Acceptability of an Interactive Computer-Animated Agent to Promote Patient-Provider Communication About Breast Density: a Mixed Method Pilot Study

Gunn, Christine M.; Maschke, Ariel; Bickmore, Timothy; Kennedy, Mark; Hopkins, Margaret; Fishman, Michael; Warner, Erica T.

doi:10.1007/s11606-019-05622-2

Cited by 12 publications

(24 citation statements)

References 52 publications

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“…Of the 53 articles, 23 explicitly described their VH design process [ 55 , 58 , 59 , 68 , 71 , 73 , 75 , 78 , 80 , 82 - 87 , 89 - 93 , 95 , 97 , 104 ]. The most common design approaches were collaboration with domain experts, qualitative observation of similar human-human interactions, and adoption of public health and governmental guidelines.…”

Section: Resultsmentioning

confidence: 99%

“…The most common design approaches were collaboration with domain experts, qualitative observation of similar human-human interactions, and adoption of public health and governmental guidelines. Some studies conducted focus groups and one-to-one interviews with target users [ 59 , 68 , 90 , 92 , 97 , 104 ]. Others informed their design decisions from prior literature or theoretical frameworks [ 58 , 59 , 68 , 71 , 90 , 91 , 93 ].…”

Section: Resultsmentioning

confidence: 99%

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Computer-Controlled Virtual Humans in Patient-Facing Systems: Systematic Review and Meta-Analysis

Chattopadhyay¹,

Ma²,

Sharifi³

et al. 2020

J Med Internet Res

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Background Virtual humans (VH) are computer-generated characters that appear humanlike and simulate face-to-face conversations using verbal and nonverbal cues. Unlike formless conversational agents, like smart speakers or chatbots, VH bring together the capabilities of both a conversational agent and an interactive avatar (computer-represented digital characters). Although their use in patient-facing systems has garnered substantial interest, it is unknown to what extent VH are effective in health applications. Objective The purpose of this review was to examine the effectiveness of VH in patient-facing systems. The design and implementation characteristics of these systems were also examined. Methods Electronic bibliographic databases were searched for peer-reviewed articles with relevant key terms. Studies were included in the systematic review if they designed or evaluated VH in patient-facing systems. Of the included studies, studies that used a randomized controlled trial to evaluate VH were included in the meta-analysis; they were then summarized using the PICOTS framework (population, intervention, comparison group, outcomes, time frame, setting). Summary effect sizes, using random-effects models, were calculated, and the risk of bias was assessed. Results Among the 8,125 unique records identified, 53 articles describing 33 unique systems, were qualitatively, systematically reviewed. Two distinct design categories emerged — simple VH and VH augmented with health sensors and trackers. Of the 53 articles, 16 (26 studies) with 44 primary and 22 secondary outcomes were included in the meta-analysis. Meta-analysis of the 44 primary outcome measures revealed a significant difference between intervention and control conditions, favoring the VH intervention (SMD = .166, 95% CI .039-.292, P=.012), but with evidence of some heterogeneity, I2=49.3%. There were more cross-sectional (k=15) than longitudinal studies (k=11). The intervention was delivered using a personal computer in most studies (k=18), followed by a tablet (k=4), mobile kiosk (k=2), head-mounted display (k=1), and a desktop computer in a community center (k=1). Conclusions We offer evidence for the efficacy of VH in patient-facing systems. Considering that studies included different population and outcome types, more focused analysis is needed in the future. Future studies also need to identify what features of virtual human interventions contribute toward their effectiveness.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Computer-Controlled Virtual Humans in Patient-Facing Systems: Systematic Review and Meta-Analysis

Chattopadhyay¹,

Ma²,

Sharifi³

et al. 2020

J Med Internet Res

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“…Data on brochure acceptability and satisfaction were collected from 44 English-speaking women ages 40–75 recruited from a safety-net hospital in Boston, MA. Participants evaluated the brochure as part of a 60-90-min focus group in which they also provided feedback on a computer-animated agent that provided breast density education [ 19 ]. Seven groups with 2–6 women each were held at either Boston Medical Center or a community site.…”

