RESUMO
BACKGROUND: Approximately 60%-80% of the primary care visits have a psychological stress component, but only 3% of patients receive stress management advice during these visits. Given recent advances in natural language processing, there is renewed interest in mental health chatbots. Conversational agents that can understand a user's problems and deliver advice that mitigates the effects of daily stress could be an effective public health tool. However, such systems are complex to build and costly to develop. OBJECTIVE: To address these challenges, our aim is to develop and evaluate a fully automated mobile suite of shallow chatbots-we call them Popbots-that may serve as a new species of chatbots and further complement human assistance in an ecosystem of stress management support. METHODS: After conducting an exploratory Wizard of Oz study (N=14) to evaluate the feasibility of a suite of multiple chatbots, we conducted a web-based study (N=47) to evaluate the implementation of our prototype. Each participant was randomly assigned to a different chatbot designed on the basis of a proven cognitive or behavioral intervention method. To measure the effectiveness of the chatbots, the participants' stress levels were determined using self-reported psychometric evaluations (eg, web-based daily surveys and Patient Health Questionnaire-4). The participants in these studies were recruited through email and enrolled on the web, and some of them participated in follow-up interviews that were conducted in person or on the web (as necessary). RESULTS: Of the 47 participants, 31 (66%) completed the main study. The findings suggest that the users viewed the conversations with our chatbots as helpful or at least neutral and came away with increasingly positive sentiment toward the use of chatbots for proactive stress management. Moreover, those users who used the system more often (ie, they had more than or equal to the median number of conversations) noted a decrease in depression symptoms compared with those who used the system less often based on a Wilcoxon signed-rank test (W=91.50; Z=-2.54; P=.01; r=0.47). The follow-up interviews with a subset of the participants indicated that half of the common daily stressors could be discussed with chatbots, potentially reducing the burden on human coping resources. CONCLUSIONS: Our work suggests that suites of shallow chatbots may offer benefits for both users and designers. As a result, this study's contributions include the design and evaluation of a novel suite of shallow chatbots for daily stress management, a summary of benefits and challenges associated with random delivery of multiple conversational interventions, and design guidelines and directions for future research into similar systems, including authoring chatbot systems and artificial intelligence-enabled recommendation algorithms.
RESUMO
BACKGROUND: Stress is a risk factor associated with physiological and mental health problems. Unobtrusive, continuous stress sensing would enable precision health monitoring and proactive interventions, but current sensing methods are often inconvenient, expensive, or suffer from limited adherence. Prior work has shown the possibility to detect acute stress using biomechanical models derived from passive logging of computer input devices. OBJECTIVE: Our objective is to detect acute stress from passive movement measurements of everyday interactions on a laptop trackpad: (1) click, (2) steer, and (3) drag and drop. METHODS: We built upon previous work, detecting acute stress through the biomechanical analyses of canonical computer mouse interactions and extended it to study similar interactions with the trackpad. A total of 18 participants carried out 40 trials each of three different types of movement-(1) click, (2) steer, and (3) drag and drop-under both relaxed and stressed conditions. RESULTS: The mean and SD of the contact area under the finger were higher when clicking trials were performed under stressed versus relaxed conditions (mean area: P=.009, effect size=0.76; SD area: P=.01, effect size=0.69). Further, our results show that as little as 4 clicks on a trackpad can be used to detect binary levels of acute stress (ie, whether it is present or not). CONCLUSIONS: We present evidence that scalable, inexpensive, and unobtrusive stress sensing can be done via repurposing passive monitoring of computer trackpad usage.
