Usability, Acceptability, and Effectiveness of Web-Based Conversational Agents to Facilitate Problem Solving in Older Adults: Controlled Study

Abstract

Background The usability and effectiveness of conversational agents (chatbots) that deliver psychological therapies is under-researched. Objective This study aimed to compare the system usability, acceptability, and effectiveness in older adults of 2 Web-based conversational agents that differ in theoretical orientation and approach. Methods In a randomized study, 112 older adults were allocated to 1 of the following 2 fully automated interventions: Manage Your Life Online (MYLO; ie, a chatbot that mimics a therapist using a method of levels approach) and ELIZA (a chatbot that mimics a therapist using a humanistic counseling approach). The primary outcome was problem distress and resolution, with secondary outcome measures of system usability and clinical outcome. Results MYLO participants spent significantly longer interacting with the conversational agent. Posthoc tests indicated that MYLO participants had significantly lower problem distress at follow-up. There were no differences between MYLO and ELIZA in terms of problem resolution. MYLO was rated as significantly more helpful and likely to be used again. System usability of both the conversational agents was associated with helpfulness of the agents and the willingness of the participants to reuse. Adherence was high. A total of 12% (7/59) of the MYLO group did not carry out their conversation with the chatbot. Conclusions Controlled studies of chatbots need to be conducted in clinical populations across different age groups. The potential integration of chatbots into psychological care in routine services is discussed.

Feasibility, Usability, and Effectiveness of a Machine Learning–Based Physical Activity Chatbot: Quasi-Experimental Study

“…For most usability and acceptability indicators, less than half of the participants provided answers in favor of the chatbot. This level of usability (SUS scores of 61.6) is comparable with the 2 psychological therapy chatbots with SUS scores of 63.6 and 57.0 [ 34 ] but lower than that of asthma management (SUS score of about 83) [ 35 ] and depression prevention chatbots (SUS score of approximately 75.7) [ 36 ]. A study by Nadarzynski et al [ 37 ] also showed higher acceptability, with 67% of participants who would like to use a health chatbot.…”

Technology for Healthy Aging and Wellbeing: Co-producing Solutions

“…The successful inclusion of measures such as the adapted SUS ( Bennion et al, 2020 ) in co-production is important, particularly for iterative projects requiring users to evaluate technology solutions over time. In the second workshop, mean SUS scores helped highlight the usability of the technologies within the target demographic, while the individual questions of the scale helped generate discussion about each technology.…”

“…Abridged version of the System Usability Scale (SUS; Brooke, 1996 ) which measures perceived usability – as used in other older adult studies relating to THAW ( Bennion et al, 2020 ). A SUS score above 68 represents an above-average usability ( Brooke, 2013 ).…”

Aging Adults’ Motivation to Use Embodied Conversational Agents in Instrumental Activities of Daily Living: Results of Latent Profile Analysis

“…In clinical settings, they have already been used to support activities in physical health (e.g., adherence to treatment, diet, and exercise behaviors) as well as psychological and social health (e.g., depression [ 22 ]; dementia [ 23 ]). Although scarce and in its early stages, the existing research generally also shows promising results related to their effectiveness for ageing adults (e.g., [ 24 , 25 ]). Despite the potential benefits, the currently available technologies are not widely adopted, and interest in them usually fades after the initial stages, especially among older adults [ 26 ].…”