{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T02:47:23Z","timestamp":1791859643638,"version":"4.3.4"},"reference-count":84,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Hum Factors"],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Mobile health (mHealth) interventions with virtual coaches offer scalable and potentially cost-effective solutions for health behavior change. However, these interventions commonly present challenges, such as limited personalization and insufficient grounding in evidence-based strategies. Perfect Fit (PF; , a personalized mHealth intervention with a text-based virtual coach, supports adults in quitting smoking and becoming more physically active. By combining innovative techniques, including sensor technology, end user involvement, and evidence-based strategies, PF aims to address common challenges faced by mHealth interventions, including those with virtual coaches.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n The study primarily investigated the feasibility and acceptability of PF. The secondary aim was to explore associations between sociodemographic, smoking-, and physical activity\u2013related characteristics and the feasibility and acceptability outcomes. The third aim was to evaluate the feasibility of conducting the research study.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n A single-arm, pre-post, mixed methods study was conducted in the Netherlands with 100 adults who smoked. The intervention lasted approximately 16 weeks. Data were collected at baseline, during the intervention, and postintervention (4 months). Quantitative data included usage data and self-report questionnaires on feasibility, acceptability, and baseline characteristics. Qualitative data were gathered through postintervention semistructured interviews. Analyses included descriptive and inferential analyses, as well as the framework approach for the qualitative data.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n PF usage varied considerably across participants (n=87). The mean satisfaction rating was 2.79 (SD 0.73; scale range 1\u20104), and perceived usability had a median score of 67.50 (range 12.50\u201087.50; scoring range 0\u2010100), indicating OK-to-good usability. The mean virtual coach acceptance rating was \u20130.27 (SD 1.30; scale range \u22123 to 3; n=77). Higher PF usage was associated with greater satisfaction, usability, and coach acceptance (all\n P<\/jats:italic>\n \u2264.004). Frequent connection issues with the smartwatch were a disruptive factor. Qualitative findings (n=12) provided in-depth insights into PF\u2019s feasibility and acceptability, encompassing both positive and negative experiences. For instance, some participants valued the virtual coach for its anonymity, low-threshold access, and the sense of control it offered, while others preferred a human coach for greater accountability. Suggested improvements included more varied content and enhanced adaptability of the coach to users\u2019 input and personal situations. Exploratory analyses suggested that high PF users were older than moderate (\n P<\/jats:italic>\n =.01) and low PF users (\n P<\/jats:italic>\n =.05). Importantly, PF was perceived as similarly feasible and acceptable across socioeconomic groups (\n P<\/jats:italic>\n >.05), aligning with one of the project\u2019s goals. Finally, research procedures and recruitment strategies proved feasible.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n PF shows potential as an accessible and inclusive strategy for multiple health behavior changes, contributing to public health. Findings highlight areas for improvement and can guide the future development of virtual coach interventions.