ArticleJMIR human factors2021
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.
Article in JMIR human factors, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 3 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
12 citing papers in PubMed, 3 syntheses or guidelines pooled it, 20 citations in OpenAlex.
- Engagement With Conversational Agent-Enabled Interventions in Cardiometabolic Disease Self-Management: Systematic Review.JMIR mHealth and uHealth · 2025Pooled it
- User and Provider Experiences With Health Education Chatbots: Qualitative Systematic Review.JMIR human factors · 2025Pooled it
- Attrition in Conversational Agent-Delivered Mental Health Interventions: Systematic Review and Meta-Analysis.Journal of medical Internet research · 2024Pooled it
- Conversational Agents for Asthma and Chronic Obstructive Pulmonary Disease Management: Scoping Review.Journal of medical Internet research · 2026Article
- Mapping behavior change techniques and health data combinations in virtual agents for chronic condition management: A systematic scoping review.PLOS digital health · 2026Article
- Embodied Intelligence Applications in Health Care Populations: Scoping Review.Journal of medical Internet research · 2026Article
- Article
- The State of the Art of eHealth Self-Management Interventions for People With Chronic Obstructive Pulmonary Disease: Scoping Review.Journal of medical Internet research · 2025Article
- Engagement With Conversational Agent-Enabled Interventions in Cardiometabolic Disease Management: Protocol for a Systematic Review.JMIR research protocols · 2024Article
- Embodied Conversational Agents for Chronic Diseases: Scoping Review.Journal of medical Internet research · 2024Article
- Experiences and perceptions of final-year nursing students of using a chatbot in a simulated emergency situation: A qualitative study.Journal of nursing management · 2022Article
- Exploring the characteristics of conversational agents in chronic disease management interventions: A scoping review.Digital healthArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEmbodied 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.
objectiveThis 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.
methodsWe 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.
resultsEleven 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.
conclusionsThis 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 registrationNetherlands Trial Register NL6480; https://www.trialregister.nl/trial/6480.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.