Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2021 Aug;29(8):804-815.
doi: 10.1016/j.jagp.2020.11.004. Epub 2020 Nov 22.

Aging and Engaging: A Pilot Randomized Controlled Trial of an Online Conversational Skills Coach for Older Adults

Rafayet Ali  1 , Ehsan Hoque  1 , Paul Duberstein  2 , Lenhart Schubert  1 , Seyedeh Zahra Razavi  1 , Benjamin Kane  1 , Caroline Silva  3 , Jennifer S Daks  4 , Meghan Huang  4 , Kim Van Orden  5
Affiliations
Randomized Controlled Trial

Aging and Engaging: A Pilot Randomized Controlled Trial of an Online Conversational Skills Coach for Older Adults

Rafayet Ali et al. Am J Geriatr Psychiatry. 2021 Aug.

Abstract

Objective: Communication difficulties negatively impact relationship quality and are associated with social isolation and loneliness in later life. There is a need for accessible communication interventions offered outside specialty mental health settings.

Design: Pilot randomized controlled trial.

Setting: Assessments in the laboratory and intervention completed in-home.

Participants: Twenty adults age 60 and older from the community and a geriatric psychiatry clinic.

Intervention: A web-based communication coach that provides automated feedback on eye contact, facial expressivity, speaking volume, and negative content (Aging and Engaging Program, AEP), delivered with minimal assistance in the home (eight brief sessions over 4-6 weeks) or control (education and videos on communication).

Measurements: System Usability Scale and Social Skills Performance Assessment, an observer-rated assessment of social communication elicited through standardized role-plays.

Results: Ninety percent of participants completed all AEP sessions and the System Usability Scale score of 68 was above the cut-off for acceptable usability. Participants randomized to AEP demonstrated statistically and clinically significant improvement in eye contact and facial expressivity.

Conclusion: The AEP is acceptable and feasible for older adults with communication difficulties to complete at home and may improve eye contact and facial expressivity, warranting a larger RCT to confirm efficacy and explore potential applications to other populations, including individuals with autism and social anxiety.

Keywords: Social communication; artificial intelligence; intervention; social isolation; technology.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest Statement

None of the authors have conflicts of interest to disclose.

Figures

Figure 1.
Figure 1.. The Aging & Engaging Program
Note. The user first initiates a conversation with the virtual agent. After conversing on a topic, the system uploads audio and video to a cloud server where features are extracted. Using a hidden Markov model classifier, the system then generates feedback. The user then sees the feedback items one-by-one with audio and visual support. The system then takes the user to the conversation interface to start the next topic. After conversing on three topics the system shows a final integrative feedback. Participants provided written informed consent for collecting video and audio data. Participants were given information about procedures to protect the privacy of their data, including data storage and limited access by only study personnel.
Figure 2.
Figure 2.
CONSORT Diagram
See this image and copyright information in PMC

References

    1. Golden J, Conroy RM, Bruce I,et al. Loneliness, social support networks, mood and wellbeing in community-dwelling elderly. Int J Geriatr Psychiatry. 2009;24(7):694–700. 10.1002/gps.2181 - DOI - PubMed
    1. Perissinotto CM, Stijacic Cenzer I, Covinsky KE. Loneliness in Older Persons: A Predictor of Functional Decline and Death. Archives of Internal Medicine. 2012:1–7. 10.1001/archinternmed.2012.1993 - DOI - PMC - PubMed
    1. Wilson RS, Krueger KR, Arnold SE, et al. Loneliness and risk of Alzheimer disease. Arch Gen Psychiatry. 2007;64(2):234–240. 10.1001/archpsyc.64.2.234 - DOI - PubMed
    1. Tomaka J, Thompson S, Palacios R. The relation of social isolation, loneliness, and social support to disease outcomes among the elderly. J Aging Health. 2006;18(3):359–384.. 18/3/359 [pii] 10.1177/0898264305280993 - DOI - PubMed
    1. Cacioppo JT, Hawkley LC, Thisted RA. Perceived social isolation makes me sad: 5-year cross-lagged analyses of loneliness and depressive symptomatology in the Chicago Health, Aging, and Social Relations Study. Psychology and aging. 2010;25(2):453–463. 2010–11857-019 [pii] 10.1037/a0017216 - DOI - PMC - PubMed

Publication types