<\/jats:p>\n <\/jats:sec>","DOI":"10.2196\/83456","type":"journal-article","created":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T20:27:41Z","timestamp":1784060861000},"page":"e83456-e83456","source":"Crossref","is-referenced-by-count":1,"title":["Evaluation of the Feasibility and Acceptability of Perfect Fit, a Virtual Coach\u2013Based mHealth Intervention for Smoking Cessation and Physical Activity in Adults: Mixed Methods Study"],"prefix":"10.2196","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9036-6206","authenticated-orcid":false,"given":"Milon H M","family":"van Vliet","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7078-5067","authenticated-orcid":false,"given":"Eline","family":"Meijer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0502-6176","authenticated-orcid":false,"given":"Nele","family":"Albers","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9758-9004","authenticated-orcid":false,"given":"Kristell M","family":"Penfornis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8888-4792","authenticated-orcid":false,"given":"Walter","family":"Baccinelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4748-2321","authenticated-orcid":false,"given":"Bouke L","family":"Scheltinga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6093-0400","authenticated-orcid":false,"given":"Roxy A","family":"van Eersel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8607-9199","authenticated-orcid":false,"given":"Niels H","family":"Chavannes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9489-7925","authenticated-orcid":false,"given":"Anke","family":"Versluis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"The Perfect Fit Consortium","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2026,7,14]]},"reference":[{"issue":"1","key":"R1","doi-asserted-by":"publisher","DOI":"10.1186\/s12966-021-01224-6","article-title":"A systematic review of artificial intelligence chatbots for promoting physical activity, healthy diet, and weight loss","volume":"18","author":"Oh","journal-title":"Int J Behav Nutr Phys Act"},{"issue":"1","key":"R2","doi-asserted-by":"publisher","first-page":"525","DOI":"10.1146\/annurev-publhealth-052620-093850","article-title":"Mobile health (mHealth) in low- and middle-income countries","volume":"43","author":"McCool","journal-title":"Annu Rev Public Health"},{"issue":"4","key":"R3","doi-asserted-by":"publisher","DOI":"10.2196\/jmir.8480","article-title":"Exploring the role of in-person components for online health behavior change interventions: can a digital person-to-person component suffice?","volume":"20","author":"Santarossa","journal-title":"J Med Internet Res"},{"issue":"7","key":"R4","doi-asserted-by":"publisher","DOI":"10.2196\/24308","article-title":"Smartphone-based interventions for physical activity promotion: scoping review of the evidence over the last 10 years","volume":"9","author":"Domin","journal-title":"JMIR Mhealth Uhealth"},{"issue":"5","key":"R5","doi-asserted-by":"publisher","DOI":"10.2196\/19688","article-title":"Effectiveness of digital interventions for reducing behavioral risks of cardiovascular disease in nonclinical adult populations: systematic review of reviews","volume":"23","author":"Gold","journal-title":"J Med Internet Res"},{"key":"R6","unstructured":"Noncommunicable diseases. World Health Organization. 2024. URL: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/noncommunicable-diseases [Accessed 02-06-2026]"},{"key":"R7","unstructured":"Physical activity. World Health Organization. 2024. URL: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/physical-activity [Accessed 02-06-2026]"},{"issue":"10","key":"R8","doi-asserted-by":"publisher","first-page":"e729","DOI":"10.1016\/S2468-2667(24)00166-X","article-title":"Forecasting the effects of smoking prevalence scenarios on years of life lost and life expectancy from 2022 to 2050: a systematic analysis for the Global Burden of Disease Study 2021","volume":"9","author":"Bryazka","journal-title":"Lancet Public Health"},{"issue":"2","key":"R9","doi-asserted-by":"publisher","DOI":"10.2196\/23786","article-title":"Effects of eHealth-based multiple health behavior change interventions on physical activity, healthy diet, and weight in people with noncommunicable diseases: systematic review and meta-analysis","volume":"23","author":"Duan","journal-title":"J Med Internet Res"},{"issue":"3","key":"R10","doi-asserted-by":"publisher","DOI":"10.1177\/1559827610391883","article-title":"A review of multiple health behavior change interventions for primary prevention","volume":"5","author":"Prochaska","journal-title":"Am J Lifestyle Med"},{"key":"R11","unstructured":"Cijfers roken. Trimbos-Instituut. URL: https:\/\/www.trimbos.nl\/kennis\/cijfers\/roken\/ [Accessed 02-06-2026]"},{"key":"R12","unstructured":"Inzicht in mensen die niet