Chatbot to reduce impacts of lockdowns on well-being

In attempts to reduce harm due to Covid-19, the focus has often been on producing models to predict and reduce virus spread via strong public health measures at the societal level. But what does behavioural science have to offer in reducing the negative effects of lockdowns on peoples’ mental, physical, and other lifestyle health factors at an individual level?

With prolonged periods of isolation and social distancing during the Covid-19 pandemic, individuals' health-promoting routines are coming under strain, contributing to poorer mental and physical health. In March 2020, a group of international researchers rapidly developed a chatbot intervention at speed to deliver pandemic lifestyle care to help people stay healthy amidst restrictions.

Digital health applications offer a low-cost and scalable means to meet challenges to public health. From the call to arms of research to tackle the pandemic, comes the challenge of delivering what the authors term “pandemic lifestyle care”. This entails boosting health at a population-level when many typical health promoting routines are severely disrupted and simple health promoting behaviours such as going for a walk or having personal space for relaxing hobbies have become more difficult.

The smartphone app, which uses conversational agent (CA), delivers a coaching program on the topics of Covid-19 information, physical activity, mental health (anxiety, loneliness, mental resources), sleep, diet and nutrition. The intervention takes a broad approach to target multiple facets of an individual's lifestyle, representing both a novel treatment and research opportunity in digital public health efforts.

As Elena+ was developed by an international and interdisciplinary team in a short time frame during the pandemic, empirical data are required to understand the effectiveness of such solutions in meeting real-world, emergent health crises. This brought 45 contributors together over three months of development, one EUvsVirus hackathon, two App Store launches and 11 months of peer-review.

In the paper ‘external page Elena+ Care for Covid-19, a Pandemic Lifestyle Care Intervention: Intervention Design and Study Protocol’, researchers review digital health intervention and its potential. By capturing user profile and usage experience data, it is possible to understand how user or usage patterns influences the success of Elena+, to enable better segmenting and tailoring of approaches in future health interventions.

The project lays the groundwork for future interventions by providing open-source intervention logic, content, and software, serving as a start-point for tackling other chronic and mental illness. In the long term, Elena+ is not meant to be a static intervention, but an intervention which will evolve and adapt, leveraging the revolutionary potential of digital health to learn, innovate and apply solutions

The Elena+ app was developed by researchers from the Future Health Technologies (FHT) programme at the Singapore-ETH Centre, under the Mobile Health Intervention module. The app is currently available on both iOS and Android devices in the United Kingdom, United States, Switzerland, Ireland, Spain, Colombia, and Mexico, at no cost.