Frontiers in Public Health (Oct 2021)

Elena+ Care for COVID-19, a Pandemic Lifestyle Care Intervention: Intervention Design and Study Protocol

  • Joseph Ollier,
  • Simon Neff,
  • Christine Dworschak,
  • Arber Sejdiji,
  • Prabhakaran Santhanam,
  • Roman Keller,
  • Grace Xiao,
  • Alina Asisof,
  • Dominik Rüegger,
  • Caterina Bérubé,
  • Lena Hilfiker Tomas,
  • Joël Neff,
  • Jiali Yao,
  • Aishah Alattas,
  • Veronica Varela-Mato,
  • Amanda Pitkethly,
  • Mª Dolores Vara,
  • Mª Dolores Vara,
  • Rocío Herrero,
  • Rocío Herrero,
  • Rosa Mª Baños,
  • Rosa Mª Baños,
  • Rosa Mª Baños,
  • Carolina Parada,
  • Rajashree Sundaram Agatheswaran,
  • Victor Villalobos,
  • Olivia Clare Keller,
  • Olivia Clare Keller,
  • Wai Sze Chan,
  • Varun Mishra,
  • Nicholas Jacobson,
  • Catherine Stanger,
  • Xinming He,
  • Viktor von Wyl,
  • Viktor von Wyl,
  • Steffi Weidt,
  • Severin Haug,
  • Michael Schaub,
  • Birgit Kleim,
  • Jürgen Barth,
  • Claudia Witt,
  • Urte Scholz,
  • Urte Scholz,
  • Elgar Fleisch,
  • Elgar Fleisch,
  • Elgar Fleisch,
  • Florian von Wangenheim,
  • Florian von Wangenheim,
  • Lorainne Tudor Car,
  • Lorainne Tudor Car,
  • Falk Müller-Riemenschneider,
  • Falk Müller-Riemenschneider,
  • Sandra Hauser-Ulrich,
  • Alejandra Núñez Asomoza,
  • Alicia Salamanca-Sanabria,
  • Jacqueline Louise Mair,
  • Tobias Kowatsch,
  • Tobias Kowatsch,
  • Tobias Kowatsch

DOI
https://doi.org/10.3389/fpubh.2021.625640
Journal volume & issue
Vol. 9

Abstract

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Background: The current COVID-19 coronavirus pandemic is an emergency on a global scale, with huge swathes of the population required to remain indoors for prolonged periods to tackle the virus. In this new context, individuals' health-promoting routines are under greater strain, contributing to poorer mental and physical health. Additionally, individuals are required to keep up to date with latest health guidelines about the virus, which may be confusing in an age of social-media disinformation and shifting guidelines. To tackle these factors, we developed Elena+, a smartphone-based and conversational agent (CA) delivered pandemic lifestyle care intervention.Methods: Elena+ utilizes varied intervention components to deliver a psychoeducation-focused coaching program on the topics of: COVID-19 information, physical activity, mental health (anxiety, loneliness, mental resources), sleep and diet and nutrition. Over 43 subtopics, a CA guides individuals through content and tracks progress over time, such as changes in health outcome assessments per topic, alongside user-set behavioral intentions and user-reported actual behaviors. Ratings of the usage experience, social demographics and the user profile are also captured. Elena+ is available for public download on iOS and Android devices in English, European Spanish and Latin American Spanish with future languages and launch countries planned, and no limits on planned recruitment. Panel data methods will be used to track user progress over time in subsequent analyses. The Elena+ intervention is open-source under the Apache 2 license (MobileCoach software) and the Creative Commons 4.0 license CC BY-NC-SA (intervention logic and content), allowing future collaborations; such as cultural adaptions, integration of new sensor-related features or the development of new topics.Discussion: Digital health applications offer a low-cost and scalable route to meet challenges to public health. As Elena+ was developed by an international and interdisciplinary team in a short time frame to meet the COVID-19 pandemic, empirical data are required to discern how effective such solutions can be in meeting real world, emergent health crises. Additionally, clustering Elena+ users based on characteristics and usage behaviors could help public health practitioners understand how population-level digital health interventions can reach at-risk and sub-populations.

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