{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T02:05:38Z","timestamp":1793239538492,"version":"4.5.0"},"reference-count":36,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,7,12]],"date-time":"2026-07-12T00:00:00Z","timestamp":1783814400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,12]],"date-time":"2026-07-12T00:00:00Z","timestamp":1783814400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis Care &amp;amp; Research"],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate utility of an artificial intelligence (AI) health coach for systemic sclerosis (SSc) self\u2010management and identify patterns associated with participant engagement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a mixed methods study in which an AI health coach, powered by a large language model (LLM), was used to support self\u2010management for SSc. Twenty individuals with SSc interacted with the AI health coach over four weeks. Quantitative usage metrics (number of conversations, user messages, and chat duration) were used to classify participants into high\u2010 and low\u2010engagement groups. A qualitative inductive content analysis of chat transcripts was used to identify the purpose of interactions. Quantitative and qualitative data were integrated using a joint display approach.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twenty participants (90% female; mean age 55 years) used the AI health coach for goals and strategies, information seeking, companionship, and disease monitoring. Participants with high engagement (N = 8) had more coded interactions related to goals and strategies (23.6 vs 5.1), information seeking (10.8 vs 3.9), and companionship (7.9 vs 1.0) compared with those with low engagement (N = 12). More participants in the high\u2010engagement group used the AI health coach for companionship compared with the low\u2010engagement group (100% vs 33%). Exploratory analyses suggested greater improvements in fatigue (mean change \u22125.04 [95% confidence interval \u22129.34 to \u22120.73]) among high\u2010engagement participants, with no statistically significant between\u2010group differences.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Engagement with an AI health coach may not be fully captured by quantitative usage metrics alone. Engagement in our study was characterized by more frequent, action\u2010oriented, and companionship\u2010oriented interactions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/acr.80109","type":"journal-article","created":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T11:11:53Z","timestamp":1782731513000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Engagement Patterns With an Artificial Intelligence Health Coach for Systemic Sclerosis Self\u2010Management: A Mixed Methods Study"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8926-5889","authenticated-orcid":false,"given":"Nirali","family":"Shah","sequence":"first","affiliation":[{"name":"University of Michigan  Ann Arbor"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melanie","family":"Morris","sequence":"additional","affiliation":[{"name":"University of Washington  Seattle"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Daraban","sequence":"additional","affiliation":[{"name":"University of Michigan  Ann Arbor"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophia","family":"Johnson","sequence":"additional","affiliation":[{"name":"University of Michigan  Ann Arbor"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7924-0012","authenticated-orcid":false,"given":"Susan L.","family":"Murphy","sequence":"additional","affiliation":[{"name":"University of Michigan  Ann 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