TY - JOUR
T1 - Effects of Chatbot Components to Facilitate Mental Health Services Use in Individuals With Eating Disorders Following Online Screening
T2 - An Optimization Randomized Controlled Trial
AU - Fitzsimmons-Craft, Ellen E.
AU - Rackoff, Gavin N.
AU - Shah, Jillian
AU - Strayhorn, Jillian C.
AU - D'Adamo, Laura
AU - DePietro, Bianca
AU - Howe, Carli P.
AU - Firebaugh, Marie Laure
AU - Newman, Michelle G.
AU - Collins, Linda M.
AU - Taylor, C. Barr
AU - Wilfley, Denise E.
N1 - Publisher Copyright:
© 2024 Wiley Periodicals LLC.
PY - 2024/11
Y1 - 2024/11
N2 - Objective: Few individuals with eating disorders (EDs) receive treatment. Innovations are needed to identify individuals with EDs and address care barriers. We developed a chatbot for promoting services uptake that could be paired with online screening. However, it is not yet known which components drive effects. This study estimated individual and combined contributions of four chatbot components on mental health services use (primary), chatbot helpfulness, and attitudes toward changing eating/shape/weight concerns (“change attitudes,” with higher scores indicating greater importance/readiness). Methods: Two hundred five individuals screening with an ED but not in treatment were randomized in an optimization randomized controlled trial to receive up to four chatbot components: psychoeducation, motivational interviewing, personalized service recommendations, and repeated administration (follow-up check-ins/reminders). Assessments were at baseline and 2, 6, and 14 weeks. Results: Participants who received repeated administration were more likely to report mental health services use, with no significant effects of other components on services use. Repeated administration slowed the decline in change attitudes participants experienced over time. Participants who received motivational interviewing found the chatbot more helpful, but this component was also associated with larger declines in change attitudes. Participants who received personalized recommendations found the chatbot more helpful, and receiving this component on its own was associated with the most favorable change attitude time trend. Psychoeducation showed no effects. Discussion: Results indicated important effects of components on outcomes; findings will be used to finalize decision making about the optimized intervention package. The chatbot shows high potential for addressing the treatment gap for EDs.
AB - Objective: Few individuals with eating disorders (EDs) receive treatment. Innovations are needed to identify individuals with EDs and address care barriers. We developed a chatbot for promoting services uptake that could be paired with online screening. However, it is not yet known which components drive effects. This study estimated individual and combined contributions of four chatbot components on mental health services use (primary), chatbot helpfulness, and attitudes toward changing eating/shape/weight concerns (“change attitudes,” with higher scores indicating greater importance/readiness). Methods: Two hundred five individuals screening with an ED but not in treatment were randomized in an optimization randomized controlled trial to receive up to four chatbot components: psychoeducation, motivational interviewing, personalized service recommendations, and repeated administration (follow-up check-ins/reminders). Assessments were at baseline and 2, 6, and 14 weeks. Results: Participants who received repeated administration were more likely to report mental health services use, with no significant effects of other components on services use. Repeated administration slowed the decline in change attitudes participants experienced over time. Participants who received motivational interviewing found the chatbot more helpful, but this component was also associated with larger declines in change attitudes. Participants who received personalized recommendations found the chatbot more helpful, and receiving this component on its own was associated with the most favorable change attitude time trend. Psychoeducation showed no effects. Discussion: Results indicated important effects of components on outcomes; findings will be used to finalize decision making about the optimized intervention package. The chatbot shows high potential for addressing the treatment gap for EDs.
KW - chatbot
KW - conversational agent
KW - digital intervention
KW - eating disorder
KW - mHealth
KW - mental health treatment
KW - optimization
KW - screening
UR - http://www.scopus.com/inward/record.url?scp=85200044004&partnerID=8YFLogxK
U2 - 10.1002/eat.24260
DO - 10.1002/eat.24260
M3 - Article
C2 - 39072846
AN - SCOPUS:85200044004
SN - 0276-3478
VL - 57
SP - 2204
EP - 2216
JO - International Journal of Eating Disorders
JF - International Journal of Eating Disorders
IS - 11
ER -