{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T10:59:55Z","timestamp":1775041195255,"version":"3.50.1"},"reference-count":41,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2023,9,6]],"date-time":"2023-09-06T00:00:00Z","timestamp":1693958400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"National Grants GPR BRAIN 2030 and Neurocampus"},{"DOI":"10.13039\/501100006251","name":"University of Bordeaux","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100006251","id-type":"DOI","asserted-by":"publisher"}]},{"name":"French National Research Agency\u2014ANR"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,11,17]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>Fully automated digital interventions show promise for disseminating evidence-based strategies to manage insomnia complaints. However, an important concept often overlooked concerns the extent to which users adopt the recommendations provided in these programs into their daily lives. Our objectives were evaluating users\u2019 adherence to the behavioral recommendations provided by an app, and exploring whether users\u2019 perceptions of the app had an impact on their adherence behavior.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Material and methods<\/jats:title>\n                  <jats:p>Case series study of individuals completing a fully automated insomnia management program, conducted by a virtual agent, during December 2020 to September 2022. Primary outcome was self-reported adherence to the behavioral recommendations provided. Perceptions of the app and of the virtual agent were measured with the Acceptability E-Scale and ECA-Trust Questionnaire. Insomnia was evaluated with the Insomnia Severity Index at baseline (phase 1), after 7\u00a0days of sleep monitoring (phase 2) and post-intervention (phase 3).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>A total of 824 users were included, 62.7% female, mean age 51.85 (\u00b112.55) years. Of them, 32.7% reported having followed at least one recommendation. Users\u2019 trust in the virtual agent and acceptance of the app were related to a pre-intervention effect in insomnia severity (phase 2). In turn, larger pre-intervention improvements predicted better adherence. Mediational analyses showed that higher levels of trust in the virtual agent and better acceptance of the app exerted statistically significant positive effects on adherence (\u03b2\u2009=\u20090.007, 95% CI, 0.001-0.017 and \u03b2\u2009=\u20090.003, 95% CI 0.0004-0.008, respectively).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>Users\u2019 adherence is motivated by positive perceptions of the app\u2019s features and pre-intervention improvements.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Determinants of adherence should be assessed, and targeted, to increase the impact of fully automated digital interventions.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jamia\/ocad163","type":"journal-article","created":{"date-parts":[[2023,9,6]],"date-time":"2023-09-06T14:28:45Z","timestamp":1694010525000},"page":"1934-1942","source":"Crossref","is-referenced-by-count":7,"title":["Predictors of users\u2019 adherence to a fully automated digital intervention to manage insomnia complaints"],"prefix":"10.1093","volume":"30","author":[{"given":"Maria Montserrat","family":"Sanchez-Ortuno","sequence":"first","affiliation":[{"name":"SANPSY, UMR 6033, University of Bordeaux , 33076 Bordeaux, France"},{"name":"School of Nursing, Department of Nursing, University of Murcia , 30120 Murcia, Spain"}]},{"given":"Florian","family":"Pecune","sequence":"additional","affiliation":[{"name":"SANPSY, UMR 6033, University of Bordeaux , 33076 Bordeaux, France"},{"name":"CNRS, SANPSY, UMR 6033 , 33076 Bordeaux, 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France"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8938-8683","authenticated-orcid":false,"given":"Marc","family":"Auriacombe","sequence":"additional","affiliation":[{"name":"SANPSY, UMR 6033, University of Bordeaux , 33076 Bordeaux, France"},{"name":"CNRS, SANPSY, UMR 6033 , 33076 Bordeaux, France"},{"name":"Addiction Treatment Services, Charles Perrens Hospital , 33076 Bordeaux, France"}]},{"given":"Fuschia","family":"Serre","sequence":"additional","affiliation":[{"name":"SANPSY, UMR 6033, University of Bordeaux , 33076 Bordeaux, France"},{"name":"CNRS, SANPSY, UMR 6033 , 33076 Bordeaux, France"},{"name":"Addiction Treatment Services, Charles Perrens Hospital , 33076 Bordeaux, France"}]},{"given":"Yannick","family":"Levavasseur","sequence":"additional","affiliation":[{"name":"SANPSY, UMR 6033, University of Bordeaux , 33076 Bordeaux, France"},{"name":"CNRS, SANPSY, UMR 6033 , 33076 Bordeaux, France"}]},{"given":"Etienne","family":"de Sevin","sequence":"additional","affiliation":[{"name":"SANPSY, UMR 6033, University of Bordeaux , 33076 Bordeaux, France"},{"name":"CNRS, SANPSY, UMR 6033 , 33076 Bordeaux, France"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2845-1199","authenticated-orcid":false,"given":"Patricia","family":"Sagaspe","sequence":"additional","affiliation":[{"name":"SANPSY, UMR 6033, University of Bordeaux , 33076 Bordeaux, France"},{"name":"CNRS, SANPSY, UMR 6033 , 33076 Bordeaux, France"},{"name":"Sleep Medicine Service, University Hospital , 33076 Bordeaux, France"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3267-634X","authenticated-orcid":false,"given":"Pierre","family":"Philip","sequence":"additional","affiliation":[{"name":"SANPSY, UMR 6033, University of Bordeaux , 33076 Bordeaux, France"},{"name":"CNRS, SANPSY, UMR 6033 , 33076 Bordeaux, France"},{"name":"Sleep Medicine Service, University Hospital , 33076 Bordeaux, 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