A smartphone-based health care chatbot to promote self-management of chronic pain (SELMA) : pilot randomized controlled trial

Background: Ongoing pain is one of the most common diseases and has major physical, psychological, social, and economic impacts. A mobile health intervention utilizing a fully automated text-based health care chatbot (TBHC) may offer an innovative way not only to deliver coping strategies and psychoeducation for pain management but also to build a working alliance between a participant and the TBHC. Objective: The objectives of this study are twofold: (1) to describe the design and implementation to promote the chatbot painSELfMAnagement (SELMA), a 2-month smartphone-based cognitive behavior therapy (CBT) TBHC intervention for pain self-management in patients with ongoing or cyclic pain, and (2) to present findings from a pilot randomized controlled trial, in which effectiveness, influence of intention to change behavior, pain duration, working alliance, acceptance, and adherence were evaluated. Methods: Participants were recruited online and in collaboration with pain experts, and were randomized to interact with SELMA for 8 weeks either every day or every other day concerning CBT-based pain management (n=59), or weekly concerning content not related to pain management (n=43). Pain-related impairment (primary outcome), general well-being, pain intensity, and the bond scale of working alliance were measured at baseline and postintervention. Intention to change behavior and pain duration were measured at baseline only, and acceptance postintervention was assessed via self-reporting instruments. Adherence was assessed via usage data. Results: From May 2018 to August 2018, 311 adults downloaded the SELMA app, 102 of whom consented to participate and met the inclusion criteria. The average age of the women (88/102, 86.4%) and men (14/102, 13.6%) participating was 43.7 (SD 12.7) years. Baseline group comparison did not differ with respect to any demographic or clinical variable. The intervention group reported no significant change in pain-related impairment (P=.68) compared to the control group postintervention. The intention to change behavior was positively related to pain-related impairment (P=.01) and pain intensity (P=.01). Working alliance with the TBHC SELMA was comparable to that obtained in guided internet therapies with human coaches. Participants enjoyed using the app, perceiving it as useful and easy to use. Participants of the intervention group replied with an average answer ratio of 0.71 (SD 0.20) to 200 (SD 58.45) conversations initiated by SELMA. Participants’ comments revealed an appreciation of the empathic and responsible interaction with the TBHC SELMA. A main criticism was that there was no option to enter free text for the patients’ own comments. Conclusions: SELMA is feasible, as revealed mainly by positive feedback and valuable suggestions for future revisions. For example, the participants’ intention to change behavior or a more homogenous sample (eg, with a specific type of chronic pain) should be considered in further tailoring of SELMA

Value Co-Creation in Smart Services: A Functional Affordances Perspective on Smart Personal Assistants

In the realm of smart services, smart personal assistants (SPAs) have become a popular medium for value co-creation between service providers and users. The market success of SPAs is largely based on their innovative material properties, such as natural language user interfaces, machine learning-powered request handling and service provision, and anthropomorphism. In different combinations, these properties offer users entirely new ways to intuitively and interactively achieve their goals and thus co-create value with service providers. But how does the nature of the SPA shape value co-creation processes? In this paper, we look through a functional affordances lens to theorize about the effects of different types of SPAs (i.e., with different combinations of material properties) on users’ value co-creation processes. Specifically, we collected SPAs from research and practice by reviewing scientific literature and web resources, developed a taxonomy of SPAs’ material properties, and performed a cluster analysis to group SPAs of a similar nature. We then derived 2 general and 11 cluster-specific propositions on how different material properties of SPAs can yield different affordances for value co-creation. With our work, we point out that smart services require researchers and practitioners to fundamentally rethink value co-creation as well as revise affordances theory to address the dynamic nature of smart technology as a service counterpart

Energy-Efficient Software

The energy consumption of ICT is growing at an unprecedented pace. The main drivers for this growth are the widespread diffusion of mobile devices and the proliferation of datacenters, the most power-hungry IT facilities. In addition, it is predicted that the demand for ICT technologies and services will increase in the coming years. Finding solutions to decrease ICT energy footprint is and will be a top priority for researchers and professionals in the field. As a matter of fact, hardware technology has substantially improved throughout the years: modern ICT devices are definitely more energy efficient than their predecessors, in terms of performance per watt. However, as recent studies show, these improvements are not effectively reducing the growth rate of ICT energy consumption. This suggests that these devices are not used in an energy-efficient way. Hence, we have to look at software. Modern software applications are not designed and implemented with energy efficiency in mind. As hardware became more and more powerful (and cheaper), software developers were not concerned anymore with optimizing resource usage. Rather, they focused on providing additional features, adding layers of abstraction and complexity to their products. This ultimately resulted in bloated, slow software applications that waste hardware resources -- and consequently, energy. In this dissertation, the relationship between software behavior and hardware energy consumption is explored in detail. For this purpose, the abstraction levels of software are traversed upwards, from source code to architectural components. Empirical research methods and evidence-based software engineering approaches serve as a basis. First of all, this dissertation shows the relevance of software over energy consumption. Secondly, it gives examples of best practices and tactics that can be adopted to improve software energy efficiency, or design energy-efficient software from scratch. Finally, this knowledge is synthesized in a conceptual framework that gives the reader an overview of possible strategies for software energy efficiency, along with examples and suggestions for future research