It's only a computer: the impact of human-agent interaction in clinical interviews

Research has begun to explore the use of virtual humans (VHs) in medical interviews. When designed as supportive and "safe" interaction partners, VHs may improve such screenings by encouraging patients to disclose more personal information [2-3]. In medical contexts, patients often feel resistance to self-disclosure and engage in impression management to be viewed more positively by healthcare providers. This paper provides the first empirical evidence that VHs can reduce such resistance and impression management. In the context of health-screening interviews, we report a study in which participants interacted with a VH that was either teleo-operated by humans (Wizard-of-Oz) or fully-automated (AI). Independently, we manipulated whether participants believed the VH was controlled by humans or automation. As predicted, participants who believed they were interacting with a computer reported lower resistance to self-disclosure, lower impression management and higher system usability than those who believed they were interacting with a human operator. Whether the virtual human was actually operated by a human or AI only affected ratings of the system's usability. These results suggest that automated VHs can help overcome a significant barrier to obtaining truthful patient information in medical domains.

[1]  Reginald P. Baker,et al.  New Technology in Survey Research: Computer-Assisted Personal Interviewing (CAPI) , 1992 .

[2]  P. Barglow,et al.  Self-disclosure in psychotherapy. , 2005, American journal of psychotherapy.

[3]  Kate Fannon.  ‘Needle Stick’ – a role-play simulation: transformative learning in complex dynamic social systems , 2004 .

[4]  Timothy W. Bickmore,et al.  Social desirability bias and engagement in systems designed for long-term health tracking , 2013 .

[5]  Owen Thornberry,et al.  Use of Capi With the U.S. National Health Interview Survey , 1991 .

[6]  Jeremy N. Bailenson,et al.  The Effect of Behavioral Realism and Form Realism of Real-Time Avatar Faces on Verbal Disclosure, Nonverbal Disclosure, Emotion Recognition, and Copresence in Dyadic Interaction , 2006, PRESENCE: Teleoperators and Virtual Environments.

[7]  Rosalind W. Picard,et al.  Establishing the computer-patient working alliance in automated health behavior change interventions. , 2005, Patient education and counseling.

[8]  R. Carleton,et al.  Addressing revisions to the Brief Fear of Negative Evaluation scale: measuring fear of negative evaluation across anxiety and mood disorders. , 2011, Journal of anxiety disorders.

[9]  R. Frankel,et al.  The effect of physician behavior on the collection of data. , 1984, Annals of internal medicine.

[10]  Ning Wang,et al.  Using Social Agents to Explore Theories of Rapport and Emotional Resonance , 2014 .

[11]  Tom W. Smith,et al.  ASKING SENSITIVE QUESTIONS THE IMPACT OF DATA COLLECTION MODE, QUESTION FORMAT, AND QUESTION CONTEXT , 1996 .

[12]  Suzanne P. Weisband,et al.  Self disclosure on computer forms: meta-analysis and implications , 1996, CHI.

[13]  A. Joinson.  Self‐disclosure in computer‐mediated communication: The role of self‐awareness and visual anonymity , 2001 .

[14]  Judith A. Hall,et al.  Physicians’ interviewing styles and medical information obtained from patients , 1987, Journal of General Internal Medicine.

[15]  References , 1971 .

[16]  J. B. Brooke,et al.  SUS: A 'Quick and Dirty' Usability Scale , 1996 .

[17]  B. J. Fogg,et al.  Can computer personalities be human personalities? , 1995, Int. J. Hum. Comput. Stud..

[18]  P Maguire,et al.  Helping cancer patients disclose their concerns. , 1996, European journal of cancer.

[19]  Jessica Bagger,et al.  The Balanced Inventory of Desirable Responding (BIDR) , 2007 .

[20]  Ning Wang,et al.  Creating Rapport with Virtual Agents , 2007, IVA.

[21]  D. Gustafson,et al.  A computer interview for suicide-risk prediction. , 1973, The American journal of psychiatry.

[22]  B. Thomas,et al.  Usability Evaluation In Industry , 1996 .

[23]  Andreas Beckenbach,et al.  Computer-Assisted Questioning: the New Survey Methods in the Perception of the Respondents , 1995 .

[24]  Judith T. Lessler,et al.  Effects of mode of administration and wording on reporting of drug use; DHHS Pub. No. (ADM) 92-1929; Technical paper 8 , 1991 .

[25]  Robin M. Kowalski,et al.  Impression management: A literature review and two-component model. , 1990 .