User Experience and Potential Health Effects of a Conversational Agent-Based Electronic Health Intervention: An Observational Cohort Study in the Netherlands

Abstract

Background: The average human life expectancy and prevalence of chronic disease have increased significantly. Adopting a healthy lifestyle can decrease the risk of getting chronic diseases. Virtual coaching systems can help older adults’ adopting a healthy lifestyle. However, little is known about the long-term use of virtual coaching systems among older adults. So, the primary aim of this study was to evaluate the use, user experience and potential health effects of a fully working virtual coaching system (Council of Coaches) implemented in a real-world setting among the target population older adults. Methods: An observational cohort study was conducted with older adults aging 55 years or older in the Netherlands. Participants were included for 5-9 weeks in which they had access to Council of Coaches. They completed three questionnaires: pre-test, post-test and follow-up questionnaire. After five weeks an interview was conducted, and participants chose whether they wanted to use the eHealth intervention for another four weeks during the facultative phase. Findings: The study population consisted of fifty-one older adults (70·6% female) with a mean age of 65·3 years (SD=7·4). 94·1% started interacting with Council of Coaches, of which most participants interacted once a week. During the facultative phase, 21 participants were still interacting with Council of Coaches. Minimal Clinical Important Differences in quality of life were found among the study population after interacting with Council of Coaches. Interpretation: Our results show us that eHealth interventions with virtual coaching can be used among older adults. This can increase older adults’ quality of life, and decrease their care needs. Future research into such eHealth interventions should take into account the inclusion of sufficient personalised content and the use of a mixed methods study for evaluating the eHealth intervention. Funding Statement: European Union’s Horizon 2020 research and innovation programme under grant agreement No. 769553. Declaration of Interests: The authors declare no competing interests. Ethics Approval Statement: This study was conducted according to the principles of the Declaration of Helsinki (64th WMA General Assembly, Fortaleza, Brazil, October 2013) and in accordance with the Medical Research Involving Human Subjects Act (Dutch law: Wet medischwetenschappelijk onderzoek met mensen). According to this law, this study did not require formal medical ethical approval. This was checked by the Medical Research Ethics Committee CMO Arnhem- Nijmegen (file number: 2019-5555).