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TRUVACE RECORD VERSION
record: TRV-2026-2756
version: 1
kind: certified
reason: Certified into the record
timestamp: 2026-11-12T17:19:56.766219Z
status: published
lens: g_space
sector: health
headline: Systematic review and meta-analysis of the effectiveness of chatbots on lifestyle behaviours
dek: Chatbots (also known as conversational agents and virtual assistants) offer the potential to deliver healthcare in an efficient, appealing and personalised manner. The purpose of this systematic review and meta-analysis was to evaluate the efficacy of chatbot interventions designed to improve physical activity, diet and sleep. Electronic databases were searched for randomised and non-randomised controlled trials, and pre-post trials that evaluated chatbot interventions targeting physical activity, diet and/or sl…
gain_title: A systematic review and meta-analysis of 19 trials with 3,567 participants found chatbot interventions raised daily steps by 735, fruit and vegetable intake by about 1 serving a day and sleep by 45 minutes a night.
problem_title: (none)
trace_subject: (none)
gain_reading: A systematic review and meta-analysis of 19 trials with 3,567 participants found chatbot interventions raised daily steps by 735, fruit and vegetable intake by about 1 serving a day and sleep by 45 minutes a night.
gain_evidence: The effects equated to increases of +735 steps per day, +1 serving of fruit and vegetables per day, and +45 min of sleep per night. | We identified 19 trials involving 3567 participants
problem_reading: (none)
problem_evidence: (none)
quick_read: A systematic review and meta-analysis from the University of South Australia pooled 19 trials with 3,567 participants and found that chatbot interventions improved physical activity, diet and sleep. The pooled effects were equal to about 735 more steps a day, roughly one extra serving of fruit and vegetables a day and 45 more minutes of sleep a night.

Standardised effects were small to moderate, ranging from 0.28 for total physical activity and daily steps to 0.59 for fruit and vegetable consumption. Moderate-to-vigorous activity rose by about 103 minutes a week, based on two studies with 184 participants. Participants ranged from age 9 to 71, and effects held across short and longer interventions.

Most trials were small and weak in quality, and only seven of the chatbots used AI or natural language processing. Nearly three-fifths of studies lasted six weeks or less, so durability remains unknown. Reviewers called for larger, longer trials with objective measures to confirm the findings.
limitation: Over half of the studies (58%) had 75 or fewer participants and most ran six weeks or less with none longer than a year; participants were mostly self-referred and may be more tech-savvy.
tag: Evidence-backed gain
key_points: The review searched 14 databases for studies published before 1 September 2022 and included 19 trials: 11 randomised trials, 2 non-randomised trials, 5 single-group pre-post studies and 1 panel design trial. | Of the 19 studies, 14 (74%) were rated weak quality, 4 moderate and 1 strong; 15 targeted physical activity, 7 healthy eating and 5 sleep. | Total physical activity rose by an SMD of 0.28 across 10 studies and 1,603 participants; in randomised trials alone the effect was 0.27. | Daily steps rose by 735 on average and moderate-to-vigorous activity by 103 minutes a week; the steps effect in randomised trials alone (SMD 0.18) just missed significance at p = 0.06. | Fruit and vegetable intake rose by about 1 serving a day across 4 studies with 289 participants; sleep duration rose by 45 minutes a night across 3 studies with 1,184 participants. | Text-based chatbots and AI or NLP chatbots outperformed voice chatbots and non-AI chatbots for fruit and vegetable intake, while multicomponent programmes beat chatbot-only ones for sleep.
rundown: The authors searched ACM Digital Library, CINAHL, Cochrane, Embase, IEEE Xplore, MEDLINE, PsycINFO, PubMed, Scopus and others for English-language peer-reviewed trials. Screening, data extraction and bias assessment were done in duplicate. Of 2,514 records, 74 full texts were retrieved and 19 included. Samples ranged from 25 to 958 people and interventions from 2 weeks to 1 year, with a median of 6 weeks.

Participants included apparently healthy adults, older adults, adolescents, families, inactive adults, cancer survivors, adults with a body mass index of 25 to 35, adults with insomnia and children with sleep difficulties. Eleven interventions were chatbot-only and eight added items such as wearable trackers, mailouts or websites. Eight chatbots were text-only, three voice-only and eight mixed formats.

Evidence on sleep was graded B and evidence on physical activity and fruit and vegetables A. Sleep quality results varied widely between studies (I2 = 80%). Subgroup tests for most outcomes found no difference by chatbot duration, output type or AI use, apart from fruit and vegetable intake.

The authors also flagged privacy risks, noting chatbots may store chat logs and intimate data. They noted that AI cannot truly empathise and that people with low digital literacy may be excluded.
sources:
- peer_reviewed | npj Digital Medicine | https://doi.org/10.1038/s41746-023-00856-1 | 2023-06-23
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