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

Urology. 2015 Mar;85(3):561-7. doi: 10.1016/j.urology.2014.11.017. Epub 2015 Jan 10.


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.

Trial registration: NCT02251054.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Female
  • Humans
  • Middle Aged
  • Patient Education as Topic / methods*
  • Self Care / methods*
  • Therapy, Computer-Assisted*
  • Urinary Bladder, Overactive / therapy*

Associated data