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. 2021 Dec 21;23(12):e31737.
doi: 10.2196/31737.

Improving User Experience of Virtual Health Assistants: Scoping Review

Rachel G Curtis  1 , Bethany Bartel  1 , Ty Ferguson  1 , Henry T Blake  1 , Celine Northcott  1 , Rosa Virgara  1 , Carol A Maher  1
Affiliations

Improving User Experience of Virtual Health Assistants: Scoping Review

Rachel G Curtis et al. J Med Internet Res. .

Abstract

Background: Virtual assistants can be used to deliver innovative health programs that provide appealing, personalized, and convenient health advice and support at scale and low cost. Design characteristics that influence the look and feel of the virtual assistant, such as visual appearance or language features, may significantly influence users' experience and engagement with the assistant.

Objective: This scoping review aims to provide an overview of the experimental research examining how design characteristics of virtual health assistants affect user experience, summarize research findings of experimental research examining how design characteristics of virtual health assistants affect user experience, and provide recommendations for the design of virtual health assistants if sufficient evidence exists.

Methods: We searched 5 electronic databases (Web of Science, MEDLINE, Embase, PsycINFO, and ACM Digital Library) to identify the studies that used an experimental design to compare the effects of design characteristics between 2 or more versions of an interactive virtual health assistant on user experience among adults. Data were synthesized descriptively. Health domains, design characteristics, and outcomes were categorized, and descriptive statistics were used to summarize the body of research. Results for each study were categorized as positive, negative, or no effect, and a matrix of the design characteristics and outcome categories was constructed to summarize the findings.

Results: The database searches identified 6879 articles after the removal of duplicates. We included 48 articles representing 45 unique studies in the review. The most common health domains were mental health and physical activity. Studies most commonly examined design characteristics in the categories of visual design or conversational style and relational behavior and assessed outcomes in the categories of personality, satisfaction, relationship, or use intention. Over half of the design characteristics were examined by only 1 study. Results suggest that empathy and relational behavior and self-disclosure are related to more positive user experience. Results also suggest that if a human-like avatar is used, realistic rendering and medical attire may potentially be related to more positive user experience; however, more research is needed to confirm this.

Conclusions: There is a growing body of scientific evidence examining the impact of virtual health assistants' design characteristics on user experience. Taken together, data suggest that the look and feel of a virtual health assistant does affect user experience. Virtual health assistants that show empathy, display nonverbal relational behaviors, and disclose personal information about themselves achieve better user experience. At present, the evidence base is broad, and the studies are typically small in scale and highly heterogeneous. Further research, particularly using longitudinal research designs with repeated user interactions, is needed to inform the optimal design of virtual health assistants.

Keywords: chatbot; conversational agent; design; digital health; eHealth; mobile phone; user experience; virtual assistant.

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Conflict of interest statement

Conflicts of Interest: None declared.

Figures

Figure 1
Figure 1
PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) flowchart. VHA: virtual health assistant.
See this image and copyright information in PMC

References

    1. Horgan D, Romao M, Morré SA, Kalra D. Artificial intelligence: power for civilisation - and for better healthcare. Public Health Genomics. 2019;22(5-6):145–61. doi: 10.1159/000504785. https://www.karger.com?DOI=10.1159/000504785 000504785 - DOI - PubMed
    1. Fitzpatrick KK, Darcy A, Vierhile M. Delivering cognitive behavior therapy to young adults with symptoms of depression and anxiety using a fully automated conversational agent (Woebot): a randomized controlled trial. JMIR Ment Health. 2017 Jun 06;4(2):e19. doi: 10.2196/mental.7785. https://mental.jmir.org/2017/2/e19/ v4i2e19 - DOI - PMC - PubMed
    1. Maher CA, Davis CR, Curtis RG, Short CE, Murphy KJ. A physical activity and diet program delivered by artificially intelligent virtual health coach: proof-of-concept study. JMIR Mhealth Uhealth. 2020 Jul 10;8(7):e17558. doi: 10.2196/17558. https://mhealth.jmir.org/2020/7/e17558/ v8i7e17558 - DOI - PMC - PubMed
    1. Cleres D, Rassouli F, Brutsche M, Kowatsch T, Barata F. Lena: a voice-based conversational agent for remote patient monitoring in chronic obstructive pulmonary disease.; April 13-17 2021; College Station, USA. Proceedings of the 26th ACM Conference on Intelligent User Interfaces; 26th ACM Conference on Intelligent User Interfaces; Apr 13-17, 2021; College Station, USA. 2021. - DOI
    1. Ergonomics of human-system interaction — Part 11: Usability: Definitions and concepts. ISO. 2018. [2021-11-29]. https://www.iso.org/obp/ui/#iso:std:iso:9241:-11:ed-2:v1:en .

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