Section: Methodsmentioning

confidence: 99%

Evaluation of existing patient educational materials and development of a brochure for women with dense breasts

et al. 2020

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Objectives: In this pilot study, we developed and assessed acceptability of a brochure for women with dense breasts. Material and methods: We measured Flesch-Kincaid Readability of 22 existing breast density educational materials. We then developed a brochure and tested it in two populations of women: 44 safety net hospital patients and 13 Breast Cancer Surveillance Consortium stakeholders. Results: Average grade score of existing materials was 10.0 (range: 5.5e12.7). Our brochure had a grade score of 5.9, and patients reported it was easy to understand. Conclusion: Our plain language brochure could improve patient understanding following mandatory dense breast notification.

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“…Despite their artificial nature, VHs are largely perceived as social actors in part because of their ability to respond realistically to external cues, including users' affective states (Nass and Moon, 2000;Becker-Asano and Wachsmuth, 2010). This capability has contributed to their integration into social environments, serving as educators in classrooms (Li et al, 2016), companions in homes (Krämer et al, 2015), and medical staff in hospitals (Gunn et al, 2020), among others. Yet, studies on the efficacy of VHs in such contexts have almost exclusively focused on how agent-specific factors, such as dialogue structure and appearance, contribute to desired social outcomes (e.g., see Chattopadhyay et al, 2020).…”

Section: Introductionmentioning

confidence: 99%

Copresence With Virtual Humans in Mixed Reality: The Impact of Contextual Responsiveness on Social Perceptions

Pimentel

Vinkers

2021

Front. Robot. AI

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Virtual humans (VHs)—automated, three-dimensional agents—can serve as realistic embodiments for social interactions with human users. Extant literature suggests that a user’s cognitive and affective responses toward a VH depend on the extent to which the interaction elicits a sense of copresence, or the subjective “sense of being together.” Furthermore, prior research has linked copresence to important social outcomes (e.g., likeability and trust), emphasizing the need to understand which factors contribute to this psychological state. Although there is some understanding of the determinants of copresence in virtual reality (VR) (cf. Oh et al., 2018), it is less known what determines copresence in mixed reality (MR), a modality wherein VHs have unique access to social cues in a “real-world” setting. In the current study, we examined the extent to which a VH’s responsiveness to events occurring in the user’s physical environment increased a sense of copresence and heightened affective connections to the VH. Participants (N = 65) engaged in two collaborative tasks with a (nonspeaking) VH using an MR headset. In the first task, no event in the participant’s physical environment would occur, which served as the control condition. In the second task, an event in the participants’ physical environment occurred, to which the VH either responded or ignored depending on the experimental condition. Copresence and interpersonal evaluations of the VHs were measured after each collaborative task via self-reported measures. Results show that when the VH responded to the physical event, participants experienced a significant stronger sense of copresence than when the VH did not respond. However, responsiveness did not elicit more positive evaluations toward the VH (likeability and emotional connectedness). This study is an integral first step in establishing how and when affective and cognitive components of evaluations during social interactions diverge. Importantly, the findings suggest that feeling copresence with VH in MR is partially determined by the VHs’ response to events in the actual physical environment shared by both interactants.

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Acceptability of an Interactive Computer-Animated Agent to Promote Patient-Provider Communication About Breast Density: a Mixed Method Pilot Study

Cited by 12 publications

References 52 publications

Computer-Controlled Virtual Humans in Patient-Facing Systems: Systematic Review and Meta-Analysis

Computer-Controlled Virtual Humans in Patient-Facing Systems: Systematic Review and Meta-Analysis

Evaluation of existing patient educational materials and development of a brochure for women with dense breasts

Copresence With Virtual Humans in Mixed Reality: The Impact of Contextual Responsiveness on Social Perceptions

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