![]() Receiving personalised support from health professionals, such as general practitioners/physicians, dietitians and exercise physiologists, is one of the most effective interventions to improve these behaviours. Programs to assist people to adopt healthier lifestyles to prevent and delay the onset of chronic diseases are urgently needed.įindings from previous systematic reviews and meta-analyses show that various forms of interventions are effective for improving physical activity, diet and sleep 5, 6, 7, 8, 9, 10, 11. The global economic burden of chronic diseases has been estimated to be $47 trillion (USD) between 20 4. Insufficient physical activity, excessive sedentary behaviour, poor diet and poor sleep are major global health issues and are among the leading modifiable causes of depression, anxiety and chronic diseases including type 2 diabetes, cardiovascular disease, obesity, cancers and increased mortality 1, 2, 3. Chatbot interventions were efficacious across a range of populations and age groups, with both short- and longer-term interventions, and chatbot only and multicomponent interventions being efficacious. Findings from this systematic review and meta-analysis indicate that chatbot interventions are efficacious for increasing physical activity, fruit and vegetable consumption, sleep duration and sleep quality. Subgroup analyses showed that text-based, and artificial intelligence chatbots were more efficacious than speech/voice chatbots for fruit and vegetable consumption, and multicomponent interventions were more efficacious than chatbot-only interventions for sleep duration and sleep quality (all p < 0.05). Meta-analysis results showed significant effects (all p < 0.05) of chatbots for increasing total physical activity (SMD = 0.28 ), daily steps (SMD = 0.28 ), MVPA (SMD = 0.53 ), fruit and vegetable consumption (SMD = 0.59 ), sleep duration (SMD = 0.44 ) and sleep quality (SMD = 0.50 ). Most interventions ( n = 15, 79%) targeted physical activity, and most trials had a low-quality rating ( n = 14, 74%). Sample sizes ranged between 25–958, and mean participant age ranged between 9–71 years. Risk of bias was assessed using the Effective Public Health Practice Project Quality Assessment tool. Subgroup analyses were conducted to assess chatbot type, intervention type, duration, output and use of artificial intelligence. Standardised mean differences (SMD) were calculated to compare intervention effects. Outcomes were total physical activity, steps, moderate-to-vigorous physical activity (MVPA), fruit and vegetable consumption, sleep quality and sleep duration. Electronic databases were searched for randomised and non-randomised controlled trials, and pre-post trials that evaluated chatbot interventions targeting physical activity, diet and/or sleep, published before 1 September 2022. The purpose of this systematic review and meta-analysis was to evaluate the efficacy of chatbot interventions designed to improve physical activity, diet and sleep. ![]() ![]() ![]() Chatbots (also known as conversational agents and virtual assistants) offer the potential to deliver healthcare in an efficient, appealing and personalised manner.
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