Using voice technology on self-management and healthy lifestyle: Where are we now?

There is a transformation of digital services from screens to voice. The use of voice activated devices and conversational assistant services in healthcare institutions are also increasing. While witnessing such prominent changes, we were curious what has been done and proved in the scientific literature about the voice technology use in healthcare -specifically in behavioral health domain.

We recently completed a comprehensive literature review on behavioral health interventions with voice assistants focusing on self-management and healthy lifestyle. It was a great experience and we learned a lot about use of voice technology in behavioral health throughout this review. Here, I would like to share a quick glimpse at our primary findings and status of the voice assistants in behavioral health. There are many more interesting findings and synthesis available in the full text here, published at Translational Behavioral Medicine.

A quick glimpse at our primary findings

...Across populations and cognitive behavioral targets, voice assistant technology was used to facilitate intervention components, namely via: feedback and monitoring, shaping knowledge, and self-beliefs, repetition and substitution, goals and planning. Theory to inform intervention development or testing was reported in three studies. Interventions may be best described as nascent, with only two trials proposing efficacy testing and the remainder in usability or feasibility trials. While the majority of studies leveraged commercially available software, we found the research delineated to either: a) explore the functionality of commercially available, standalone voice assistants, or b) feasibility/usability testing of interventions that adapted commercial products to suit research needs. The most common research conducted on commercially available, standalone voice assistants was associated with health information seeking/response quality and accuracy. The most common research associated with research-developed voice assistant technology targeted healthy lifestyle behaviors (e.g. diet, physical activity and screen time) associated with overweight, obesity, hypertension, and T2D.

Status of voice assistants in behavioral health

...We argue the value of the voice assistant in self-management and behavioral health will have increasing impact as the abilities of voice assistants expand. We adapted the spectrum of applications of voice assistants to illustrate the state of voice assistants in behavioral health (Figure). Starting information-level services (e.g. asking Amazon Alexa to start self-management podcasts or healthy lifestyle quick tips) can progress to assistance (e.g. set up reminders for medication or physical activity), then to assessment (e.g. creating voice markers to identify changes in mood and health, enabling assessment “on the go”), and eventually support (prescribing cognitive behavioral therapies and activities towards improving health and wellness). In this representation, it is important to note that the progression is not linear, and impact size as well as value and risk changes may not be highly representative. Suggested services may be used alone or in conjunction. Based on findings from this review, current implementations of voice assistants in behavioral health best aligns with “information” services and moving towards “assistance”,demonstrating similar trajectory of the healthcare initiatives of voice technology in the market assistance”.

Note: References are accessible through the full text available open access in this link.