en weinig bewegen in nederland. Rijksinstituut voor Volksgezondheiden Milieu Ministerie van Volksgezondheid,Welzijn en Sport. URL: https:\/\/www.rivm.nl\/publicaties\/inzicht-in-mensen-die-niet-en-weinig-bewegen-in-nederland#:~:text=Een%20deel%20van%20de%20bevolking,beweegt%20(ruim%2053%20procent) [Accessed 02-06-2026]"},{"key":"R13","unstructured":"Kloosterman R Akkermans M Reep C Aa M . (On)gezonde leefstijl 2022: opvattingen, motieven en gedragingen. Centraal Bureau voor de Statistiek. URL: https:\/\/www.cbs.nl\/nl-nl\/longread\/rapportages\/2023\/on--gezonde-leefstijl-2022-opvattingen-motieven-en-gedragingen\/8-roken [Accessed 02-06-2026]"},{"issue":"8","key":"R14","doi-asserted-by":"publisher","DOI":"10.2196\/34229","article-title":"The barriers and facilitators of eHealth-based lifestyle intervention programs for people with a low socioeconomic status: scoping review","volume":"24","author":"Al-Dhahir","journal-title":"J Med Internet Res"},{"key":"R15","doi-asserted-by":"publisher","DOI":"10.1016\/j.addbeh.2021.107156","article-title":"Examining the effect of exercise on the relationship between affect and cravings among smokers engaged in cessation treatment","volume":"125","author":"Kunicki","journal-title":"Addict Behav"},{"key":"R16","doi-asserted-by":"publisher","DOI":"10.3389\/fphys.2023.1221898","article-title":"Effect of exercise intervention on smoking cessation: a meta-analysis","volume":"14","author":"Zhou","journal-title":"Front Physiol"},{"issue":"6","key":"R17","doi-asserted-by":"publisher","first-page":"807","DOI":"10.1177\/2047487314535116","article-title":"Time-dependent relation between smoking cessation and improved exercise tolerance in apparently healthy middle-age men and women","volume":"22","author":"Berkovitch","journal-title":"Eur J Prev Cardiol"},{"key":"R18","unstructured":"West R Papadakis S . Stop smoking services: increased chances of quitting. National Centre for Smoking Cessation and Training. URL: https:\/\/www.ncsct.co.uk\/publications\/Stop_smoking_services_impact_on_quitting [Accessed 02-06-2026]"},{"issue":"1","key":"R19","doi-asserted-by":"publisher","first-page":"147","DOI":"10.1093\/tbm\/iby010","article-title":"Are physical activity interventions for healthy inactive adults effective in promoting behavior change and maintenance, and which behavior change techniques are effective? A systematic review and meta-analysis","volume":"9","author":"Howlett","journal-title":"Transl Behav Med"},{"issue":"4","key":"R20","doi-asserted-by":"publisher","first-page":"179","DOI":"10.1080\/13814788.2019.1658190","article-title":"SERIES: eHealth in primary care. Part 1: concepts, conditions and challenges","volume":"25","author":"van der Kleij","journal-title":"Eur J Gen Pract"},{"issue":"20552076231211634","key":"R21","doi-asserted-by":"publisher","DOI":"10.1177\/20552076231211634","article-title":"Conversational artificial intelligence interventions to support smoking cessation: a systematic review and meta-analysis","volume":"9","author":"Bendotti","journal-title":"Digit Health"},{"key":"R22","unstructured":"Keij B Versluis A Alblas EE Keuper JJ Tuyl LHD Vaart R . E-healthmonitor 2023: stand van zaken digitale zorg. Nivel. 2024. URL: https:\/\/www.nivel.nl\/nl\/publicatie\/e-healthmonitor-2023-stand-van-zaken-digitale-zorg [Accessed 02-06-2026]"},{"issue":"6","key":"R23","doi-asserted-by":"publisher","first-page":"446","DOI":"10.1007\/s12160-016-9830-8","article-title":"Just-in-time adaptive interventions (JITAIs) in mobile health: key components and design principles for ongoing health behavior support","volume":"52","author":"Nahum-Shani","journal-title":"Ann Behav Med"},{"issue":"1","key":"R24","doi-asserted-by":"publisher","first-page":"140","DOI":"10.1080\/13814788.2020.1826431","article-title":"SERIES: eHealth in primary care. Part 4: addressing the challenges of implementation","volume":"26","author":"Versluis","journal-title":"Eur J Gen Pract"},{"issue":"7","key":"R25","doi-asserted-by":"publisher","first-page":"1241","DOI":"10.1093\/ntr\/ntac281","article-title":"Effectiveness and acceptability of conversational agents for smoking cessation: a systematic review and meta-analysis","volume":"25","author":"He","journal-title":"Nicotine Tob