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Conversational agent-based interventions for lifestyle behavior modification in older adults: a systematic review
Qian Zhang1, Arkers Kwan Ching Wong2,3, Vivian Hui1
1School of Nursing, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hong Kong, China.
Conversational agents show promise for promoting healthy aging and lifestyle changes in older adults. However, current evidence on their effectiveness is inconclusive, necessitating improved designs and rigorous evaluations.
Area of Science:
- Gerontology
- Digital Health
- Behavioral Science
Background:
- Aging populations and non-communicable diseases require scalable healthy aging strategies.
- Conversational agents offer personalized, interactive support for lifestyle behavior change in older adults.
- This field remains underexplored, necessitating systematic investigation.
Purpose of the Study:
- To systematically review conversational agent interventions for lifestyle modification in older adults.
- To assess intervention characteristics, acceptability, and effectiveness.
- To identify design and research considerations for future advancements.
Main Methods:
- Comprehensive database search (MEDLINE, EMBASE, PsycINFO, CINAHL) up to February 28, 2025.
- Inclusion of studies evaluating behavior-related outcomes in older adults.
- Quality appraisal using the Quality Assessment Tool for Studies with Diverse Designs (QATSDD).
Main Results:
- Six studies (4 RCTs, 1 quasi-experimental, 1 cohort) met inclusion criteria.
- Interventions were typically frame-based, computer-delivered, embodied, and used persuasive strategies.
- Feasibility and acceptability were generally good, but efficacy for physical activity and diet remains inconclusive due to limited evidence and design variability.
Conclusions:
- Key features of conversational agents for older adults were identified.
- Design limitations may hinder user engagement and technology adoption.
- Future efforts should prioritize user-friendly designs, transparent reporting, and robust outcome evaluations to support healthy aging.
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