Effectiveness of A Mindfulness-centered Stress Management AI Chatbot to Reduce Stress and Enhance Mental Health Among Men Who Have Sex With Men in China

Chinese MSM often experience unique social stress factors related to stigma, discrimination, and the pressures of concealing their sexual identity. These ongoing challenges are closely linked to elevated levels of anxiety, depressive symptoms, and general psychological distress. While traditional face-to-face therapy can be effective, common barriers such as waiting lists, costs, and privacy concerns frequently prevent individuals from seeking care. To help bridge this gap, the trial evaluates an accessible, private, and real-time AI tool that delivers safe, low-intensity mental health preventive support directly to a user's smartphone.

The investigational tool is a web-based chatbot built on a open-source Chinese large language model and tailored using Retrieval-Augmented Generation technology. This design ensures that the chatbot's responses are empathetic, culturally sensitive, and tailored to MSM-related stress and mental health topics. During conversations, the chatbot guides users through brief, evidence-based mindfulness practices-such as grounding, cognitive defusion, self-compassion, and sleep support-designed for 10-to-20-minute sessions. The tool focuses strictly on stress management and coping skills; it is not intended to provide clinical diagnosis, formal psychotherapy, or emergency crisis intervention.

The research follows a randomized controlled trial design spanning four weeks of intervention followed by a post-study assessment four weeks later. Adult participants with mild-to-moderate stress are recruited via major social media platforms, including Xiaohongshu, Weibo, and WeChat. After completing online consent and baseline surveys, participants are randomly assigned to either the intervention group or a control group. Those in the intervention group attend a brief online orientation and gain access to the AI chatbot, which they are recommended to use at least twice a week. Participants in the control group receive non-interactive educational readings on general stress management twice weekly. Researchers measure changes in stress levels, anxiety, depression, emotion regulation, rumination, and coping strategies across three key evaluation points.

• Score of Difficulties in Emotion Regulation [Срок оценки: From enrollment to the end of intervention at week 1, week 4, and week 8.]
• Score of Stress Coping [Срок оценки: From enrollment to the end of intervention at week 1, week 4, and week 8.]
• Score of Rumination [Срок оценки: From enrollment to the end of intervention at week 1, week 4, and week 8.]
• Score of Depressive symptom [Срок оценки: From enrollment to the end of intervention at week 1, week 4, and week 8.]
• Score of Anxiety Symptom [Срок оценки: From enrollment to the end of intervention at week 1, week 4, and week 8.]
• Score of Subjective Well-Being [Срок оценки: From enrollment to the end of intervention at week 1, week 4, and week 8.]
• Score of Positive and Negative Emotions [Срок оценки: From enrollment to the end of intervention at week 1, week 4, and week 8.]
• Score of Acceptability of Intervention [Срок оценки: From enrollment to the end of intervention at week 4.]
• Score of Intervention Appropriateness [Срок оценки: From enrollment to the end of intervention at week 4.]
• Score of AI Psychological Dialogue Quality [Срок оценки: From enrollment to the end of intervention at week 4.]