Fitness apps out; virtual coaches in

Health and fitness apps and websites may be getting a bad rap these days, with many viewed as ineffective and unlikely to help users achieve long-term results. But add a "virtual coach" and you may boost effectiveness, according to a new study in the Journal of Medical Internet Research, conducted by Partners' Center for Connected Health in Boston.

The 70-patient study tested the value of a virtual coach, an "automated, animated computer agent" installed on participants' home computers to provide personalized feedback to users, researchers said. The nonhuman avatar engages directly with participants, carrying on five- to 10-minute semi-scripted conversations to encourage good behaviors and help participants set incremental goals and devise motivational strategies.

The conversations with the coach were tailored to each participant, with the coach's responses based on whether the participant had met exercise goals (according to data from a study-provided pedometer), complied with their diet for that day, or asked for help on a particular issue, according to the study.

"Virtual coaching has many applications beyond promoting activity and is increasingly recognized as an important component in the management of chronic conditions, such as diabetes and heart disease, and in the promotion of healthy behaviors, such as adherence to medication," center director and study co-author, Joseph Kvedar, said in a statement this week.

The coach's primary value seems to be in keeping participants engaged with the exercise program, the study found. Although participants working with a coach didn't walk more that those that did not, they did maintain a steady step count of about 7,000 per day throughout the 12-week study. Participants who didn't have a virtual coach saw their step count gradually fall off from about 7,100 to 6,100 per day.

One of the study's weaknesses is its reliance on desktop computers, researchers admitted. "Equitable access to technology is still a further concern, as groups most affected by obesity, such as minorities and low-socioeconomic status groups, are least likely to have access to technology," they wrote. With that in mind, researchers recommend creating a mobile virtual coach for cell phones.

Virtual coaching also may require more technical support for users, researchers noted. Study participants using the virtual coach made about 40 percent more requests for technical assistance that participants in the control group, who only used a pedometer and website.

To learn more:
- read the JMIR study
- check out Partners' announcement (.pdf)
- get more detail from mHIMSS article