A staged approach to the development of an embodied conversational agent to support wellbeing after injury

Poor mental health following traumatic injury is associated with disability, delayed return to work and reduced quality of life. Digital mental health and wellbeing programs may provide an opportunity to support mental health post-injury. This paper describes the development of an embodied conversational agent to deliver an interactive emotion regulation psychoeducation program (ERICA), to support mental health following injury. Iterative program development, with a key focus of ensuring safety, was achieved via two acceptability studies. Study one used mixed methods to test program acceptability and preliminary effects in a sample of 138 university students with ready access to psychological support services. Results confirmed the feasibility of the conversational agent approach and provided evidence that the content had an immediate impact on participant’s self-efficacy and beliefs about how they manage emotions. Study two consisted of 13 semi-structured, qualitative interviews with people with a lived experience of recovering from injury or adversity. Interviews following participant engagement with ERICA identified four key themes: visual look, voice, content and experience. Stakeholder insights from both studies have led to key program enhancements resulting in efficient continuous program improvement in readiness for phase two of the Accelerated Creation to Sustainment model, piloting within a real-world setting.