Nemours Uses an mHealth Chatbot to Help Kids Manage Their Weight

Researchers with the Nemours Children’s Health System say an on-demand mHealth platform that includes an AI-enabled chatbot can help adolescents stay on a weight management program and reduce their chances of developing health issues like diabetes.

Their study, published in a recent issue of Translational Behavioral Medicine, found that an SMS text platform integrated with a chatbot called Tess improved patient engagement and often initiated conversations that participants found helpful in supporting their weight management goals.

"Everyone is used to AI technology, it’s like Siri on your iPhone, so texting with a chatbot isn’t that weird,” Laura Hernandez, 20, a participant in the study, said in a press release issued by Nemours. “The difference with Tess is that you can actually text her about what you need to achieve or improve your goals and she's encouraging. You can’t do that with Siri.”

“Tess would ask me, ‘Did you meet that goal?’ and then give me ways to improve or encourage me to continue working on that goal,” she added.

The program is the latest effort by healthcare providers and researchers to enhance telehealth and mHealth programs to give patients a 24/7 connection to resources and support, while also fine-tuning provider workflows to make the best use of their time. Researchers noted the platform took part in mHealth conversations that would have taken staff hundreds of hours to answer, resulting in a savings of almost $9,000.

Nemours spent about five years working with digital health company X2ai to create a library of goal-setting behavioral interactions for Tess, and spent about two years populating the chatbot with hundreds of prompts and responses designed for adolescents dealing with obesity and pre-diabetes symptoms. They also customized the platform to address specific patients, like a teenage boy who likes to play basketball or a young girl who enjoys cooking.

Their goal was to create a digital health platform that would respond to the targeted patient population whenever and wherever needed, guiding patients toward a goal. By adding AI technology to the mix, they could create a platform that was interactive, promoting patient engagement.

That’s important. With parents often declining to take their children to weight management programs because of time, travel or cost issues, a connected health platform could go a long way toward keeping those children in a program regardless of whether they’re physically attending the classes. And with nearly one in five conversations taking place outside normal office hours, that platform would be there when the patients needed it, not just when class is in session.

“Nemours uses innovative tools, such as telemedicine health coaching and text reminders, to help patients and families achieve their weight-loss goals, and overcome the time and resource demands of regular office visits,” Lloyd Werk, MD, MPH, director of the Healthy Choices Clinic at Nemours Children Hospital in Orlando, said in the press release. “A natural next step was adding an AI behavioral coach to allow more frequent and shorter interactions to keep patients engaged on the path toward healthier behaviors, as well as provide an extra layer of care outside of office hours.”

For the study, Nemours’ Healthy Choices Clinic enrolled 23 patients, ages 9-18, with obesity symptoms.  Over roughly three months, those patients exchanged 4,123 messages with Tess in 270 conversations. The chatbot initiated almost three-quarters of the conversations, providing almost 56 hours of support, with an average conversation length of 12.5 minutes.

According to researchers, those involved in the study said 96 percent of the interactions were helpful - in some cases, perhaps more than a patient realized. In one particular case, they noted that a teen-aged boy who wouldn’t often participate in classes was much more comfortable working with a chatbot – to the tune of 425 messages.