Embodied Digital Health Agent System Overview

Digital health agents can circumvent several common barriers to treatment, such as scheduling and transportation. Embodied agents can run on several different tech platforms, such as desktops and cell phones, and are not limited to specific appointment times as human providers are. Agents can be and are programmed to deliver evidence-based treatment, which can ensure care rooted in research is being given. Additionally, embodied agents can be racially and culturally diverse, which may affect treatment outcomes.

How Digital Health Agents May Overcome Barriers to Care for Alcohol Abuse

Providers, including embodied conversational health agents, can deliver Brief Motivational Interviewing characterized by the acronym FRAMES:

F- Feedback about client’s individual status is personalized and stored in a user model database, keeping a record of their answers for the next session.

R- Responsibility for changing is left with the individual.

A- Advice is provided in a supportive manner and paired with empathetic words and body language.

M- Menus of different options for change are offered.

E- Empathy via verbal and nonverbal language.

S- Self-efficacy is encouraged and nurtured.

FRAMES Model of Brief Motivational Interviewing

Digital Health Agents are conversational agents (sometimes called chatbots) that are designed specifically for health interventions. When paired with a simulated human character, they are called Embodied Conversational Agents.

Cleveland State University

Digital health agents  provide a promising alternative or supplement to behavioral health services by reducing barriers to treatment for alcohol abuse/misuse.

Development, feasibility, acceptability, and utility of an expressive speech-enabled digital health agent delivering motivational interviewing for alcohol misuse

Boustani M, Lunn S, Visser U & Lisetti C. (2021).
Development, Feasibility, Acceptability, and Utility of an Expressive Speech-Enabled Digital Health Agent to Deliver Online, Brief Motivational Interviewing for Alcohol Misuse: Descriptive Study.
Journal of Medical Internet Research, 23 (9).
https://www.jmir.org/2021/9/e25837

Development, Feasibility, Acceptability, and Utility of an Expressive Speech-Enabled Digital Health Agent to Deliver Online, Brief Motivational Interviewing for Alcohol Misuse: Descriptive Study

Embodied Conversational Digital Health Agents

The availability of trained providers, proximity of providers, access to reliable transportation, cost, insurance coverage, scheduling, and stigma all serve as barriers to treatment for alcohol abuse. When care may be available, it is not always evidence-based treatment, further complicating issues around access to quality care.

Barriers to Care for Alcohol Abuse

Brief motivational Interviewing includes motivational interviewing's style of communication (empathy, increasing discrepancy, rolling with resistance, and supporting self-efficacy) with common elements of brief counseling interventions ( feedback, options for change, respectful of current readiness to change, supportive advice). It has been found to be an effective intervention for substance use disorders.

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