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“I Am Scared of Viruses, Too” - Studying the Impact of Self-disclosure in Chatbots for Health-Related Applications

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Human-Computer Interaction. User Experience and Behavior (HCII 2022)

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Abstract

Chatbots are gaining popularity in the healthcare sector, as they provide easy access to information while supporting both users and medical personnel. While some users might be reluctant to talk to a chatbot about their personal health, as this is a sensitive subject area, different factors can contribute to more successful interactions between chatbots and humans - such as self-disclosure. Previous studies within human-machine-interaction have shown that self-disclosure from a chatbot or conversational agent leads to better relationship and rapport building in the interaction. In this work, we investigated if this also holds true for chatbots in health-related applications - e.g., the chatbot uttering “I am scared of viruses, too”. We conducted two studies with two different chatbots and specific use cases, one health assessment chatbot and one health information chatbot. For both use cases, we compared the non self-disclosing version with the self-disclosing version of each chatbot. Overall, both studies show that the integration of self-disclosure into the conversation between chatbots and humans in the context of health-related applications has a positive effect on the rapport building between chatbot and human. We also found that there is a difference in the effect of the introduced self-disclosure depending on the specific context in which the chatbot is used.

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References

  1. Altman, I.: Reciprocity of interpersonal exchange. J. Theory Soc. Behav. 3(2), 249–261 (1973). https://doi.org/10.1111/j.1468-5914.1973.tb00325.x

    Article  Google Scholar 

  2. Altman, I., Taylor, D.A.: Social Penetration: The Development of Interpersonal Relationships. Rinehart & Winston, Holt (1973)

    Google Scholar 

  3. Amtmann, D., et al.: Development of a promis item bank to measure pain interference. Pain 150(1), 173–182 (2010). https://doi.org/10.1016/j.pain.2010.04.025

    Article  Google Scholar 

  4. Argyle, M.: The biological basis of rapport. Psychol. Inq. 1(4), 297–300 (1990). https://doi.org/10.1207/s15327965pli0104_3

    Article  Google Scholar 

  5. Black, N.: Patient reported outcome measures could help transform healthcare. BMJ 346, f167 (2013). https://doi.org/10.1136/bmj.f167

    Article  Google Scholar 

  6. Cella, D.: PROMIS Health Organization Measuring Quality of Life in Neurological Disorders: Final Report of the Neuro-QoL Study (2018)

    Google Scholar 

  7. Choi, Y.H., Bazarova, N.N.: Self-disclosure characteristics and motivations in social media: extending the functional model to multiple social network sites. Hum. Commun. Res. 41(4), 480–500 (2015). https://doi.org/10.1111/hcre.12053

    Article  Google Scholar 

  8. Fan, X., Chao, D., Zhang, Z., Wang, D., Li, X., Tian, F.: Utilization of self-diagnosis health chatbots in real-world settings: case study. J. Med. Internet Res. 23(1), e19928 (2021). https://doi.org/10.2196/19928

    Article  Google Scholar 

  9. Fitzpatrick, K.K., 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 Mental Health 4(2), e7785 (2017)

    Article  Google Scholar 

  10. Gratch, J., Wang, N., Gerten, J., Fast, E., Duffy, R.: Creating rapport with virtual agents. In: Pelachaud, C., Martin, J.-C., André, E., Chollet, G., Karpouzis, K., Pelé, D. (eds.) IVA 2007. LNCS (LNAI), vol. 4722, pp. 125–138. Springer, Heidelberg (2007). https://doi.org/10.1007/978-3-540-74997-4_12

  11. Hanmer, J., Jensen, R.E., Rothrock, N.: A reporting checklist for HealthMeasures’ patient-reported outcomes: ASCQ-Me, Neuro-QoL, NIH Toolbox, and PROMIS. J. Patient-Rep. Outcomes 4(1), 1–7 (2020). https://doi.org/10.1186/s41687-020-0176-4

