Evidence map›Paper›PMID 40503914›Full record

SynthesisJMIR mHealth and uHealth2025

Natural Language Processing Chatbot-Based Interventions for Improvement of Diet, Physical Activity, and Tobacco Smoking Behaviors: Systematic Review.

Jing Chen, Run-Ze Hu, Yu-Xuan Zhuang, Jia-Qi Zhang, Rui Shan, Yang Yang, Zheng Liu

Abstract readSystematic Review
In one paragraph

Synthesis in JMIR mHealth and uHealth, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
  3. Article
  4. Article
  5. Article
  6. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Jing Chen *Department of Maternal and Child Health, School of Public Health, Peking University, No. 38, Xueyuan Road, Haidian District, Beijing, 100191, China.ORCID 0000-0002-6640-7140
Run-Ze Hu *Department of Preventive Medicine, School of Public Health, Peking University, Beijing, China.ORCID 0009-0003-2968-555X
Yu-Xuan ZhuangDepartment of Preventive Medicine, School of Public Health, Peking University, Beijing, China.ORCID 0009-0006-5331-0602
Jia-Qi ZhangDepartment of Preventive Medicine, School of Public Health, Peking University, Beijing, China.ORCID 0009-0002-8588-6818
Rui ShanDepartment of Maternal and Child Health, School of Public Health, Peking University, No. 38, Xueyuan Road, Haidian District, Beijing, 100191, China.ORCID 0009-0006-7603-337X
Yang YangDepartment of Maternal and Child Health, School of Public Health, Peking University, No. 38, Xueyuan Road, Haidian District, Beijing, 100191, China.ORCID 0009-0006-8429-9573
Zheng LiuDepartment of Maternal and Child Health, School of Public Health, Peking University, No. 38, Xueyuan Road, Haidian District, Beijing, 100191, China.ORCID 0000-0002-0405-2348

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: The rapid development of artificial intelligence technology has enabled chatbots to increasingly promote health-related behaviors, addressing the high demand for human resources in traditional interventions. Several systematic reviews have been conducted in this area. However, the existing reviews have not focused on the rigorously designed randomized trials of the state-of-the-art chatbots (interacting with users through unconstrained natural language), thus calling for an updated review. Objective: We aimed to explore the effects of natural language processing (NLP) chatbot-based interventions on improving diet, physical activity, and tobacco smoking behaviors in the general population and to evaluate the chatbot use behaviors during the implementation process. Methods: We comprehensively searched 12 databases or registers for eligible studies published from January 1, 2010, until July 16, 2024, and obtained a total of 6301 studies. We included randomized controlled trials (RCTs) that used NLP-chatbots to promote diet, physical activity, or tobacco smoking behaviors among adults or children. Due to considerable heterogeneity across the included studies, we adopted the synthesis without meta-analysis guidelines and summarized the effectiveness of NLP chatbot-based interventions. We used the new evidence-mapping method (bubble plot) to visualize the results. We also described the results related to the changes in diet, physical activity, or tobacco smoking behaviors (eg, change of BMI and stage of change). To evaluate the implementation process of the intervention, we summarized users' interaction with NLP-chatbots and their feelings (eg, satisfaction) about NLP-chatbot use. Additionally, we assessed the risk of bias of studies using the RoB 2.0 (Risk of Bias; The Cochrane Collaboration) tools. Results: We finally included 7 RCTs. Concerning dietary and physical activity behaviors, the effectiveness of NLP chatbot-based interventions was inconsistent among adults, while no evidence of effect was observed among children. Concerning tobacco smoking behaviors, the included studies showed consistent evidence of improving this behavior among adults. Regarding the risk of bias of the changes in diet, physical activity, and tobacco smoking behaviors, 2 of 3, 2 of 4, and 1 of 2 studies had a high risk of bias, respectively, while the remaining had a low risk of bias. Concerning the interactions with NLP-chatbots, studies showed an overall high percentage of general interaction between users and NLP-chatbots, but not a satisfactorily high percentage of interactions specific to health behaviors. Concerning feelings about NLP-chatbot use, users showed a positive impression of NLP-chatbot use, feeling it was useful, credible, and financially feasible. Conclusions: NLP chatbot-based interventions were beneficial for adults' tobacco smoking behaviors, but no such evidence was found on diet or physical activity behaviors among adults or children. More RCTs with larger samples and lower risk of bias are urgently needed to enhance our findings in the future.

Indexed as

DietExerciseNatural Language ProcessingTobacco SmokingAdultGenerative Artificial IntelligenceHealth PromotionHumansdietinterventionnatural language processingNLP-chatbotphysical activityrandomized controlled trialRCTstobacco smoking

Identifiers

PMID40503914
PMCPMC12175970

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.