ABSTRACT
Skillful, collaborative conversations are powerful tools to improve physical and mental health. Whether you are a parent talking with your child about the dangers of substance abuse, an educator concerned about a student's signs of psychological distress, a veteran worried about a buddy who is contemplating suicide, or a healthcare professional wanting to better engage patients to increase treatment compliance, having the skill, confidence and motivation to engage in conversations can truly transform the health and well-being of those you interact with. Kognito develops role-play simulations that prepare individuals to effectively lead real-life conversations that measurably improve social, emotional, and physical health. The behavior change model that drives the simulations draws upon components of game mechanics, virtual human simulation technology and integrates evidence-based instructional design components as well as principles of social-cognitive theory and neuroscience such as motivational interviewing, emotional regulation, empathy and mindfulness. In the simulations, users or enter a risk-free practice environment and engage in a conversation with intelligent, fully animated, and emotionally responsive virtual characters that model human behavior. It is in practicing these conversations, and receiving feedback from a virtual coach, that users learn to better lead conversations in real life. Numerous longitudinal studies have shown that users who complete Kognito simulations demonstrate statistically significant and sustained increases in attitudinal variables that predict behavior change including preparedness, likelihood, and self-efficacy to better manage conversations. Pending the target population, each online or mobile simulation resulted in desired behavior changes ranging from increased referrals of students, patients or veterans in psychological distress to mental health support services, or increasing physician patient-centered communication or patient self-confidence and active involved in the decision-making processes. These simulations have demonstrated a capability to address major health and public health concerns where effective conversations are necessary to bring about changes in attitudes and behaviors.
ABSTRACT
Every year, one in four American adults suffers from a diagnosable mental disorder, yet most of them go untreated, creating a significant public health challenge. This challenge is compounded by large-scale disasters, which can cause an influx of primary care patients presenting with physical symptoms that mask mental health disorders. Primary care providers (PCPs) are usually the first point of contact for those patients; thus there exist crucial opportunities to detect and address nonphysical disorders in primary care settings that would improve patient outcomes and quality of care. Unfortunately, many PCPs view mental health as separate from the services that they provide, and the majority of them have received little training during or after medical or nursing school about risk factors, symptoms, and treatment options. To help integrate behavioral health into primary care, Kognito Interactive developed "At-Risk in Primary Care," an online game-based simulation that integrates role-play conversations with virtual humans to train PCPs to screen patients for mental health disorders, perform brief behavioral interventions using motivational interviewing (MI), refer patients, and integrate behavioral health into their treatment while building patients' intrinsic motivation to adhere to it. Preliminary findings on the implementation of this game in New York City show significant increases in skill and motivation to screen patients, conduct behavioral interventions, and refer patients to specialized care. These results show the promise of innovative technology-based solutions to integrate mental health training in primary care.
