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An Embodied Conversational Agent in an eHealth Self-management Intervention for Chronic Obstructive Pulmonary Disease and Chronic Heart Failure: Exploratory Study in a Real-life Setting

BACKGROUND: Embodied conversational agents (ECAs) have the potential to stimulate actual use of eHealth apps. An ECA’s design influences the user’s perception during short interactions, but daily life evaluations of ECAs in health care are scarce. OBJECTIVE: This is an exploratory, long-term study o...

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Autores principales: ter Stal, Silke, Sloots, Joanne, Ramlal, Aniel, op den Akker, Harm, Lenferink, Anke, Tabak, Monique
Formato: Online Artículo Texto
Lenguaje:English
Publicado: JMIR Publications 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8603169/
https://www.ncbi.nlm.nih.gov/pubmed/34734824
http://dx.doi.org/10.2196/24110
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author ter Stal, Silke
Sloots, Joanne
Ramlal, Aniel
op den Akker, Harm
Lenferink, Anke
Tabak, Monique
author_facet ter Stal, Silke
Sloots, Joanne
Ramlal, Aniel
op den Akker, Harm
Lenferink, Anke
Tabak, Monique
author_sort ter Stal, Silke
collection PubMed
description BACKGROUND: Embodied conversational agents (ECAs) have the potential to stimulate actual use of eHealth apps. An ECA’s design influences the user’s perception during short interactions, but daily life evaluations of ECAs in health care are scarce. OBJECTIVE: This is an exploratory, long-term study on the design of ECAs for eHealth. The study investigates how patients perceive the design of the ECA over time with regard to the ECA’s characteristics (friendliness, trustworthiness, involvement, expertise, and authority), small talk interaction, and likeliness of following the agent’s advice. METHODS: We developed an ECA within an eHealth self-management intervention for patients with both chronic obstructive pulmonary disease (COPD) and chronic heart failure (CHF), which we offered for 4 months. Patients rated 5 agent characteristics and likeliness of following the agent’s advice before use and after 3 and 9 weeks of use. The amount of patients’ small talk interaction was assessed by log data. Lastly, individual semistructured interviews were used to triangulate results. RESULTS: Eleven patients (7 male and 4 female) with COPD and CHF participated (median age 70 years). Patients’ perceptions of the agent characteristics did not change over time (P>.05 for all characteristics) and only 1 participant finished all small talk dialogues. After 3 weeks of use, the patients were less likely to follow the agent’s advice (P=.01). The agent’s messages were perceived as nonpersonalized and the feedback as inappropriate, affecting the agent’s perceived reliability. CONCLUSIONS: This exploratory study provides first insights into ECA design for eHealth. The first impression of an ECA’s design seems to remain during long-term use. To investigate future added value of ECAs in eHealth, perceived reliability should be improved by managing users’ expectations of the ECA’s capabilities and creating ECA designs fitting individual needs. TRIAL REGISTRATION: Netherlands Trial Register NL6480; https://www.trialregister.nl/trial/6480
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spelling pubmed-86031692021-12-09 An Embodied Conversational Agent in an eHealth Self-management Intervention for Chronic Obstructive Pulmonary Disease and Chronic Heart Failure: Exploratory Study in a Real-life Setting ter Stal, Silke Sloots, Joanne Ramlal, Aniel op den Akker, Harm Lenferink, Anke Tabak, Monique JMIR Hum Factors Original Paper BACKGROUND: Embodied conversational agents (ECAs) have the potential to stimulate actual use of eHealth apps. An ECA’s design influences the user’s perception during short interactions, but daily life evaluations of ECAs in health care are scarce. OBJECTIVE: This is an exploratory, long-term study on the design of ECAs for eHealth. The study investigates how patients perceive the design of the ECA over time with regard to the ECA’s characteristics (friendliness, trustworthiness, involvement, expertise, and authority), small talk interaction, and likeliness of following the agent’s advice. METHODS: We developed an ECA within an eHealth self-management intervention for patients with both chronic obstructive pulmonary disease (COPD) and chronic heart failure (CHF), which we offered for 4 months. Patients rated 5 agent characteristics and likeliness of following the agent’s advice before use and after 3 and 9 weeks of use. The amount of patients’ small talk interaction was assessed by log data. Lastly, individual semistructured interviews were used to triangulate results. RESULTS: Eleven patients (7 male and 4 female) with COPD and CHF participated (median age 70 years). Patients’ perceptions of the agent characteristics did not change over time (P>.05 for all characteristics) and only 1 participant finished all small talk dialogues. After 3 weeks of use, the patients were less likely to follow the agent’s advice (P=.01). The agent’s messages were perceived as nonpersonalized and the feedback as inappropriate, affecting the agent’s perceived reliability. CONCLUSIONS: This exploratory study provides first insights into ECA design for eHealth. The first impression of an ECA’s design seems to remain during long-term use. To investigate future added value of ECAs in eHealth, perceived reliability should be improved by managing users’ expectations of the ECA’s capabilities and creating ECA designs fitting individual needs. TRIAL REGISTRATION: Netherlands Trial Register NL6480; https://www.trialregister.nl/trial/6480 JMIR Publications 2021-11-04 /pmc/articles/PMC8603169/ /pubmed/34734824 http://dx.doi.org/10.2196/24110 Text en ©Silke ter Stal, Joanne Sloots, Aniel Ramlal, Harm op den Akker, Anke Lenferink, Monique Tabak. Originally published in JMIR Human Factors (https://humanfactors.jmir.org), 04.11.2021. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Human Factors, is properly cited. The complete bibliographic information, a link to the original publication on https://humanfactors.jmir.org, as well as this copyright and license information must be included.
spellingShingle Original Paper
ter Stal, Silke
Sloots, Joanne
Ramlal, Aniel
op den Akker, Harm
Lenferink, Anke
Tabak, Monique
An Embodied Conversational Agent in an eHealth Self-management Intervention for Chronic Obstructive Pulmonary Disease and Chronic Heart Failure: Exploratory Study in a Real-life Setting
title An Embodied Conversational Agent in an eHealth Self-management Intervention for Chronic Obstructive Pulmonary Disease and Chronic Heart Failure: Exploratory Study in a Real-life Setting
title_full An Embodied Conversational Agent in an eHealth Self-management Intervention for Chronic Obstructive Pulmonary Disease and Chronic Heart Failure: Exploratory Study in a Real-life Setting
title_fullStr An Embodied Conversational Agent in an eHealth Self-management Intervention for Chronic Obstructive Pulmonary Disease and Chronic Heart Failure: Exploratory Study in a Real-life Setting
title_full_unstemmed An Embodied Conversational Agent in an eHealth Self-management Intervention for Chronic Obstructive Pulmonary Disease and Chronic Heart Failure: Exploratory Study in a Real-life Setting
title_short An Embodied Conversational Agent in an eHealth Self-management Intervention for Chronic Obstructive Pulmonary Disease and Chronic Heart Failure: Exploratory Study in a Real-life Setting
title_sort embodied conversational agent in an ehealth self-management intervention for chronic obstructive pulmonary disease and chronic heart failure: exploratory study in a real-life setting
topic Original Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8603169/
https://www.ncbi.nlm.nih.gov/pubmed/34734824
http://dx.doi.org/10.2196/24110
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