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  4. Development of “LvL UP 1.0”: a smartphone-based, conversational agent-delivered holistic lifestyle intervention for the prevention of non-communicable diseases and common mental disorders
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Development of “LvL UP 1.0”: a smartphone-based, conversational agent-delivered holistic lifestyle intervention for the prevention of non-communicable diseases and common mental disorders

Journal
Frontiers in Digital Health
ISSN
2673-253X
Type
journal article
Date Issued
2023
Author(s)
Oscar Castro
;
Jacqueline Louise Mair
;
Alicia Salamanca-Sanabria
;
Aishah Alattas
;
Roman Keller
;
Shenglin Zheng
;
Ahmad Jabir
;
Xiaowen Lin
;
Bea Franziska Frese
;
Chang Siang Lim
;
Prabhakaran Santhanam
;
Rob M. van Dam
;
Josip Car
;
Jimmy Lee
;
E Shyong Tai
;
Elgar Fleisch  
;
Florian von Wangenheim
;
Lorainne Tudor Car
;
Falk Müller-Riemenschneider
;
Tobias Kowatsch  
DOI
10.3389/fdgth.2023.1039171
Abstract
Background
Non-communicable diseases (NCDs) and common mental disorders (CMDs) are the leading causes of death and disability worldwide. Lifestyle interventions mobile apps and conversational agents present themselves as low-cost, scalable solutions to prevent these conditions. This paper describes the rationale for, and development of, “LvL UP 1.0″, a smartphone-based lifestyle intervention aimed at preventing NCDs and CMDs.
Materials and Methods
A multidisciplinary team led the intervention design process of LvL UP 1.0, involving four phases: (i) preliminary research (stakeholder consultations, systematic market reviews), (ii) selecting intervention components and developing the conceptual model, (iii) whiteboarding and prototype design, and (iv) testing and refinement. The Multiphase Optimization Strategy and the UK Medical Research Council framework for developing and evaluating complex interventions were used to guide the intervention development.
Results
Preliminary research highlighted the importance of targeting holistic wellbeing (i.e., both physical and mental health). Accordingly, the first version of LvL UP features a scalable, smartphone-based, and conversational agent-delivered holistic lifestyle intervention built around three pillars: Move More (physical activity), Eat Well (nutrition and healthy eating), and Stress Less (emotional regulation and wellbeing). Intervention components include health literacy and psychoeducational coaching sessions, daily “Life Hacks” (healthy activity suggestions), breathing exercises, and journaling. In addition to the intervention components, formative research also stressed the need to introduce engagement-specific components to maximise uptake and long-term use. LvL UP includes a motivational interviewing and storytelling approach to deliver the coaching sessions, as well as progress feedback and gamification. Offline materials are also offered to allow users access to essential intervention content without needing a mobile device.
Conclusions
The development process of LvL UP 1.0 led to an evidence-based and user-informed smartphone-based intervention aimed at preventing NCDs and CMDs. LvL UP is designed to be a scalable, engaging, prevention-oriented, holistic intervention for adults at risk of NCDs and CMDs. A feasibility study, and subsequent optimisation and randomised-controlled trials are planned to further refine the intervention and establish effectiveness. The development process described here may prove helpful to other intervention developers.
Volume
5
URL
https://www.alexandria.unisg.ch/handle/20.500.14171/117499
Support
HSG researchers can find instructions here for adding or importing publications (DOI, ORCID). Please send questions to alexandria@unisg.ch

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