Res"},{"issue":"10","key":"R26","doi-asserted-by":"publisher","DOI":"10.2196\/20346","article-title":"The effectiveness of artificial intelligence conversational agents in health care: systematic review","volume":"22","author":"Milne-Ives","journal-title":"J Med Internet Res"},{"key":"R27","doi-asserted-by":"publisher","DOI":"10.1177\/2055207619880676","article-title":"Does the addition of a supportive chatbot promote user engagement with a smoking cessation app? An experimental study","volume":"5","author":"Perski","journal-title":"Digit Health"},{"key":"R28","doi-asserted-by":"crossref","unstructured":"He L Braggaar A Basar E Krahmer E Antheunis M Wiers R . Exploring user engagement through an interaction lens: what textual cues can tell us about human-chatbot interactions. Presented at: CUI \u201924; Jul 8-10, 2024; Luxembourg City, Luxembourg. Jul 8, 2024.URL: https:\/\/dl.acm.org\/doi\/proceedings\/10.1145\/3640794 [doi: 10.1145\/3640794.3665536]","DOI":"10.1145\/3640794.3665536"},{"issue":"1","key":"R29","doi-asserted-by":"publisher","first-page":"81","DOI":"10.1007\/s12160-013-9486-6","article-title":"The behavior change technique taxonomy (v1) of 93 hierarchically clustered techniques: building an international consensus for the reporting of behavior change interventions","volume":"46","author":"Michie","journal-title":"Ann Behav Med"},{"issue":"4","key":"R30","doi-asserted-by":"publisher","DOI":"10.2196\/11819","article-title":"Consumer-based wearable activity trackers increase physical activity participation: systematic review and meta-analysis","volume":"7","author":"Brickwood","journal-title":"JMIR Mhealth Uhealth"},{"issue":"1","key":"R31","doi-asserted-by":"publisher","DOI":"10.2196\/mhealth.8873","article-title":"The impact of mHealth interventions: systematic review of systematic reviews","volume":"6","author":"Marcolino","journal-title":"JMIR Mhealth Uhealth"},{"issue":"6","key":"R32","doi-asserted-by":"publisher","first-page":"648","DOI":"10.1080\/08839514.2010.492259","article-title":"Maintaining engagement in long-term interventions with relational agents","volume":"24","author":"Bickmore","journal-title":"Appl Artif Intell"},{"key":"R33","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n2061","article-title":"A new framework for developing and evaluating complex interventions: update of Medical Research Council guidance","volume":"374","author":"Skivington","journal-title":"BMJ"},{"key":"R34","unstructured":"Suijkerbuijk A Bruijn A Stok M Zorginnovaties JM . Zorginnovaties. een checklist voor succesvolle implementatie. Rijksinstituut voor Volksgezondheiden Milieu Ministerie van Volksgezondheid, Welzijn en Sport. 2022. URL: https:\/\/www.rivm.nl\/documenten\/zorginnovaties-checklist-voor-succesvolle-implementatie [Accessed 02-06-2026]"},{"key":"R35","doi-asserted-by":"publisher","DOI":"10.1016\/j.invent.2025.100896","article-title":"A practical step-by-step approach for patient and public involvement in eHealth intervention research: lessons learned from three case projects","volume":"43","author":"van Vliet","journal-title":"Internet Interv"},{"issue":"1","key":"R36","doi-asserted-by":"publisher","DOI":"10.2196\/47730","article-title":"Targeting key risk factors for cardiovascular disease in at-risk individuals: developing a digital, personalized, and real-time intervention to facilitate smoking cessation and physical activity","volume":"8","author":"Versluis","journal-title":"JMIR Cardio"},{"issue":"4","key":"R37","doi-asserted-by":"publisher","first-page":"315","DOI":"10.1016\/j.addbeh.2010.11.016","article-title":"Development of a taxonomy of behaviour change techniques used in individual behavioural support for smoking cessation","volume":"36","author":"Michie","journal-title":"Addict Behav"},{"issue":"11","key":"R38","doi-asserted-by":"publisher","first-page":"1479","DOI":"10.1080\/08870446.2010.540664","article-title":"A refined taxonomy of behaviour change techniques to help people change their physical activity and healthy eating behaviours: the CALO-RE taxonomy","volume":"26","author":"Michie","journal-title":"Psychol Health"},{"key":"R39","doi-asserted-by":"crossref","unstructured":"Burke PJ Stets JE . Identity Theory. Oxford University Press; 2009. ISBN: 0199889112","DOI":"10.1093\/acprof:oso\/9780195388275.001.0001"},{"key":"R40","doi-asserted-by":"crossref","unstructured":"West R Brown J . Theory of Addiction. 