A Conversational Agent (PracticePal) to Support the Delivery of a Brief Behavioral Activation Treatment for...

Area of Science:

• Digital mental health interventions
• Psychosocial interventions
• Human-computer interaction

Background:

• Brief psychosocial interventions like the Healthy Activity Program (HAP) delivered by nonspecialist providers (NSPs) are cost-effective for depression.
• Patient engagement and homework adherence are crucial for HAP success.
• Current paper-based workbooks limit engagement and adherence.

Purpose of the Study:

• To describe the user-centered development of PracticePal, a chatbot aimed at enhancing patient engagement and homework adherence.
• To evaluate the feasibility and acceptability of PracticePal as a therapy aid in India.

Main Methods:

• User-centered design approach with Hindi conversational flows and video scripts.
• Pilot study with 30 depression patients and 15 NSPs in rural India.
• Feasibility and acceptability assessed via engagement data, interviews, and focus groups.

Main Results:

• Average patient engagement lasted 29 days; engagement increased with treatment progression.
• 20 out of 30 patients (67%) accessed over half of the chatbot's multimedia content.
• All patients completed treatment, with mean depression scores reducing from 13 to 4.
• Patients and NSPs found the chatbot helpful; challenges included low internet bandwidth and limited literacy.

Conclusions:

• PracticePal is a feasible and acceptable therapy aid for complementing psychological treatment.
• The chatbot shows potential to enhance NSP-delivered psychosocial interventions in low-resource settings.
• A randomized controlled trial is planned to assess effectiveness in improving mental health outcomes.