Public perceptions of a healthy lifestyle change conversational agent in Singapore: A qualitative study

Abstract

Objective: Conversational agents (CAs) are increasingly used for the delivery of healthy lifestyle behaviour interventions. This qualitative study aimed to explore the barriers and facilitators to participants’ usage of a healthy lifestyle change CA and collect their views on areas for its improvement. Methods: Twenty participants were recruited from a convenience sample of users interacting with a CA promoting healthy lifestyle changes to the general population in Singapore. This CA, Precilla, educated users on healthy living, specifically: diet, exercise, sleep and stress; for four weeks. The volunteers participated in semi-structured interviews where an interview guide was used, with questions on acceptability, satisfaction and critical appraisal of the CA. Interviews were transcribed and analysed in parallel by two researchers using thematic content analysis. Results: Four main themes were identified: (1) enjoyable and acceptable experiences, (2) suboptimal experience(s), (3) alterations to Precilla for enhanced interaction and (4) suggestions for the future. Enjoyable experiences referenced the CA's friendly personality and important content that motivated a positive change to their lifestyle. Some participants were less satisfied and found the content to be too simple or sometimes, the messages too lengthy. Conclusions: Participants suggested that in the future, CAs should provide regularly updated content on healthy living, specifically pre-diabetes. Multiple answer options should also be provided for more personalisation along with links to external resources to help improve users’ health literacy. Further recommendations include a necessity for a user-centered approach in CA development, employment of engagement strategies, use of a delivery platform most familiar to the target population and stratified message timings to suit the population and purpose of CA. Translating the health CAs to languages relevant to the target group could also enable wider reach and applicability.