2nd ed. Wiley-Blackwell; 2013. [doi: 10.1002\/9781118484890] ISBN: 9780470674215","DOI":"10.1002\/9781118484890"},{"key":"R41","unstructured":"Oyserman D Elmore K Smith G . Self, self-concept, and identity. In: Handbook of Self and Identity. 2nd ed. The Guilford Press; 2012:69-104. ISBN: 9781462503056"},{"key":"R42","unstructured":"Marlatt GA Donovan DM , editors. Relapse Prevention: Maintenance Strategies in the Treatment of Addictive Behaviors. The Guilford press; 2007. ISBN: 1606238310"},{"key":"R43","doi-asserted-by":"publisher","DOI":"10.1177\/20552076241300020","article-title":"Protocol of a mixed-methods evaluation of Perfect Fit: a personalized mHealth intervention with a virtual coach to promote smoking cessation and physical activity in adults","volume":"10","author":"van Vliet","journal-title":"Digit Health"},{"issue":"2","key":"R44","doi-asserted-by":"publisher","first-page":"92","DOI":"10.1258\/jhsrp.2007.007074","article-title":"The quality of mixed methods studies in health services research","volume":"13","author":"O\u2019Cathain","journal-title":"J Health Serv Res Policy"},{"issue":"1","key":"R45","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-023-15869-4","article-title":"Translation, cultural adaptation and validity assessment of the Dutch version of the eHealth Literacy Questionnaire: a mixed-method approach","volume":"23","author":"Poot","journal-title":"BMC Public Health"},{"issue":"2","key":"R46","doi-asserted-by":"publisher","DOI":"10.2196\/jmir.8371","article-title":"A multidimensional tool based on the eHealth Literacy Framework: development and initial validity testing of the eHealth Literacy Questionnaire (eHLQ)","volume":"20","author":"Kayser","journal-title":"J Med Internet Res"},{"issue":"9","key":"R47","doi-asserted-by":"publisher","first-page":"1119","DOI":"10.1111\/j.1360-0443.1991.tb01879.x","article-title":"The Fagerstr\u00f6m Test for Nicotine Dependence: a revision of the Fagerstr\u00f6m Tolerance Questionnaire","volume":"86","author":"Heatherton","journal-title":"Br J Addict"},{"issue":"1","key":"R48","doi-asserted-by":"publisher","first-page":"18","DOI":"10.14288\/hfjc.v4i1.82","article-title":"The Godin-Shephard Leisure-Time Physical Activity Questionnaire","volume":"4","author":"Godin","journal-title":"Health Fit J Can"},{"issue":"2","key":"R49","doi-asserted-by":"publisher","first-page":"604","DOI":"10.2466\/03.27.PMS.120v19x7","article-title":"The Godin-Shephard Leisure-Time Physical Activity Questionnaire: validity evidence supporting its use for classifying healthy adults into active and insufficiently active categories","volume":"120","author":"Amireault","journal-title":"Percept Mot Skills"},{"key":"R50","unstructured":"Brooke J . SUS-a quick and dirty usability scale. In: Jordan PW Thomas B Weerdmeester BA McClelland IL , editors. Usability Evaluation in Industry. Taylor & Francis; 1996:189-194. ISBN: 9780748404605"},{"issue":"13","key":"R51","doi-asserted-by":"publisher","DOI":"10.1186\/s40900-017-0062-2","article-title":"GRIPP2 reporting checklists: tools to improve reporting of patient and public involvement in research","volume":"3","author":"Staniszewska","journal-title":"Res Involv Engagem"},{"key":"R52","unstructured":"Nederlands Huisartsen Genootschap. Cardiovasculair risicomanagement. NHG-Richtlijnen. URL: https:\/\/richtlijnen.nhg.org\/standaarden\/cardiovasculair-risicomanagement [Accessed 02-06-2026]"},{"issue":"4","key":"R53","doi-asserted-by":"publisher","first-page":"591","DOI":"10.1177\/1049732316665344","article-title":"Code saturation versus meaning saturation: how many interviews are enough?","volume":"27","author":"Hennink","journal-title":"Qual Health Res"},{"key":"R54","unstructured":"Forerunner\u00ae 55. Garmin Ltd. URL: https:\/\/www.garmin.com\/en-US\/p\/741137\/ [Accessed 02-06-2026]"},{"key":"R55","unstructured":"The treatment platform in mental healthcare. NiceDay Nederland. 