Comparing informativeness of an NLG chatbot vs graphical app in diet-information domain

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Generating Personalized Pregnancy Nutrition Recommendations with GPT-Powered AI Chatbot. In: 20th International Conference on Information Systems for Crisis Response and Management

Low socioeconomic status (SES) and inadequate nutrition during pregnancy are linked to health disparities and adverse outcomes, including an increased risk of preterm birth, low birth weight, and intrauterine growth restriction. AI-powered computational agents have enormous potential to address this challenge by providing nutrition guidelines or advice to patients with different health literacy and demographics. This paper presents our preliminary exploration of creating a GPT-powered AI chatbot called NutritionBot and investigates the implications for pregnancy nutrition recommendations. We used a user-centered design approach to define the target user persona and collaborated with medical professionals to co-design the chatbot. We integrated our proposed chatbot with ChatGPT to generate pregnancy nutrition recommendations tailored to patients’ lifestyles. Our contributions include introducing a design persona of a pregnant woman from an underserved population, co-designing a nutrition advice chatbot with healthcare experts, and sharing design implications for future GPT-based nutrition chatbots based on our preliminary findings

Factors associated with adherence to a public mobile nutritional health intervention: retrospective cohort study

BACKGROUND: Obesity is a global health issue affecting over 2 billion people. Mobile health apps, specifically nutrition apps, have been identified as promising solutions to combat obesity. However, research on adherence to nutrition apps is scarce, especially for publicly available apps without monetary incentives and personal onboarding. Understanding factors associated with adherence is essential to improve the efficacy of these apps. This study aims to identify such factors by analyzing a large dataset of a free and publicly available app (“MySwissFoodPyramid”) that promotes healthy eating through dietary self-monitoring and nutrition literacy delivered via a conversational agent. METHODS: A retrospective analysis was conducted on 19,805 users who used the app for at least two days between November 2018 and May 2022. Adherence was defined as completing a food diary by tracking dietary intake over a suggested period of three days. Users who finished multiple diaries were considered long-term adherent. The associations between the day and time of installation, tutorial use, reminder use, and conversational agent choice were examined regarding adherence, long-term adherence, and the number of completed diaries. RESULTS: Overall, 66.8% of included users were adherent, and 8.5% were long-term adherent. Users who started the intervention during the day (5 am – 7 pm) were more likely to be adherent and completed more diaries. Starting to use the intervention between Sunday and Wednesday was associated with better adherence and a higher number of completed diaries. Users who chose the female conversational agent were more likely to be adherent, long-term adherent, and completed more diaries. Users who skipped the tutorial were less adherent and completed fewer diaries. Users who set a follow-up reminder were more likely to be long-term adherent and completed more diaries. CONCLUSIONS: This study demonstrates the potential of digital health interventions to achieve comparably high adherence rates, even without monetary incentives or human-delivered support. It also reveals factors associated with adherence highlighting the importance of app tutorials, customizable reminders, tailored content, and the date and time of user onboarding for improving adherence to mHealth apps. Ultimately, these findings may help improve the effectiveness of digital health interventions in promoting healthy behaviors

Keystroke-Level Model to Evaluate Chatbot Interface for Reservation System

The tour package reservation system is an important part of improving tourism services. Reservations must be able to meet the information needs of prospective customers and can serve the desired tour package bookings. A reservation system is usually a form that must be filled in sequence by prospective visitors. This paper discusses the evaluation of the application of the chatbot interface on the reservation system with the keystroke-level model. Changing the interaction design that previously did the task fills out the form into a conversation interaction. The aim is to increase the speed of the ordering process through the system. Prospective visitors do not need to fill in the form, they only need to have a conversation with the system while entering the order data. The evaluation results using the keystroke-level model show that the chatbot interface can increase the speed of the process by shortening steps

