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Multidisciplinary Approach to Obesity Management: A Case Report

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Engagement With Conversational Agent-Enabled Interventions in Cardiometabolic Disease Self-Management: Systematic

Nick Kashyap^1,2,3, Ann Tresa Sebastian⁴, Chris Lynch^1,3

¹School of Psychology and Public Health, La Trobe University, Melbourne, Australia.

JMIR Mhealth and Uhealth

|September 18, 2025

Summary

Conversational agents can improve self-management for cardiometabolic diseases (CMD). Design features like communication style and personality significantly impact user engagement, enhancing autonomy and investment in these digital health tools.

Keywords:

cardiovascular disease chatbot chronic disease diabetes digital assistant digital health qualitative user experience

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Area of Science:

Digital Health
Human-Computer Interaction
Behavioral Science

Background:

Conversational agents offer potential to enhance healthcare capacity for self-managing cardiometabolic diseases (CMD).
Limited empirical evidence exists on design features of conversational agent-enabled interventions and their impact on user engagement.
This review synthesizes evidence to guide the development of more engaging interventions for CMD self-management.

Purpose of the Study:

To synthesize evidence on design features of conversational agent-enabled interventions.
To examine the impact of these design features on user engagement among individuals with CMD.

Main Methods:

Systematic literature search across Ovid (MEDLINE), Web of Science, and Scopus.
Inclusion of primary research studies on conversational agent-enabled interventions with engagement measures and adult CMD populations.
Data extraction focused on user perspectives regarding various design features.

Main Results:

Twenty studies were included, with 18 focusing on qualitative or quasi-experimental evaluations of intervention prototypes.
Five key domains of design features influencing engagement were identified: communication style, functionality, accessibility, visual appearance, and personality.
Redundancy and anthropomorphism emerged as effective strategies to boost engagement.

Conclusions:

Integrating redundancy and anthropomorphism in conversational agents can enhance user engagement by fostering autonomy and investment.
Future research should prioritize inclusive and adaptive design strategies tailored to diverse user needs and intervention contexts.
Optimizing design features is crucial for developing effective conversational agent-enabled interventions for CMD self-management.