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Interactive conversational agents, also known as “chatbots,” are computer programs that use natural language processing to engage in conversations with humans to provide or collect information. Although the literature on the development and use of chatbots for health interventions is growing, important knowledge gaps remain, such as identifying design aspects relevant to health care and functions to offer transparency in decision-making automation.
This paper presents the protocol for a scoping review that aims to identify and categorize the interactive conversational agents currently used in health care.
A mixed methods systematic scoping review will be conducted according to the Arksey and O’Malley framework and the guidance of Peters et al for systematic scoping reviews. A specific search strategy will be formulated for 5 of the most relevant databases to identify studies published in the last 20 years. Two reviewers will independently apply the inclusion criteria using the full texts and extract data. We will use structured narrative summaries of main themes to present a portrait of the current scope of available interactive conversational agents targeting health promotion, prevention, and care. We will also summarize the differences and similarities between these conversational agents.
The search strategy and screening steps were completed in March 2022. Data extraction and analysis started in May 2022, and the results are expected to be published in October 2022.
This fundamental knowledge will be useful for the development of interactive conversational agents adapted to specific groups in vulnerable situations in health care and community settings.
DERR1-10.2196/40265
Digital technologies are an engine of transformation in the health sector and represent a promising avenue for improving access to care, care personalization, health prevention, and health promotion, particularly for those in vulnerable situations [
Conversational agents, also known as “chatbots,” are computer programs that use natural language processing to engage in conversations with humans to provide or collect information [
Although the literature on the development and use of chatbots for patients’ health is growing, there are still important knowledge gaps that remain, such as identifying design aspects relevant to health care and functions to offer transparency in decision-making automation [
The goal of this mixed methods systematic scoping review is to identify and categorize interactive conversational technologies currently used in health promotion, prevention, and care.
A mixed methods systematic scoping review will be conducted according to the Arksey and O’Malley [
Our key synthesis question is as follows: (1) in which population and settings are interactive conversational agents used for health promotion, prevention, and care? and (2) what are the characteristics of the technologies supporting these interactive conversational agents?
We will address all types of evidence matching the PICOS (population, intervention, comparison, outcomes, setting or context) criteria:
Participants or population: we will include all studies targeting laypeople (eg, patients, students, citizens). Studies targeting only health care providers will be excluded.
Interventions or phenomena of interest: we will include all interactive conversational agents, that is, those involving a 2-way exchange (written, oral, and visual dialogue), directed at laypeople for health promotion, prevention, and care.
Comparator: no restrictions will be applied.
Outcomes: we will consider all outcomes reported in the studies. We will seek outcomes related to patients, caregivers, health care providers, and policy makers. Those could include barriers, facilitators, acceptability, feasibility, adoption, fidelity, morbidity, mortality, quality of life, satisfaction, cost, and cost-effectiveness.
Setting: we will include studies taking place in a health care or community setting, in any geographical area. All types of studies will be included (qualitative, quantitative, and mixed methods).
The search strategy was developed in collaboration with a university librarian who has experience in literature reviews (FB) (
All citations will be exported to the online collaboration tool Covidence (Veritas Health Innovation) [
Team members will complete the extraction, and the data will be reviewed by an experienced researcher (MPG or MS). We will extract descriptive data (title, year of publication, authors, country), study type (published or gray literature, study design), intervention data (name of the technology, language of the technology, implementation channel, and features like audio, text, voice, avatar), setting data (target population, place of implementation), sample data (comparator, number of participants, sample sizes), outcomes (process, patients, providers, or systems related), and outcome type (qualitative and quantitative). We will appraise the quality of the studies included by applying the Mixed Methods Appraisal Tool [
We will complete the data synthesis using structured narrative summaries of main themes and provide a portrait of the current scope of available technologies using descriptive analysis. A summary of the differences and similarities between conversational agents will highlight the following points: strengths and weaknesses, main outcomes, main resources used, and trade-offs. A map of outcomes and targeted populations will be built and presented [
The search strategy and screening steps of the review were completed in March 2022. Data extraction and analysis began in May 2022, and the results are expected to be published in October 2022.
Literature reviews on chatbots in health care are available in specific contexts, such as mental health management [
There is a human resources crisis in health care. Worldwide shortages in health care professionals, increasing burnout rates, and an aging population are 3 major factors causing an imbalance in the offering and demand of health care services [
Accelerated by the COVID-19 pandemic, the shift to digital care has caused health inequities [
Finally, the widespread implementation of conversational agents is still burdened by ethical and clinical implications [
The results of this scoping review will provide a portrait of interactive conversational agents and their various applications in health promotion, prevention, and care. This fundamental knowledge will be useful for the development of interactive conversational agents adapted to specific users and people in vulnerable situations.
Detailed search strategy.
Preferred Reporting Items for Systematic Reviews and Meta-Analyses
Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews
population, intervention, comparison, outcomes, setting or context
This project is funded by a Research Development Grant from Université Laval’s Faculty of Nursing Sciences.
The data for this review will be deposited and made available online in the Open Science Framework depository.
None declared.