헬스케어를 위한 대화형 인공지능의 모사된 페르소나 디자인 및 사용자 경험 연구

학위논문(박사) -- 서울대학교대학원 : 인문대학 협동과정 인지과학전공, 2021.8. 이준환.디지털 헬스케어(Digital Healthcare) 기술의 발전은 일상 헬스케어 영역에서의 혁신을 주도 하고 있다. 이는 의학 전문가들의 정확한 진단, 질병의 치료를 도울 뿐만 아니라 사용자가 스스로 일상에서 자기관리를 할 수 있도록 돕는다. 디지털 헬스케어 기술의 대표적인 목표 중 하나는 효과적으로 헬스케어 서비스를 개인화 시키는 것인데, 이러한 측면에서 대화형 인공지능(Conversational AI)은 사용하기 쉽고 효율적인 비용으로 개인화된 서비스를 제공할 수 있기에 주목받고 있다. 기존의 개인화된 케어 서비스들의 경우는 대부분 의료기관의 질병치료 서비스들에 포함되었는데, 대화형 인공지능은 이러한 개인화된 케어 서비스의 영역을 일상에서의 질병 예방을 위한 관리로 확장하는데 기여한다. 일대일 대화를 통해 맞춤형 교육, 테라피, 그외의 관련 정보 등을 제공할 수 있다는 측면에서 일상 헬스케어에 적합한 디지털 헬스케어 기술로의 활용도가 높다. 이러한 이점으로 인해 다양한 역할을 가진 대화형 인공지능들의 개발이 이루어지고 있다. 그러나, 이러한 대화형 인공지능들에게 사용자의 선호도에 적합한 페르소나를 부여하는 연구는 드물게 이루어 지고 있다. 대화형 인공지능의 주요 기능인 자연어 기반 상호작용은 CASA 패러다임(CASA Paradigm)에서 제기하는 사용자가 시스템을 의인화하는 경향을 높인다. 때문에 페르소나에 대한 사용자의 선호도가 지속적인 대화형 인공지능의 사용과 몰입에 영향을 미친다. 또한 대화형 인공지능의 장기적인 사용을 위해서 적절한 사용자와의 사회적, 감정적 상호작용을 디자인 해 주어야 하는데, 인지된 페르소나에 대한 사용자의 선호도가 이 과정에도 유의미한 영향을 미친다. 때문에 지속적인 참여가 결과에 큰 영향을 미치는 일상 헬스케어 영역에서 대화형 인공지능을 활용하는데 개인화된 페르소나 디자인이 긍정적인 사용자 경험 및 사용자 건강 증진의 가능성을 높일 것으로 본 연구는 가정한다. 개인화된 페르소나 디자인을 위해 사용자와 현실에서 친밀한 관계에 있는 실존인물(호스트)의 페르소나를 대화형 인공지능에 적용하고 평가하는 것이 본 연구의 핵심적인 아아디어이다. 이를 검증하기 위해서 해당 학위 논문은 총 세 가지의 세부 연구를 포함한다. 첫째는 실존인물의 페르소나 중에서도 일상 건강관리에 적합한 호스트의 페르소나를 탐색하는 연구이다. 둘째는 호스트의 페르소나를 대화형 인공지능에 적용하기 위해 고려해야 할 언어적 요소들을 정의하는 연구이다. 마지막으로는 위의 과정을 통해 개발된 실존하는 인물의 페르소나를 가진 대화형 인공지능이 일상 헬스케어 영역에서 실제 효과를 보이는지를 평가하는 연구이다. 또한 해당 학위논문은 일련의 연구들에서 발견한 결과들을 바탕으로 사용자와 친밀한 관계에 있는 페르소나를 일상 헬스케어를 위한 대화형 인공지능에 적용할 때 고려해야할 디자인 함의점들을 도출하고 가이드라인을 제시한다.Advance in digital healthcare technologies has been leading a revolution in healthcare. It has been showing the enormous potential to improve medical professionals’ ability for accurate diagnosis, disease treatment, and the users’ daily self-care. Since the recent transformation of digital healthcare aims to provide effective personalized health services, Conversational AI (CA) is being highlighted as an easy-to-use and cost-effective means to deliver personalized services. Particularly, CA is gaining attention as a mean for personalized care by ingraining positive self-care behavior in a daily manner while previous methods for personalized care are focusing on the medical context. CA expands the boundary of personalized care by enabling one-to-one tailored conversation to deliver health education and healthcare therapies. Due to CA's opportunities as a method for personalized care, it has been implemented with various types of roles including CA for diagnosis, CA for prevention, and CA for therapy. However, there lacks study on the personalization of healthcare CA to meet user's preferences on the CA's persona. Even though the CASA paradigm has been applied to previous studies designing and evaluating the human-likeness of CA, few healthcare CAs personalize its human-like persona except some CAs for mental health therapy. Moreover, there exists the need to improve user experience by increasing social and emotional interaction between the user and the CA. Therefore, designing an acceptable and personalized persona of CA should be also considered to make users to be engaged in the healthcare task with the CA. In this manner, the thesis suggests an idea of applying the persona of the person who is in a close relationship with the user to the conversational CA for daily healthcare as a strategy for persona personalization. The main hypothesis is the idea of applying a close person's persona would improve user engagement. To investigate the hypothesis, the thesis explores if dynamics derived from the social relationship in the real world can be implemented to the relationship between the user and the CA with the persona of a close person. To explore opportunities and challenges of the research idea, series of studies were conducted to (1) explore appropriate host whose persona would be implemented to healthcare CA, (2) define linguistic characteristics to consider when applying the persona of a close person to the CA, and (3)implement CA with the persona of a close person to major lifestyle domains. Based on findings, the thesis provides design guidelines for healthcare CA with the persona of the real person who is in a close relationship with the user.Abstract 1 1 Introduction 12 2 Literature Review 18 2.1 Roles of CA in Healthcare 18 2.2 Personalization in Healthcare CA 23 2.3 Persona Design CA 25 2.4 Methods for Designing Chatbot’s Dialogue Style 30 2.4.1 Wizard of Oz Method 32 2.4.2 Analyzing Dialogue Data with NLP 33 2.4.3 Participatory Design 35 2.4.4 Crowdsourcing 37 3 Goal of the Study 39 4 Study 1. Exploring Candidate Persona for CA 43 4.1 Related Work 44 4.1.1 Need for Support in Daily Healthcare 44 4.1.2 Applying Persona to Text-based CA 45 4.2 Research Questions 47 4.3 Method 48 4.3.1 Wizard of Oz Study 49 4.3.2 Survey Measurement 52 4.3.3 Post Interview 54 4.3.4 Analysis 54 4.4 Results 55 4.4.1 System Acceptance 56 4.4.2 Perceived Trustfulness and Perceived Intimacy 57 4.4.3 Predictive Power of Corresponding Variables 58 4.4.4 Linguistic Factors Affecting User Perception 58 4.5 Implications 60 5 Study 2. Linguistic Characteristics to Consider When Applying Close Person’s Persona to a Text-based Agent 63 5.1 Related Work 64 5.1.1 Linguistic Characteristics and Persona Perception 64 5.1.2 Language Component 66 5.2 Research Questions 68 5.3 Method 69 5.3.1 Modified Wizard of Oz Study 69 5.3.2 Survey 72 5.4 Results 73 5.4.1 Linguistic Characteristics 73 5.4.2 Priority of Linguistic Characteristics 80 5.4.3 Differences between language Component 82 5.5 Implications 82 6 Study3.Implementation on Lifestyle Domains 85 6.1 Related Work 86 6.1.1 Family as Effective Healthcare Provider 86 6.1.2 Chatbots Promoting Healthy Lifestyle 87 6.2 Research questions 94 6.3 Implementing Persona of Family Member 95 6.3.1 Domains of Implementation 96 6.3.2 Measurements Used in the Study 97 6.4 Experiment 1: Food Journaling Chatbot 100 6.4.1 Method 100 6.4.2 Results 111 6.5 Experiment 2: Physical Activity Intervention 128 6.5.1 Method 131 6.5.2 Results 140 6.6 Experiment 3: Chatbot for Coping Stress 149 6.6.1 Method 151 6.6.2 Results 158 6.7 Implications from Domain Experiments 169 6.7.1 Comparing User Experience 170 6.7.2 Comparing User Perception 174 6.7.3 Implications from Study 3 183 7 Discussion 192 7.1 Design Guidelines 193 7.2 Ethical Considerations 200 7.3 Limitations 206 8 Conclusion 210 References 212 Appendix 252 국문초록 262박

