Background: Chatbots are growing in popularity as they offer a range of potential benefits to end users and service providers. Objective: Our scoping review aimed to explore studies that used 2-way chatbots to support healthy eating, physical activity, and mental wellness interventions. Our objectives were to report the nontechnical (eg, unrelated to software development) approaches for chatbot development and to examine the level of patient engagement in these reported approaches. Methods: Our team conducted a scoping review following the framework proposed by Arksey and O’Malley. Nine electronic databases were searched in July 2022. Studies were selected based on our inclusion and exclusion criteria. Data were then extracted and patient involvement was assessed. Results: 16 studies were included in this review. We report several approaches to chatbot development, assess patient involvement where possible, and reveal the limited detail available on reporting of patient involvement in the chatbot implementation process. The reported approaches for development included: collaboration with knowledge experts, co-design workshops, patient interviews, prototype testing, the Wizard of Oz (WoZ) procedure, and literature review. Reporting of patient involvement in development was limited; only 3 of the 16 included studies contained sufficient information to evaluate patient engagement using the Guidance for Reporting Involvement of Patients and Public (GRIPP2). Conclusions: The approaches reported in this review and the identified limitations can guide the inclusion of patient engagement and the improved documentation of engagement in the chatbot development process for future health care research. Given the importance of end user involvement in chatbot development, we hope that future research will more systematically report on chatbot development and more consistently and actively engage patients in the codevelopment process.
A survey was conducted to identify barriers and facilitators to engaging in virtual and in-person cancer-specific exercise during COVID-19. A theory-informed, multi-method, cross-sectional survey was electronically distributed to 192 individuals with cancer investigating preferences towards exercise programming during COVID-19. Respondents had previously participated in an exercise program and comprised two groups: those who had experience with virtual exercise programming (‘Virtual’) and those who had only taken part in in-person exercise (‘In-Person’). Quantitative data were summarized descriptively. Qualitative data were thematically categorized using framework analysis and findings were mapped to an implementation model. The survey completion response rate was 66% (N = 127). All respondents identified barriers to attending in-person exercise programming during COVID-19 with concerns over the increased risk of viral exposure. Virtual respondents (n = 39) reported: (1) feeling confident in engaging in virtual exercise; and (2) enhanced motivation, accessibility and effectiveness as facilitators to virtual exercise. In-Person respondents (n = 88) identified: (1) technology as a barrier to virtual exercise; and (2) low motivation, accessibility and exercise effectiveness as barriers towards virtual exercise. Sixty-six percent (n = 58) of In-Person respondents reported that technology support would increase their willingness to exercise virtually. With appropriately targeted support, perceived barriers to accessing virtual exercise—including motivation, accessibility and effectiveness—may become facilitators. The availability of technology support may increase the engagement of individuals with cancer towards virtual exercise programming.
Background: Our aim was to understand cancer survivor needs prior to, and following the Alberta Cancer Exercise (ACE) pilot randomized trial as a means to inform implementation of a province-wide cancer-specific, community-based exercise program. Methods: Questionnaires and semi-structured stakeholder engagement sessions were conducted with cancer survivors to explore preferences, barriers and facilitators/benefits at two timepoints: (1) pre-ACE: prior to initiation of the ACE pilot trial (n = 13 survivors and n = 5 caregivers); and (2) post-ACE: following participation in the ACE pilot trial (n = 20 survivors). Descriptive statistics were used to summarize quantitative data from questionnaires. Stakeholder engagement data were analyzed using a framework analysis approach. Emergent themes were then mapped to actionable outcomes. Results: Pre-ACE, survivors indicated a preference for exercise programs that were (1) supervised by exercise specialists knowledgeable about cancer, (2) included support from other health care providers, (3) were held in community locations that were easily accessible. Post-ACE, participants identified (1) a lack of exercise counseling from health care providers, (2) the need for earlier introduction of exercise in the care pathway, and (3) supported referral to exercise programming. Conclusions: An integrated knowledge translation approach identified actionable outcomes to address survivor needs related to exercise in clinical cancer and community-based contexts.
Mobile motion capture is a promising technology for assessing physical movement; markerless motion capture systems (MLSs) offer great potential in rehabilitation settings, given their accessibility compared to marker-based motion capture systems (MBSs). This review explores the current literature on rehabilitation, for direct comparison of movement-related outcomes captured by MLSs to MBSs and for application of MLSs in movement measurements. Following a scoping review methodology, nine databases were searched (May to August 2023). Eligible articles had to present at least one estimate of the mean difference between a measure of a physical movement assessed by MLS and by MBS. Sixteen studies met the selection criteria and were included. For comparison of MLSs with MBSs, measures of mean joint range of motion (ROM) displacement were found to be similar, while peak joint angle outcomes were significantly different. Upper body movement outcomes were found to be comparable, while lower body movement outcomes were very different. Overall, nearly two-thirds of measurements identified statistical differences between MLS and MBS outcomes. Regarding application, no studies assessed the technology with patient populations. Further MLS-specific research with consideration of patient populations (e.g., intentional error testing, testing in less-than-ideal settings) would be beneficial for utilization of motion capture in rehabilitation contexts.
Survivors with head and neck cancer (HNC) report cancer-related fatigue (CRF) as a devastating, prevalent health issue that limits activity engagement and adversely influences quality of life. To explore HNC survivors' written responses and descriptors regarding CRF, and offer potential healthcare strategies based on findings. In written format, similar to responses on intake forms in outpatient-clinics, 25 HNC survivors provided descriptions of their CRF experiences and their perspectives on its impact. An exploratory descriptive research design was utilized, drawing on social theory for content analysis and thematic development. Two main themes regarding CRF arose from the data: (1) CRF as a barrier to daily function; and (2) uncontrollable and unpredictable energy fluctuations. To enhance outcomes of CRF symptom management in HNC survivors, a healthcare approach that targets the functional implications of CRF, and utilizes energy cultivation strategies when communicating about the negative impacts of CRF (including limited function and fluctuating energy levels) may be beneficial for HNC survivors. Further research into the effects of CRF on function for HNC survivors is warranted.