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Published on: April 14, 2016
Virtual Human-Delivered Interviews for Patients With Chronic Pain: Feasibility, Acceptability, and a Pilot Randomized
Doerte U Junghaenel1, Stefan Schneider, Gale Lucas
1From the Dornsife Center for Self-Report Science and Center for Economic & Social Research (Junghaenel, Schneider, Stone), Department of Psychology (Junghaenel, Schneider, Stone), Leonard Davis School of Gerontology (Junghaenel, Schneider), Institute for Creative Technologies (Lucas, Boberg), Viterbi School of Engineering (Lucas), and Department of Anesthesiology, Keck School of Medicine (Weinstein, Richeimer), University of Southern California, Los Angeles, California; and Department of Psychology (Lumley), Wayne State University, Detroit, Michigan.
Objective:
Seminal advances in virtual human (VH) technology have introduced highly interactive, computer-animated VH interviewers. Their utility for aiding in chronic pain care is unknown. We developed three interactive telehealth VH interviews-a standard pain-focused, a psychosocial risk factor, and a pain psychology and neuroscience educational interview. We then conducted a preliminary investigation of their feasibility, acceptability, and efficacy. We also experimentally compared a human and a computer-generated VH voice.
Methods:
Patients ( N = 94, age = 22-78 years) with chronic musculoskeletal pain were randomly assigned to the standard ( n = 31), psychosocial ( n = 34), or educational ( n = 29) VH interview and one of the two VH voices. Acceptability ratings included patient satisfaction and expectations/evaluations of the VH interview. Outcomes assessed at baseline and about 1-month postinterview were pain intensity, interference, emotional distress, pain catastrophizing, and readiness for pain self-management. Linear mixed-effects models were used to test between- and within-condition effects.
Results:
Acceptability ratings showed that satisfaction with the VH and telehealth format was generally high, with no condition differences. Study attrition was low ( n = 5). Intent-to-treat-analyses showed that, compared with the standard interview, the psychosocial interview yielded a significantly greater reduction in pain interference ( p = .049, d = 0.43) and a marginally greater reduction in pain intensity ( p = .054, d = 0.36), whereas the educational interview led to a marginally greater yet nonsignificant increase in readiness for change ( p = .095, d = 0.24), as well as several significant improvements within-condition. Results did not differ by VH voice.
Conclusions:
Interactive VH interviewers hold promise for improving chronic pain care, including probing for psychosocial risk factors and providing pain-related education.
