0374 Does adding a chatbot and human support enhance treatment adherence to and efficacy of digital CBTi? A randomized controlled trial

Abstract Introduction Digital cognitive behavioral therapy for insomnia (dCBTi) has been shown to be efficacious; however, treatment adherence and efficacy are suboptimal compared CBTi delivered in person. The present study evaluated whether the addition of different types coaching support (i.e., phone by a therapist trained CBTi, research assistant not virtual chatbot that simulates human dialogue) would improve dCBTi. It was hypothesized any form will have beneficial effects, with achieving best outcomes. Methods A single-blind, parallel, randomized controlled trial conducted. One-hundred-fifty adults insomnia, indicated Insomnia Severity Index (ISI) >=10, were randomly assigned one five conditions: dCBTi three 20-min sessions (C1), non-therapist (C2), (C3), without (C4), sleep hygiene diary control (C5). is smartphone application adopting six-session components hygiene, restriction, stimulus control, relaxation, therapy. Participants completed diaries, ISI, dysfunctional beliefs about (DBAS), sleep-related behavior questionnaire (SRBQ), measures mood, fatigue, quality life at pre-intervention, post-intervention, 4-week follow-up. Results Mixed modeling analysis showed participants C1, C2, C3, C4 had greater improvements symptoms, efficiency, DBAS, SRBQ, fatigue than C5. C1 significantly improvement DBAS SRBQ those C4; conditions C4. However, symptoms between or coaching. Conclusion Adding support, especially coaching, improved but efficacy. Nonetheless, adding led mechanisms change, i.e., reductions behaviors related which may promote maintenance longer Clinicaltrials.gov registration#: NCT05136638 Support (if any) HKU Fund Translation Research #104005654