2024. URL: https:\/\/nicedaynederland.nl\/en\/home-en\/ [Accessed 06-02-2026]"},{"key":"R56","doi-asserted-by":"crossref","unstructured":"Baccinelli W van der Burg S Richardson R et al. Reusable virtual coach for smoking cessation and physical activity coaching. Presented at: IVA \u201922; Sep 6-9, 2022; Faro Portugal. Sep 6, 2022.URL: https:\/\/dl.acm.org\/doi\/proceedings\/10.1145\/3514197 [Accessed 06-05-2026] [doi: 10.1145\/3514197.3551252]","DOI":"10.1145\/3514197.3551252"},{"key":"R57","unstructured":"Burg S Baccinelli W Richardson R et al. PerfectFit. Zenodo. URL: https:\/\/doi.org\/10.5281\/zenodo.10837093 [Accessed 02-06-2026]"},{"key":"R58","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2016.06.022","article-title":"Socio-economic status in relation to smoking: the role of (expected and desired) social support and quitter identity","volume":"162","author":"Meijer","journal-title":"Soc Sci Med"},{"issue":"9","key":"R59","doi-asserted-by":"publisher","first-page":"1101","DOI":"10.1093\/ntr\/ntx092","article-title":"Construct and predictive validity of three measures of intention to quit smoking: findings from the International Tobacco Control (ITC) Netherlands Survey","volume":"20","author":"Hummel","journal-title":"Nicotine Tob Res"},{"key":"R60","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2023.115667","article-title":"My future-self has (not) quit smoking: an experimental study into the effect of a future-self intervention on smoking-related self-identity constructs","volume":"320","author":"Penfornis","journal-title":"Soc Sci Med"},{"issue":"1","key":"R61","doi-asserted-by":"publisher","DOI":"10.1186\/s13063-020-04777-2","article-title":"Improving adherence to an online intervention for low mood with a virtual coach: study protocol of a pilot randomized controlled trial","volume":"21","author":"Provoost","journal-title":"Trials"},{"issue":"4","key":"R62","doi-asserted-by":"publisher","first-page":"289","DOI":"10.1016\/j.intcom.2009.12.001","article-title":"Response to a relational agent by hospital patients with depressive symptoms","volume":"22","author":"Bickmore","journal-title":"Interact Comput"},{"issue":"1","key":"R63","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1214\/aoms\/1177704711","article-title":"The future of data analysis","volume":"33","author":"Tukey","journal-title":"Ann Math Statist"},{"issue":"1","key":"R64","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2288-13-117","article-title":"Using the framework method for the analysis of qualitative data in multi-disciplinary health research","volume":"13","author":"Gale","journal-title":"BMC Med Res Methodol"},{"key":"R65","unstructured":"Ritchie J Lewis J Nicholls CM Ormston R . Qualitative Research Practice: A Guide for Social Science Students and Researchers. Sage Publications Ltd; 2013. ISBN: 1446296202"},{"key":"R66","unstructured":"Electronic data capture (EDC). Castor. 2025. URL: https:\/\/www.castoredc.com\/electronic-data-capture-system\/ [Accessed 02-06-2026]"},{"issue":"10489","key":"R67","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(25)00672-5","article-title":"CONSORT 2025 statement: updated guideline for reporting randomised trials","volume":"405","author":"Hopewell","journal-title":"Lancet"},{"key":"R68","unstructured":"Wat is het onderwijs\u00adniveau van nederland? Nederlandin cijfers. Centraal Bureau voor de Statistiek; URL: https:\/\/longreads.cbs.nl\/nederland-in-cijfers-2024\/wat-is-het-onderwijsniveau-van-nederland\/ [Accessed 02-06-2026]"},{"issue":"1","key":"R69","doi-asserted-by":"publisher","first-page":"73","DOI":"10.1590\/S1806-37132009000100011","article-title":"Psychometric properties of the Fagerstr\u00f6m Test for nicotine dependence","volume":"35","author":"Meneses-Gaya","journal-title":"J Bras Pneumol"},{"issue":"6","key":"R70","doi-asserted-by":"publisher","first-page":"574","DOI":"10.1080\/10447310802205776","article-title":"An empirical evaluation of the System Usability Scale","volume":"24","author":"Bangor","journal-title":"Int J Hum Comput Interact"},{"issue":"9","key":"R71","doi-asserted-by":"publisher","DOI":"10.2196\/20283","article-title":"Rates of attrition and dropout in app-based interventions for chronic disease: systematic review and meta-analysis","volume":"22","author":"Meyerowitz-Katz","journal-title":"J Med Internet Res"},{"issue":"2","key":"R72","doi-asserted-by":"publisher","first-page":"254","DOI":"10.1007\/s13142-016-0453-1","article-title":"Conceptualising engagement with digital behaviour change interventions: a systematic