  12. Ho, A., Hancock, J., Miner, A.S.: Psychological, relational, and emotional effects of self-disclosure after conversations with a chatbot. J. Commun. 68(4), 712–733 (2018). https://doi.org/10.1093/joc/jqy026

  13. Huang, L., Morency, L.-P., Gratch, J.: Virtual rapport 2.0. In: Vilhjálmsson, H.H., Kopp, S., Marsella, S., Thórisson, K.R. (eds.) IVA 2011. LNCS (LNAI), vol. 6895, pp. 68–79. Springer, Heidelberg (2011). https://doi.org/10.1007/978-3-642-23974-8_8

  14. Ignatius, E., Kokkonen, M.: Factors contributing to verbal self-disclosure. Nordic Psychol. 59(4), 362–391 (2007). https://doi.org/10.1027/1901-2276.59.4.362

  15. Kang, S.H., Gratch, J.: People like virtual counselors that highly-disclose about themselves. Annu. Rev. Cyberther. Telemed. 2011, 143–148 (2011). https://doi.org/10.3233/978-1-60750-766-6-143

  16. Kawasaki, M., Yamashita, N., Lee, Y.C., Nohara, K.: Assessing users’ mental status from their journaling behavior through chatbots. In: Proceedings of the 20th ACM International Conference on Intelligent Virtual Agents, no. 32, pp. 1–8. Association for Computing Machinery, New York (2020)

    Google Scholar 

  17. Keller, S.D., Yang, M., Treadwell, M.J., Werner, E.M., Hassell, K.L.: Patient reports of health outcome for adults living with sickle cell disease: development and testing of the ASCQ-Me item banks. Health Qual. Life Outcomes 12(1), 125 (2014). https://doi.org/10.1186/s12955-014-0125-0

  18. Laranjo, L., et al.: Conversational agents in healthcare: a systematic review. J. Am. Med. Inf. Assoc. 25(9), 1248–1258 (2018)

    Google Scholar 

  19. Lee, Y.C., Yamashita, N., Huang, Y.: Designing a chatbot as a mediator for promoting deep self-disclosure to a real mental health professional. Proc. ACM Hum. Comput. Interact. 4(CSCW1), 1–27 (2020). https://doi.org/10.1145/3392836

  20. Lee, Y.C., Yamashita, N., Huang, Y., Fu, W.: “I hear you, i feel you”: encouraging deep self-disclosure through a chatbot. In: Proceedings of the 2020 CHI Conference on Human Factors in Computing Systems (CHI 2020), pp. 1–12. Association for Computing Machinery, New York (2020). https://doi.org/10.1145/3313831.3376175

  21. Lucas, G.M., Gratch, J., King, A., Morency, L.P.: It’s only a computer: virtual humans increase willingness to disclose. Comput. Hum. Behav. 37, 94–100 (2014). https://doi.org/10.1016/j.chb.2014.04.043

  22. Mai, V., Wolff, A., Richert, A., Preusser, I.: Accompanying reflection processes by an AI-based StudiCoachBot: a study on rapport building in human-machine coaching using self disclosure. In: Stephanidis, C., et al.: (eds.) HCII 2021. LNCS, vol. 13096, pp. 439–457. Springer, Cham (2021). https://doi.org/10.1007/978-3-030-90328-2_29

  23. Moon, Y.: Intimate exchanges: using computers to elicit self-disclosure from consumers. J. Consum. Res. 26(4), 323–339 (2000). https://doi.org/10.1086/209566

  24. Nadarzynski, T., Miles, O., Cowie, A., Ridge, D.: Acceptability of artificial intelligence (AI)-led chatbot services in healthcare: a mixed-methods study. Digit. Health 5, 2055207619871808 (2019). https://doi.org/10.1177/2055207619871808