A multilingual neural coaching model with enhanced long-term dialogue structure

In this work we develop a fully data-driven conversational agent capable of carrying out motivational coach- ing sessions in Spanish, French, Norwegian, and English. Unlike the majority of coaching, and in general well-being related conversational agents that can be found in the literature, ours is not designed by hand- crafted rules. Instead, we directly model the coaching strategy of professionals with end users. To this end, we gather a set of virtual coaching sessions through a Wizard of Oz platform, and apply state of the art Natural Language Processing techniques. We employ a transfer learning approach, pretraining GPT2 neural language models and fine-tuning them on our corpus. However, since these only take as input a local dialogue history, a simple fine-tuning procedure is not capable of modeling the long-term dialogue strategies that appear in coaching sessions. To alleviate this issue, we first propose to learn dialogue phase and scenario embeddings in the fine-tuning stage. These indicate to the model at which part of the dialogue it is and which kind of coaching session it is carrying out. Second, we develop a global deep learning system which controls the long-term structure of the dialogue. We also show that this global module can be used to visualize and interpret the decisions taken by the the conversational agent, and that the learnt representations are comparable to dialogue acts. Automatic and human evaluation show that our proposals serve to improve the baseline models. Finally, interaction experiments with coaching experts indicate that the system is usable and gives rise to positive emotions in Spanish, French and English, while the results in Norwegian point out that there is still work to be done in fully data driven approaches with very low resource languages.This work has been partially funded by the Basque Government under grant PRE_2017_1_0357 and by the European Union’s Horizon 2020 research and innovation programme under grant agreement No. 769872

Towards structured neural spoken dialogue modelling.