review using principles from critical interpretive synthesis","volume":"7","author":"Perski","journal-title":"Transl Behav Med"},{"key":"R73","unstructured":"Csikszentmihalyi M . Beyond Boredom and Anxiety: Experiencing Flow in Work and Play. Jossey-Bass; 2000. ISBN: 9780787951405"},{"key":"R74","doi-asserted-by":"publisher","DOI":"10.1016\/j.invent.2025.100806","article-title":"Chatting your way to quitting: a longitudinal exploration of smokers\u2019 interaction with a cessation chatbot","volume":"39","author":"He","journal-title":"Internet Interv"},{"issue":"12","key":"R75","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0208759","article-title":"Experiences of mobile health in promoting physical activity: a qualitative systematic review and meta-ethnography","volume":"13","author":"Carter","journal-title":"PLoS ONE"},{"issue":"11","key":"R76","doi-asserted-by":"publisher","DOI":"10.2196\/20251","article-title":"Engaging unmotivated smokers to move toward quitting: design of motivational interviewing-based chatbot through iterative interactions","volume":"22","author":"Almusharraf","journal-title":"J Med Internet Res"},{"key":"R77","doi-asserted-by":"publisher","DOI":"10.2196\/66896","article-title":"Assessing the adherence of ChatGPT chatbots to public health guidelines for smoking cessation: content analysis","volume":"27","author":"Abroms","journal-title":"J Med Internet Res"},{"key":"R78","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijhcs.2025.103514","article-title":"LLM-based conversational agents for behaviour change support: a randomised controlled trial examining efficacy, safety, and the role of user behaviour","volume":"200","author":"Meyer","journal-title":"Int J Hum Comput Stud"},{"key":"R79","doi-asserted-by":"crossref","unstructured":"Basar E Balaji D He L et al. HyLECA: a framework for developing hybrid long-term engaging controlled conversational agents. Presented at: CUI \u201923; Jul 19-21, 2023; Eindhoven Netherlands. Jul 19, 2023.URL: https:\/\/dl.acm.org\/doi\/proceedings\/10.1145\/3571884 [Accessed 05-06-2026] [doi: 10.1145\/3571884.3604404]","DOI":"10.1145\/3571884.3604404"},{"key":"R80","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijhcs.2018.01.004","article-title":"A practical approach to measuring user engagement with the refined user engagement scale (UES) and new UES short form","volume":"112","author":"O\u2019Brien","journal-title":"Int J Hum Comput Stud"},{"issue":"2","key":"R81","doi-asserted-by":"publisher","first-page":"252","DOI":"10.1007\/s12160-010-9240-2","article-title":"Directive and nondirective e-coach support for weight loss in overweight adults","volume":"41","author":"Gabriele","journal-title":"Ann Behav Med"},{"issue":"3","key":"R82","doi-asserted-by":"publisher","first-page":"391","DOI":"10.1080\/15213269.2019.1604235","article-title":"From self-reliers to expert-dependents: identifying classes based on health-related need for autonomy and need for external control among mobile users","volume":"23","author":"Smit","journal-title":"Media Psychol"},{"issue":"1","key":"R83","doi-asserted-by":"publisher","DOI":"10.1038\/s41746-025-01701-3","article-title":"Psychological, economic, and ethical factors in human feedback for a chatbot-based smoking cessation intervention","volume":"8","author":"Albers","journal-title":"NPJ Digit Med"},{"key":"R84","doi-asserted-by":"publisher","DOI":"10.1016\/j.cct.2025.107833","article-title":"The LvL UP trial: protocol for a sequential, multiple assignment, randomised controlled trial to assess the effectiveness of a blended mobile lifestyle intervention","volume":"150","author":"Castro","journal-title":"Contemp Clin Trials"}],"container-title":["JMIR Human Factors"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/humanfactors.jmir.org\/2026\/1\/e83456","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T22:26:11Z","timestamp":1785536771000},"score":1,"resource":{"primary":{"URL":"https:\/\/humanfactors.jmir.org\/2026\/1\/e83456"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,14]]},"references-count":84,"URL":"https:\/\/doi.org\/10.2196\/83456","relation":{},"ISSN":["2292-9495"],"issn-type":[{"value":"2292-9495","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,14]]},"article-number":"v13i1e83456"}}