  25. Ni, L., Lu, C., Liu, N., Liu, J.: MANDY: towards a smart primary care chatbot application. In: Chen, J., Theeramunkong, T., Supnithi, T., Tang, X. (eds.) KSS 2017. CCIS, vol. 780, pp. 38–52. Springer, Singapore (2017). https://doi.org/10.1007/978-981-10-6989-5_4

  26. Palanica, A., Flaschner, P., Thommandram, A., Li, M., Fossat, Y.: Physicians’ perceptions of chatbots in health care: cross-sectional web-based survey. J. Med. Internet Res. 21(4), e12887 (2019). https://doi.org/10.2196/12887

  27. Ravichander, A., Black, A.W.: An empirical study of self-disclosure in spoken dialogue systems. In: Proceedings of the 19th Annual SIGdial Meeting on Discourse and Dialogue, pp. 253–263. Association for Computational Linguistics, Melbourne (2018). https://doi.org/10.18653/v1/W18-5030

  28. Skjuve, M., Brandtzæg, P.B.: Chatbots as a New User Interface for Providing Health Information to Young People (2018)

    Google Scholar 

  29. van Uffelen, L., van Waterschoot, J., Theune, M.: Show me yours if i show you mine: self-disclosure in conversational agents. In: Proceedings Robo-Identity 2021. Association for Computing Machinery (ACM) (2021)

    Google Scholar 

  30. Vaidyam, A.N., Wisniewski, H., Halamka, J.D., Kashavan, M.S., Torous, J.B.: Chatbots and conversational agents in mental health: a review of the psychiatric landscape. Canadian J. Psychiatry 64(7), 456–464 (2019). https://doi.org/10.1177/0706743719828977

  31. van der Lee, C., Croes, E., de Wit, J., Antheunis, M.: Digital Confessions: Exploring the Role of Chatbots in Self-Disclosure (2019)

    Google Scholar 

  32. von der Pütten, A.M., Hoffmann, L., Klatt, J., Krämer, N.C.: Quid pro quo? Reciprocal self-disclosure and communicative accomodation towards a virtual interviewer. In: Vilhjálmsson, H.H., Kopp, S., Marsella, S., Thórisson, K.R. (eds.) IVA 2011. LNCS (LNAI), vol. 6895, pp. 183–194. Springer, Heidelberg (2011). https://doi.org/10.1007/978-3-642-23974-8_20

  33. Zhao, R., Papangelis, A., Cassell, J.: Towards a dyadic computational model of rapport management for human-virtual agent interaction. In: Bickmore, T., Marsella, S., Sidner, C. (eds.) IVA 2014. LNCS (LNAI), vol. 8637, pp. 514–527. Springer, Cham (2014). https://doi.org/10.1007/978-3-319-09767-1_62

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Acknowledgements

We would like to thank Marcel Germer, Sebastian Hell, Leon Hommel, Martin Junge, Marvin Kindermann, Andrea Linden, Christina Löcker, Johannes Sittel and Tim Wittig for their invaluable contributions to the studies described in this paper.

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Authors and Affiliations

  1. Cologne Cobots Lab, TH Köln - University of Applied Sciences, Cologne, Germany

    Caterina Neef & Anja Richert

  2. Faculty of Process Engineering, Energy and Mechanical Systems, TH Köln - University of Applied Sciences, Cologne, Germany

    Caterina Neef, Vanessa Mai & Anja Richert

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  1. Caterina Neef
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  2. Vanessa Mai
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Correspondence to Caterina Neef .

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  1. The Open University of Japan, Chiba, Japan

    Masaaki Kurosu

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Neef, C., Mai, V., Richert, A. (2022). “I Am Scared of Viruses, Too” - Studying the Impact of Self-disclosure in Chatbots for Health-Related Applications. In: Kurosu, M. (eds) Human-Computer Interaction. User Experience and Behavior. HCII 2022. Lecture Notes in Computer Science, vol 13304. Springer, Cham. https://doi.org/10.1007/978-3-031-05412-9_35

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  • DOI: https://doi.org/10.1007/978-3-031-05412-9_35

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