195 p.In this thesis, we try to alleviate some of the weaknesses of the current approaches to dialogue modelling,one of the most challenging areas of Artificial Intelligence. We target three different types of dialogues(open-domain, task-oriented and coaching sessions), and use mainly machine learning algorithms to traindialogue models. One challenge of open-domain chatbots is their lack of response variety, which can betackled using Generative Adversarial Networks (GANs). We present two methodological contributions inthis regard. On the one hand, we develop a method to circumvent the non-differentiability of textprocessingGANs. On the other hand, we extend the conventional task of discriminators, which oftenoperate at a single response level, to the batch level. Meanwhile, two crucial aspects of task-orientedsystems are their understanding capabilities because they need to correctly interpret what the user islooking for and their constraints), and the dialogue strategy. We propose a simple yet powerful way toimprove spoken understanding and adapt the dialogue strategy by explicitly processing the user's speechsignal through audio-processing transformer neural networks. Finally, coaching dialogues shareproperties of open-domain and task-oriented dialogues. They are somehow task-oriented but, there is norush to complete the task, and it is more important to calmly converse to make the users aware of theirown problems. In this context, we describe our collaboration in the EMPATHIC project, where a VirtualCoach capable of carrying out coaching dialogues about nutrition was built, using a modular SpokenDialogue System. Second, we model such dialogues with an end-to-end system based on TransferLearning

Designing, Developing, Evaluating, and Implementing a Smartphone-Delivered, Rule-Based Conversational Agent (DISCOVER): Development of a Conceptual Framework

Background: Conversational agents (CAs), also known as chatbots, are computer programs that simulate human conversations by using predetermined rule-based responses or artificial intelligence algorithms. They are increasingly used in health care, particularly via smartphones. There is, at present, no conceptual framework guiding the development of smartphone-based, rule-based CAs in health care. To fill this gap, we propose structured and tailored guidance for their design, development, evaluation, and implementation. Objective: The aim of this study was to develop a conceptual framework for the design, evaluation, and implementation of smartphone-delivered, rule-based, goal-oriented, and text-based CAs for health care. Methods: We followed the approach by Jabareen, which was based on the grounded theory method, to develop this conceptual framework. We performed 2 literature reviews focusing on health care CAs and conceptual frameworks for the development of mobile health interventions. We identified, named, categorized, integrated, and synthesized the information retrieved from the literature reviews to develop the conceptual framework. We then applied this framework by developing a CA and testing it in a feasibility study. Results: The Designing, Developing, Evaluating, and Implementing a Smartphone-Delivered, Rule-Based Conversational Agent (DISCOVER) conceptual framework includes 8 iterative steps grouped into 3 stages, as follows: design, comprising defining the goal, creating an identity, assembling the team, and selecting the delivery interface; development, including developing the content and building the conversation flow; and the evaluation and implementation of the CA. They were complemented by 2 cross-cutting considerations-user-centered design and privacy and security-that were relevant at all stages. This conceptual framework was successfully applied in the development of a CA to support lifestyle changes and prevent type 2 diabetes. Conclusions: Drawing on published evidence, the DISCOVER conceptual framework provides a step-by-step guide for developing rule-based, smartphone-delivered CAs. Further evaluation of this framework in diverse health care areas and settings and for a variety of users is needed to demonstrate its validity. Future research should aim to explore the use of CAs to deliver health care interventions, including behavior change and potential privacy and safety concerns. Keywords: chatbot; conceptual framework; conversational agent; digital health; mHealth; mobile health; mobile phone

Is it COVID or a Cold? An Investigation of the Role of Social Presence, Trust, and Persuasiveness for Users\u27 Intention to Comply with COVID-19 Chatbots

The COVID-19 pandemic challenged the existing healthcare system by demanding potential patients to self-diagnose and self-test a potential virus contraction. In this process, some individuals need help and guidance. However, the previous modus-operandi to go to a physician is no longer viable because of the limited capacity and danger of spreading the virus. Hence, digital means had to be developed to help and inform individuals at home, such as conversational agents (CA). The human-like design and perceived social presence of such a CA are central to attaining users’ compliance. Against this background, we surveyed 174 users of a commercial COVID-19 chatbot to investigate the role of perceived social presence. Our results provide support that the perceived social presence of chatbots leads to higher levels of trust, which are a driver of compliance. In contrast, perceived persuasiveness seems to have no significant effect