TY  - JOUR
AU  - Potts, Courtney
AU  - Lindström, Frida
AU  - Bond, Raymond
AU  - Mulvenna, Maurice
AU  - Booth, Frederick
AU  - Ennis, Edel
AU  - Parding, Karolina
AU  - Kostenius, Catrine
AU  - Broderick, Thomas
AU  - Boyd, Kyle
AU  - Vartiainen, Anna-Kaisa
AU  - Nieminen, Heidi
AU  - Burns, Con
AU  - Bickerdike, Andrea
AU  - Kuosmanen, Lauri
AU  - Dhanapala, Indika
AU  - Vakaloudis, Alex
AU  - Cahill, Brian
AU  - MacInnes, Marion
AU  - Malcolm, Martin
AU  - O'Neill, Siobhan
PY  - 2023
DA  - 2023/7/6
TI  - A Multilingual Digital Mental Health and Well-Being Chatbot (ChatPal): Pre-Post Multicenter Intervention Study
JO  - J Med Internet Res
SP  - e43051
VL  - 25
KW  - conversational user interfaces
KW  - digital interventions
KW  - Warwick-Edinburgh Mental Well-Being Scale
KW  - Satisfaction With Life Scale
KW  - World Health Organization-Five Well-Being Index Scale
KW  - mental health
KW  - apps
KW  - health care
KW  - mixed methods
KW  - conversation agent
KW  - mental well-being
KW  - digital health intervention
AB  - Background: In recent years, advances in technology have led to an influx of mental health apps, in particular the development of mental health and well-being chatbots, which have already shown promise in terms of their efficacy, availability, and accessibility. The ChatPal chatbot was developed to promote positive mental well-being among citizens living in rural areas. ChatPal is a multilingual chatbot, available in English, Scottish Gaelic, Swedish, and Finnish, containing psychoeducational content and exercises such as mindfulness and breathing, mood logging, gratitude, and thought diaries. Objective: The primary objective of this study is to evaluate a multilingual mental health and well-being chatbot (ChatPal) to establish if it has an effect on mental well-being. Secondary objectives include investigating the characteristics of individuals that showed improvements in well-being along with those with worsening well-being and applying thematic analysis to user feedback. Methods: A pre-post intervention study was conducted where participants were recruited to use the intervention (ChatPal) for a 12-week period. Recruitment took place across 5 regions: Northern Ireland, Scotland, the Republic of Ireland, Sweden, and Finland. Outcome measures included the Short Warwick-Edinburgh Mental Well-Being Scale, the World Health Organization-Five Well-Being Index, and the Satisfaction with Life Scale, which were evaluated at baseline, midpoint, and end point. Written feedback was collected from participants and subjected to qualitative analysis to identify themes. Results: A total of 348 people were recruited to the study (n=254, 73% female; n=94, 27% male) aged between 18 and 73 (mean 30) years. The well-being scores of participants improved from baseline to midpoint and from baseline to end point; however, improvement in scores was not statistically significant on the Short Warwick-Edinburgh Mental Well-Being Scale (P=.42), the World Health Organization-Five Well-Being Index (P=.52), or the Satisfaction With Life Scale (P=.81). Individuals that had improved well-being scores (n=16) interacted more with the chatbot and were significantly younger compared to those whose well-being declined over the study (P=.03). Three themes were identified from user feedback, including “positive experiences,” “mixed or neutral experiences,” and “negative experiences.” Positive experiences included enjoying exercises provided by the chatbot, while most of the mixed, neutral, or negative experiences mentioned liking the chatbot overall, but there were some barriers, such as technical or performance errors, that needed to be overcome. Conclusions: Marginal improvements in mental well-being were seen in those who used ChatPal, albeit nonsignificant. We propose that the chatbot could be used along with other service offerings to complement different digital or face-to-face services, although further research should be carried out to confirm the effectiveness of this approach. Nonetheless, this paper highlights the need for blended service offerings in mental health care. 
SN  - 1438-8871
UR  - https://www.jmir.org/2023/1/e43051
UR  - https://doi.org/10.2196/43051
UR  - http://www.ncbi.nlm.nih.gov/pubmed/37410537
DO  - 10.2196/43051
ID  - info:doi/10.2196/43051
ER  -