Elena+ A Pandemic Lifestyle Care Intervention

The current COVID-19 coronavirus pandemic is an emergency on a global scale, with huge swathes of the population required to remain inside for prolonged periods at a time to tackle the virus. In this new context, individuals’ health-promoting routines are under greater strain, with prolonged indoor-periods contributing to feelings of isolation, poorer mental health, increased risk of interpersonal conflict and difficulties sleeping. Additionally, individuals are also required to keep up to date with latest health guidelines about the virus, which may be confusing in an age of social-media disinformation and shifting guidelines. To tackle these factors, that represent a clear threat to public health, we have developed Elena+, a smartphone-based and conversational agent (CA) delivered pandemic lifestyle care intervention.

Elena+ utilizes varied intervention components to deliver a psychoeducation-focused coaching program on the topics of: COVID-19 information, physical activity, mental health (anxiety, loneliness, mental resources), sleep, and diet & nutrition. Over 43 subtopics, a CA guides individuals through content and tracks progress over time; such as changes in health outcome assessments per topic, alongside user-set behavioral intentions and user-reported actual behaviors. Ratings of the usage experience, social demographics and the user profile are also captured. Elena+ is available for public download on iOS (App Store Link) and Android (Play Store Link) devices in English, with future languages and launch countries planned, and no limits on planned recruitment. Panel data methods will be used to track user progress over time in subsequent analyses. The Elena+ intervention is open-source under the Apache 2 license (MobileCoach software) and the Creative Commons license CC BY-NC-SA (intervention logic and content), allowing future collaborations and adaptions; such as cultural adaptions, integration of new sensor-related features or the development of new topics.

Digital health applications offer a low-cost and scalable route to meet challenges to public health. As Elena+ was developed by an international and interdisciplinary team in a short time frame to meet the COVID-19 pandemic, empirical data are required to discern how effective such solutions can be in meeting real world, emergent health crises. Additionally, clustering Elena+ users based on characteristics and usage behaviors could help public health practitioners understand how population-level digital health interventions can reach at-risk and sub-populations.

Elena+ Overview

The Elena+ Team

Guest Lecture by Joseph Ollier

Some Early Conversational Turns with Elena+


Ollier, J.B., Neff, S., Dworschak, C., Sejdiji, A., Santhanam, P., Keller, R., Xiao, G., Asisof, A., Rüegger, D., Bérubé, C., Hilfiker Tomas, L., Neff, J., Yao, J., Alattas, A., Varela-Mato, V., Pitkethly, A., Vara, M.D., Herrero, R., Baños, R.M., Parada, C., Agatheswaran, R.S., Villalobos, V., Keller, O., Chan, W.S., Mishra, V., Jacobson, N.C., Stanger, C., He, X., von Wyl, V., Weidt, S., Haug, S., Schaub, M.P., Kleim, B., Barth, J., Witt, C., Scholz, U., Fleisch, E., von Wangenheim, F., Tudor Car, L., Müller-Riemenschneider, F., Hauser-Ulrich, S., Núñez Asomoza, A., Salamanca-Sanabria, A., Mair, J., Kowatsch, T. (2021) Elena Care for COVID-19, a Pandemic Lifestyle Care Intervention: Intervention Design and Study Protocol, Frontiers in Public Health, 9(1543), 10.3389/fpubh.2021.625640, Guest Lecture by J. Ollier, [PDF]

Ollier, J.B., Santhanam, P., Kowatsch, T., Face(book)ing the Truth: Initial Lessons Learned using Facebook Advertisements for the Chatbot-delivered Elena+ Care for COVID-19 Intervention, In Proceedings of the 14th International Joint Conference on Biomedical Engineering Systems and Technologies (BIOSTEC 2021) – Volume 5: HEALTHINF, 781-788 ISBN: 978-989-758-490-9 ISSN: 2184-4305. [PDF]

Visual Abstract by:
Joseph Ollier M.Sc.

Related Work

Kowatsch, T., Volland, D., Shih, I., Rüegger, D., Künzler, F., Barata, F., Filler, A., Büchter, D., Brogle, B., Heldt, K., Gindrat, P., Farpour-Lambert, N., l’Allemand, D. (2017) Design and Evaluation of a Mobile Chat App for the Open Source Behavioral Health Intervention Platform MobileCoach, In: Maedche A., vom Brocke J., Hevner A. (eds) Designing the Digital Transformation. DESRIST 2017. Lecture Notes in Computer Science, vol 10243. Springer: Berlin; Germany, 485-489. (Paper-PDF | Poster-PDF | Slide-PDF | Screencast)

Filler, A., Kowatsch, T., Haug, S., Wahle, F., Staake, T. & Fleisch, E. (2015) MobileCoach: A Novel Open Source Platform for the Design of Evidence-based, Scalable and Low-Cost Behavioral Health Interventions – Overview and Preliminary Evaluation in the Public Health Context. Wireless Telecommunications Symposium 2015 (WTS 2015), New York, USA. ***Outstanding Paper Award & Best Graduate Student Paper Award*** PDF

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CDHI Research Team

Joseph Ollier MSc, Prabhakaran “PrabhuSanthanam MSc, Roman Keller MSc, Alina Asisof MSc, Marcia Nißen MSc, Aishah Alattas MSc, Jiali Yao MSc, Theresa Schachner MSc, Gisbert Teepe MSc, Caterina Bérubé MSc, Prof. Dr. Florian v. Wangenheim, Prof. Dr. Elgar FleischAlicia Salamanca PhD, Jacqueline Mair PhD and Prof. Dr. Tobias Kowatsch (Principal Investigator)


since April 2020


Prof. Falk Müller Riemendschneider, MD (National University of Singapore), Assist. Prof. Lorainne Tudor Car, MD (Nanyang Technological University), Assist. Prof. Nicholas JacobsonVarun Mishra MSc, Prof. Catherine Stanger, PhD (Center for Technology and Behavioral Health, Dartmouth College), PD Dr. Jürgen Barth, Christine Dworschak MSc, PD Dr. Dr. Severin Haug, Prof. Dr. Birgit Kleim, Prof. Dr. Michael Schaub, Prof. Dr. Urte Scholz, PD Dr. med. Steffi Weidt, Prof. Dr. med. Claudia Witt MBA, Assist. Prof. Viktor von Wyl (University of Zurich), Sandra Hauser-Ulrich, MSc (Zurich University of Applied Sciences), Grace Xiao BA (Johns Hopkins University), Prof. Dr. Xinming He and Prof. Dr. Zhibin Lin (Durham University), Uli Stöckli (Sooli Film), Lutz Augspurger MSc, Birgit Hepting MSc, Vanessa Dragojevic, Bersu Inanir, and Maren Röttele (Flipping Rocks), and many more see Elena+