Effects of Chatbot Components to Facilitate Mental Health Services Use in Individuals with Eating Disorders Following Online Screening: An Optimization Randomized Controlled Trial
Abstract
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: 205 individuals screening with an ED but not in treatment were randomized in an optimization randomized controlled trial to receive up to 4 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,…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 205 participants or records.
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