An overactive bladder online self-management program with embedded avatars: A randomized controlled trial of efficacy

Allen D. Andrade, Ramanakumar Anam, Chandana Karanam, Pamela Downey, Jorge G. Ruiz

Research output: Contribution to journalArticlepeer-review

18 Scopus citations


Objective To determine whether an avatar-based, online, self-management program is an effective therapeutic approach for women with overactive bladder (OAB). OAB is a highly prevalent symptom complex that significantly impacts health-related quality of life (HRQOL). Behavioral interventions can produce substantial improvement in symptoms and HRQOL. Online education programs offer patients with OAB an alternative to face-to-face self-management instruction. Evidence suggests that avatars (digital humans) embedded into online programs may help persuade and motivate patients to adopt healthy behaviors. Methods In a 12-week, randomized, controlled trial, women (aged >55 years) with symptoms of OAB for at least 3 months were randomized to 2 versions of a 3-part, online, self-management program. After collecting the baseline metrics, the intervention group viewed a generic avatar coach with a self-avatar peer mentor designed to resemble the participant, and the control group viewed the identical online program with voice only. Participants viewed part 1 at week 1 and parts 2 and 3 at week 6. Participants completed daily bladder diaries throughout the 12-week period and OAB-related outcome measures at weeks 1, 6, and 12. Results Forty-one women completed the study (mean age = 61 years, standard deviation = 6). The analysis of covariance of week-12 outcome measures with the baseline as covariates demonstrated significant improvements in the intervention group in OAB questionnaire HRQOL (P =.02; large effect), 24-hour frequency (P <.001; large effect), night-time urination (P <.001; large effect), urgency (P <.001; large effect), and urge incontinence (P <.001; large effect). Conclusion An avatar-based intervention embedded into an online self-management program improved OAB HRQOL and symptoms in women.

Original languageEnglish (US)
Pages (from-to)561-567
Number of pages7
Issue number3
StatePublished - Mar 1 2015
Externally publishedYes

ASJC Scopus subject areas

  • Urology


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