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Elena+ Care for COVID-19, A Pandemic Lifestyle Care Intervention: Intervention Design and Study Protocol

Ollier, Joseph; Neff, Simon; Dworschak, Christine; Sejdiji, Arber; Santhanam, Prabhakaran; Keller, Roman; Xiao, Grace; Asisof, Alina; R�egger, Dominik; B�rub�, Caterina; Hilfiker Tomas, Lena; Neff, Jo�l; Yao, Jiali; Alattas, Aishah; Varela-Mato, Veronica; Pitkethly, Amanda; Dolores Vara, M�; Herrero, Roc�o; M. Ba�os, Rosa; Parada, Carolina; Sundaram Agatheswaran, Rajashree; Villalobos, Victor; Keller, Olivia C.; Chan, Wai Sze; Mishra, Varun; Jacobson, Nicholas; Stanger, Catherine; He, Xinming; Von Wyl, Viktor; Weidt, Steffi; Haug, Severin; Schaub, Michael P.; Kleim, Birgit; Barth, J�rgen; Witt, Claudia M.; Scholz, Urte; Fleisch, Elgar; von Wangenheim, Florian; Tudor Car, Lorainne; M�ller-Riemenschneider, Falk; Hauser-Ulrich, Sandra; N��ez Asomoza, Alejandra; Salamanca-Sanabria, Alicia; Mair, Jacqueline L.; Kowatsch, Tobias

Authors

Joseph Ollier

Simon Neff

Christine Dworschak

Arber Sejdiji

Prabhakaran Santhanam

Roman Keller

Grace Xiao

Alina Asisof

Dominik R�egger

Caterina B�rub�

Lena Hilfiker Tomas

Jo�l Neff

Jiali Yao

Aishah Alattas

Veronica Varela-Mato

M� Dolores Vara

Roc�o Herrero

Rosa M. Ba�os

Carolina Parada

Rajashree Sundaram Agatheswaran

Victor Villalobos

Olivia C. Keller

Wai Sze Chan

Varun Mishra

Nicholas Jacobson

Catherine Stanger

Xinming He

Viktor Von Wyl

Steffi Weidt

Severin Haug

Michael P. Schaub

Birgit Kleim

J�rgen Barth

Claudia M. Witt

Urte Scholz

Elgar Fleisch

Florian von Wangenheim

Lorainne Tudor Car

Falk M�ller-Riemenschneider

Sandra Hauser-Ulrich

Alejandra N��ez Asomoza

Alicia Salamanca-Sanabria

Jacqueline L. Mair

Tobias Kowatsch



Abstract

Background: The current COVID-19 coronavirus pandemic is an emergency on a global scale, with huge swathes of the population required to remain indoors for prolonged periods to tackle the virus. In this new context, individuals’ health-promoting routines are under greater strain, contributing to poorer mental and physical health. Additionally, individuals are required to keep up to date with latest health guidelines about the virus, which may be confusing in an age of social-media disinformation and shifting guidelines. To tackle these factors, we developed Elena+, a smartphone-based and conversational agent (CA) delivered pandemic lifestyle care intervention.
Methods: Elena+ utilizes varied intervention components to deliver a psychoeducation-focused coaching program on the topics of: COVID-19 information, physical activity, mental health (anxiety, loneliness, mental resources), sleep and diet and nutrition. Over 43 subtopics, a CA guides individuals through content and tracks progress over time, such as changes in health outcome assessments per topic, alongside user-set behavioral intentions and user-reported actual behaviors. Ratings of the usage experience, social demographics and the user profile are also captured. Elena+ is available for public download on iOS and Android devices in English, European Spanish and Latin American Spanish with future languages and launch countries planned, and no limits on planned recruitment. Panel data methods will be used to track user progress over time in subsequent analyses. The Elena+ intervention is open-source under the Apache 2 license (MobileCoach software) and the Creative Commons 4.0 license CC BY-NC-SA (intervention logic and content), allowing future collaborations; such as cultural adaptions, integration of new sensor-related features or the development of new topics.
Discussion: Digital health applications offer a low-cost and scalable route to meet challenges to public health. As Elena+ was developed by an international and interdisciplinary team in a short time frame to meet the COVID-19 pandemic, empirical data are required to discern how effective such solutions can be in meeting real world, emergent health crises. Additionally, clustering Elena+ users based on characteristics and usage behaviors could help public health practitioners understand how population-level digital health interventions can reach at-risk and sub-populations.

Citation

Ollier, J., Neff, S., Dworschak, C., Sejdiji, A., Santhanam, P., Keller, R., Xiao, G., Asisof, A., Rüegger, D., Bérubé, C., Hilfiker Tomas, L., Neff, J., Yao, J., Alattas, A., Varela-Mato, V., Pitkethly, A., Dolores Vara, M., Herrero, R., M. Baños, R., Parada, C., …Kowatsch, T. (2021). Elena+ Care for COVID-19, A Pandemic Lifestyle Care Intervention: Intervention Design and Study Protocol. Frontiers in Public Health, 9, Article 625640. https://doi.org/10.3389/fpubh.2021.625640

Journal Article Type Article
Acceptance Date Sep 20, 2021
Online Publication Date Oct 21, 2021
Publication Date 2021
Deposit Date Oct 14, 2021
Publicly Available Date Dec 14, 2021
Publisher Frontiers Media
Peer Reviewed Peer Reviewed
Volume 9
Article Number 625640
DOI https://doi.org/10.3389/fpubh.2021.625640
Keywords Chatbot, Conversational agent (CA), Digital coaching, Digital Health, Coronavirus – COVID-19, Gamification, Mental Health, lifestyle
Public URL http://researchrepository.napier.ac.uk/Output/2812049
Publisher URL https://www.frontiersin.org/articles/10.3389/fpubh.2021.625640/full

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