINFO. To keep the review current, another search was conducted in March 2022. To identify as many eligible primary sources as possible, we used a snowballing approach by searching reference lists and conducted a hand search. Factors influencing the acceptability, acceptance, and adoption of CAs in health care were coded through parallel deductive and inductive approaches, which were informed by current technology acceptance and adoption models. Finally, the factors were synthesized in a thematic map. Results Overall, 76 studies were included in this review. We identified influencing factors related to 4 core Unified Theory of Acceptance and Use of Technology (UTAUT) and Unified Theory of Acceptance and Use of Technology 2 (UTAUT2) factors (performance expectancy, effort expectancy, facilitating conditions, and hedonic motivation), with most studies underlining the relevance of performance and effort expectancy. To meet the particularities of the health care context, we redefined the UTAUT2 factors social influence, habit, and price value. We identified 6 other influencing factors: perceived risk, trust, anthropomorphism, health issue, working alliance, and user characteristics. Overall, we identified 10 factors influencing acceptability, acceptance, and adoption among health care professionals (performance expectancy, effort expectancy, facilitating conditions, social influence, price value, perceived risk, trust, anthropomorphism, working alliance, and user characteristics) and 13 factors influencing acceptability, acceptance, and adoption among patients (additionally hedonic motivation, habit, and health issue). Conclusions This review shows manifold factors influencing the acceptability, acceptance, and adoption of CAs in health care. Knowledge of these factors is fundamental for implementation planning. Therefore, the findings of this review can serve as a basis for future studies to develop appropriate implementation strategies. Furthermore, this review provides an empirical test of current technology acceptance and adoption models and identifies areas where additional research is necessary. Trial Registration PROSPERO CRD42022343690; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=343690

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Factors Influencing the Acceptability, Acceptance, and Adoption of Conversational Agents in Health Care: Integrative Review

Wutz¹,

Hermes²,

Winter³

et al. 2023

J Med Internet Res

View full text Add to dashboard Cite

show abstract

“…Additionally, our review identi ed initiatives like the usability assessment of Assistant on Care and Health O ine (ACHO), a voice assistant designed to enhance therapeutic adherence among elderly individuals in rural communities [36]. Furthermore, we highlighted a study that employed the living lab methodology to assess the feasibility of user groups designing content for a chatbot to support the mental well-being of individuals in rural areas [37]. Another European study used the living lab approach to establish a robust institutional and organizational foundation at regional and community levels, aiming to advance an integrated care model for elderly individuals in rural and remote areas of Low-and Middle-Income Countries [38].…”

Section: The Broader Implications Of Living Labs In Rural Healthcarementioning

confidence: 99%

Bridging the Gap in Rural Emergency Care: A Scoping Review of Living Lab Hospitals and their Potential in Rural Healthcare

JOYAL,

Tounkara,

Singhroy

et al. 2024

Preprint

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Background. Rural Canadian hospitals are increasingly vulnerable to service reductions and emergency department closures, compromising the emergency care access for the 6 million residents (20% of the population) living in these areas. Current standards for rural emergency care in Canada are outdated, necessitating innovative, locally adapted solutions. The Living Lab concept, a collaborative, real-world innovation ecosystem involving patients, citizens, healthcare professionals, learners and researchers, may address this gap. In 2020, we initiated a rural Living Lab hospital project in Charlevoix, Québec, where no prior studies on such hospitals existed. Our research aims to assess the current state of literature on rural Living Lab hospitals. Objectives. Our specific goal was to examine and characterize the existing research on Living Lab Hospitals in rural settings while precisely identifying areas where further research is required. Methodology. Our scoping review was conducted through a structured five-stage process: [1] problem formulation, [2] literature search, across five databases: PubMed, MEDLINE, EMBASE, CINAHL, and Web of Sciences, [3] data evaluation and analysis, [4] data collection and summary, and [5] presentation. Results. A total of 212 studies from Embase, 134 from MEDLINE, 91 from CINAHL, 10 from Web of Science, and 4 from PubMed were initially part of our analysis. After eliminating 169 duplicate entries, our team scrutinized 282 titles and abstracts. Given our primary aim of identifying living labs based in rural hospital settings, only our original publication, “A Canadian Rural Living Lab Hospital: Implementing solutions for improving rural emergency care”, was found. Conclusion: This scoping review indicates a stark research deficit on Living Lab hospitals in rural contexts, with only one relevant study identified. This highlights a critical need for further investigation into the adoption and impact of Living Lab models in rural healthcare. Given the risks faced by rural emergency services, it is vital to prioritize research in this area to improve and innovate care for vulnerable populations.

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“…talking therapies). This preference could be due to the level of anonymity that digital support provides allowing the client to avoid any stigma whilst mitigating the risk of feeling judged in a human facing service 17 , as well as the agency to the individual offered by self-managed care. This idea is revisited later in this paper in the section related to digital ethics.…”

Section: Benefits Of Digital Interventionsmentioning

confidence: 99%

Digital transformation of mental health services

Bond,

Mulvenna,

Potts

et al. 2023

npj Mental Health Res

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This paper makes a case for digital mental health and provides insights into how digital technologies can enhance (but not replace) existing mental health services. We describe digital mental health by presenting a suite of digital technologies (from digital interventions to the application of artificial intelligence). We discuss the benefits of digital mental health, for example, a digital intervention can be an accessible stepping-stone to receiving support. The paper does, however, present less-discussed benefits with new concepts such as ‘poly-digital’, where many different apps/features (e.g. a sleep app, mood logging app and a mindfulness app, etc.) can each address different factors of wellbeing, perhaps resulting in an aggregation of marginal gains. Another benefit is that digital mental health offers the ability to collect high-resolution real-world client data and provide client monitoring outside of therapy sessions. These data can be collected using digital phenotyping and ecological momentary assessment techniques (i.e. repeated mood or scale measures via an app). This allows digital mental health tools and real-world data to inform therapists and enrich face-to-face sessions. This can be referred to as blended care/adjunctive therapy where service users can engage in ‘channel switching’ between digital and non-digital (face-to-face) interventions providing a more integrated service. This digital integration can be referred to as a kind of ‘digital glue’ that helps join up the in-person sessions with the real world. The paper presents the challenges, for example, the majority of mental health apps are maybe of inadequate quality and there is a lack of user retention. There are also ethical challenges, for example, with the perceived ‘over-promotion’ of screen-time and the perceived reduction in care when replacing humans with ‘computers’, and the trap of ‘technological solutionism’ whereby technology can be naively presumed to solve all problems. Finally, we argue for the need to take an evidence-based, systems thinking and co-production approach in the form of stakeholder-centred design when developing digital mental health services based on technologies. The main contribution of this paper is the integration of ideas from many different disciplines as well as the framework for blended care using ‘channel switching’ to showcase how digital data and technology can enrich physical services. Another contribution is the emergence of ‘poly-digital’ and a discussion on the challenges of digital mental health, specifically ‘digital ethics’.

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Chatbots to Support Mental Wellbeing of People Living in Rural Areas: Can User Groups Contribute to Co-design?

Cited by 31 publications

References 40 publications

Factors Influencing the Acceptability, Acceptance, and Adoption of Conversational Agents in Health Care: Integrative Review

Factors Influencing the Acceptability, Acceptance, and Adoption of Conversational Agents in Health Care: Integrative Review

Bridging the Gap in Rural Emergency Care: A Scoping Review of Living Lab Hospitals and their Potential in Rural Healthcare

Digital transformation of mental health services

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