BACKGROUND
People who smoke tobacco are at greater risk of developing severe COVID-19. Moreover, the COVID-19 pandemic has reduced the accessibility of smoking cessation services globally. Innovations are needed to support smoking cessation care during the pandemic. Virtual humans are artificially intelligent computer agents with a hyperrealistic, humanlike appearance. Virtual humans may be a scalable and engaging way to deliver smoking cessation support. Florence, a virtual human health worker, was developed in collaboration with the World Health Organization (WHO) to support people towards tobacco cessation. Florence provides evidence-based information, assists with making quit plans, and directs people to WHO-recommended cessation services in their country.
OBJECTIVE
This study aimed to: (1) describe the development of Florence, a virtual health worker for tobacco cessation; and (2) conduct a preliminary user evaluation of the virtual health worker, the program content, and the effects on making quit attempts.
METHODS
115 users from 49 unique countries (lower-middle income: 50 of 115, 43.5%; high-income: 49 of 115, 42.6%; upper-middle income: 16 of 115, 12.9%; low-income 0 of 115, 0.0%) participated in an anonymous online survey following an interaction with the English version of Florence. They completed 1-item self-report scales on the quality of the user experience, information and advice, and whether Florence helped with making a quit plan and influenced behavioral intent to try the recommended services. Open-ended qualitative feedback was collected about the virtual health worker and analysed using reflexive thematic analysis.
RESULTS
Analyses revealed promising results. On average, participants reported having a good interaction experience with Florence (M=3.17/ 4, SD=0.81). They perceived that she provided good information and advice (M=3.21/ 4, SD=0.92). Most respondents reported that Florence helped or maybe helped them to make a quit plan (yes: 50 of 114, 43.5%; maybe: 37 of 114, 32.5%; probably not: 12 of 114, 10.5%; no: 15 of 114, 13.2%), and that they planned to try the tobacco cessation services she recommended (yes: 50 of 112, 43.5%; maybe: 49 of 112, 42.6%; probably not: 9 of 112, 8.0%). Very few participants were not willing to try the services recommended by Florence (4 of 112; 3.5%). Qualitative data revealed Florence’s strengths (informative, sense of connection, clear communication, useful) and areas to improve in the future (aspects of the virtual human design, cessation program, and interface).
CONCLUSIONS
Virtual health workers are a promising innovation to expand the reach of tobacco cessation information and support during the COVID-19 pandemic. Further trials are needed to evaluate the acceptability and effectiveness of Florence at reducing tobacco use in diverse populations.
CLINICALTRIAL
Not applicable.