Giulia Bassi

Neuroscience, Technology, and Society, XXXIV series
Grant sponsor

Silvia Salcuni
Alberto Lavelli (FBK)


Project: MOTIBOT: Il coach virtuale per interventi di coping sano per adulti con diabete mellito
Full text of the dissertation book can be downloaded from:

Abstract: Diabetes Mellitus (DM) is a self-managed, metabolic disease, in which if the individual is unwilling, unmotivated, or unable to regularly self-manage their DM, the medical and psychosocial outcomes will be poor. Indeed, DM is more than a physical health condition: it has behavioural, physiological, psychological, and social impacts, and demands high levels of motivation in order to follow the clinical recommendations and adopt healthy behaviours. To this end, the American Association of Diabetes Educators (AADE) guidelines introduced the healthy coping construct to identify healthy coping strategies for reducing symptoms of depression, anxiety, stress, and diabetes-related emotional distress while also improving the well-being of adults with DM. Virtual Coaches (VCs) have recently become more prevalent in the support and management of common barriers in the context of adherence to healthy behaviours among adults with DM, in particular those regarding medical and physical behaviours. However, few VCs were found to be specifically aimed at providing psychosocial support to adults with DM. The main aim of the present thesis was, indeed, the development and implementation of a VC for the provision of psychosocial support to adults with Type 1 (T1DM) or Type 2 DM (T2DM). More specifically, this VC aimed at motivating adults with DM to reduce depression, anxiety, perceived stress symptoms, diabetes-related emotional distress, and improve their well-being, by encouraging them to acquire and cultivate psychosocial healthy coping strategies. These coping skills referred to the AADE guidelines and thus to practicing meditation; in this study, the Mindfulness-Based Cognitive Therapy has been applied. The present thesis is articulated according to three studies. Study 1 aimed at providing meta-analytical evidence on the efficacy of eHealth interventions in supporting the psychosocial and medical well-being of adults with T1DM or T2DM. Study 2 aimed at testing the prototype of the simulated VC, namely Wizard of Oz (WOZ), via the WhatsApp messaging platform for 6-week, with two sessions per week. In particular, this study investigated the preliminary acceptability and the User Experience (UX) of the intervention protocol, which will be incorporated into the future VC. Indeed, the design method was two-fold. On the one hand, the WOZ method was applied, in which psychology students believed that they were interacting with a VC, instead they were communicating with a human being. On the other hand, the Obesity-Related Behavioural Intervention Trials (ORBIT) model was used, particularly its early phases, since it favours an iterative approach. Study 3, following the next phases of the ORBIT model, aimed at assessing the preliminary efficacy of the VC, called Motibot—the abbreviation for Motivational bot—developed through a combination of Natural Language Processing (NLU) and hand-crafted rules. A total of 13 Italian adults with DM (Mage = 30.08, SD = 10.61) interacted with Motibot through the Telegram messaging application for 12 sessions, in which the patient planned the appointment according to his/her needs: he/she interacted with Motibot one or two sessions per week. Therefore, Motibot was perceived as motivating, encouraging and able to trigger self-reflection on one’s own emotions: users and patients reported having a very positive experience with Motibot. Motibot, thus, can be a useful tool to provide psychosocial support to adults with DM; as such, it might be prescribed by the diabetologist as a preventive measure for the patient’s well-being and/or when the patient presents mild and moderate psychosocial symptoms. The user-centred design approach and the concept of bidirectionality between psychosocial and medical factors are key points in the development of a personalised