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<p>Artificial intelligence-powered lifestyle interventions may expand access to behavioral change support, but patient experience remains critical to real-world uptake and effectiveness. In a phase 3 randomized clinical trial of adults with prediabetes and overweight or obesity (<i>N</i> = 368), we compared a fully automated AI-driven diabetes prevention program (DPP) with a CDC-recognized human-coach-based DPP. Participants assigned to the AI-led DPP initiated the intervention sooner (median 11 vs 26 days; <i>p</i> &lt; 0.001) and demonstrated higher and more evenly distributed engagement over 12 months. Acceptability ratings were consistently higher for the human-led DPP across all domains, with the largest differences in satisfaction (<i>p</i> &lt; 0.001). Preference responses also favored human coaching, with 46.5% of AI-assigned participants indicating they would have preferred a human coach compared with 31.5% preferring a fully automated program in the human-led group (<i>p</i> = 0.012). These findings illustrate a trade-off between scalability and perceived quality of experience. Clinical trial registration: ClinicalTrials.gov NCT05056376 (registered September 24, 2021).</p>

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Patient engagement, acceptability, and preference of artificial intelligence versus human coaching for diabetes prevention

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年8月3日

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  • Benjamin Lalani,
  • Cyd Eaton,
  • Daniel Zade,
  • Kristin Riekert,
  • Nisa Maruthur,
  • Adrian Dobs,
  • Nestoras Mathioudakis

摘要

Artificial intelligence-powered lifestyle interventions may expand access to behavioral change support, but patient experience remains critical to real-world uptake and effectiveness. In a phase 3 randomized clinical trial of adults with prediabetes and overweight or obesity (N = 368), we compared a fully automated AI-driven diabetes prevention program (DPP) with a CDC-recognized human-coach-based DPP. Participants assigned to the AI-led DPP initiated the intervention sooner (median 11 vs 26 days; p < 0.001) and demonstrated higher and more evenly distributed engagement over 12 months. Acceptability ratings were consistently higher for the human-led DPP across all domains, with the largest differences in satisfaction (p < 0.001). Preference responses also favored human coaching, with 46.5% of AI-assigned participants indicating they would have preferred a human coach compared with 31.5% preferring a fully automated program in the human-led group (p = 0.012). These findings illustrate a trade-off between scalability and perceived quality of experience. Clinical trial registration: ClinicalTrials.gov NCT05056376 (registered September 24, 2021).