Using Chatbot Technology to Improve Brazilian Adolescents' Body Image and Mental Health at Scale: Randomized...

Area of Science:

• Digital mental health interventions
• Adolescent psychology
• Public health

Background:

• Limited accessible, cost-effective, and scalable mental health interventions exist, especially in low- and middle-income countries.
• Microinterventions offer a scalable framework for embedding mental health promotion into digital environments.
• Body image issues are a global public health concern for young people, exacerbated by social media exposure.

Purpose of the Study:

• To assess the impact of a body image chatbot with microinterventions on Brazilian adolescents' state and trait body image.
• To evaluate associated well-being outcomes, including affect and self-efficacy.

Main Methods:

• A 2-armed, fully remote, randomized controlled trial involving 901 Brazilian adolescents (aged 13-18).
• Participants were randomized to a body image chatbot or an assessment-only control group.
• Web-based self-assessments were conducted at baseline, post-intervention, and at 1-week and 1-month follow-ups.

Main Results:

• Chatbot users (78.9% completed ≥1 microintervention) showed significant improvements in state and trait body image compared to controls.
• Significant improvements were also observed in state affect, positive affect, negative affect, and body image self-efficacy.
• Intervention benefits were moderated by baseline concerns but not by gender.

Conclusions:

• This is the first large-scale trial of a body image chatbot for Brazilian adolescents.
• Findings support the effectiveness and acceptability of microinterventions and chatbot technology for web-based mental health provision.
• The study provides a blueprint for scalable digital mental health solutions in low- and middle-income countries.