School of Humanities and Social Sciences, Harbin Institute of Technology, Shenzhen, China.
School of Design, The Hong Kong Polytechnic University, Hong Kong, China.
J Med Internet Res. 2023 Aug 10;25:e44479. doi: 10.2196/44479.
The last decade has witnessed the rapid development of health care conversational agents (CAs); however, there are still great challenges in making health care CAs trustworthy and acceptable to patients.
Focusing on intelligent guidance CAs, a type of health care CA for web-based patient triage, this study aims to investigate how anthropomorphic cues influence patients' perceived anthropomorphism and social presence of such CAs and evaluate how these perceptions facilitate their trust-building process and acceptance behavior.
To test the research hypotheses, the video vignette methodology was used to evaluate patients' perceptions and acceptance of various intelligent guidance CAs. The anthropomorphic cues of CAs were manipulated in a 3×2 within-subject factorial experiment with 103 participants, with the factors of agent appearance (high, medium, and low anthropomorphic levels) and verbal cues (humanlike and machine-like verbal cues) as the within-subject variables.
The 2-way repeated measures ANOVA analysis indicated that the higher anthropomorphic level of agent appearance significantly increased mindful anthropomorphism (high level>medium level: 4.57 vs 4.27; P=.01; high level>low level: 4.57 vs 4.04; P<.001; medium level>low level: 4.27 vs 4.04; P=.04), mindless anthropomorphism (high level>medium level: 5.39 vs 5.01; P<.001; high level>low level: 5.39 vs 4.85; P<.001), and social presence (high level>medium level: 5.19 vs 4.83; P<.001; high level>low level: 5.19 vs 4.72; P<.001), and the higher anthropomorphic level of verbal cues significantly increased mindful anthropomorphism (4.83 vs 3.76; P<.001), mindless anthropomorphism (5.60 vs 4.57; P<.001), and social presence (5.41 vs 4.41; P<.001). Meanwhile, a significant interaction between agent appearance and verbal cues (.004) was revealed. Second, the partial least squares results indicated that privacy concerns were negatively influenced by social presence (β=-.375; t=4.494) and mindful anthropomorphism (β=-.112; t=1.970). Privacy concerns (β=-.273; t=9.558), social presence (β=.265; t=4.314), and mindless anthropomorphism (β=.405; t=7.145) predicted the trust in CAs, which further promoted the intention to disclose information (β=.675; t=21.163), the intention to continuously use CAs (β=.190; t=4.874), and satisfaction (β=.818; t=46.783).
The findings show that a high anthropomorphic level of agent appearance and verbal cues could improve the perceptions of mindful anthropomorphism and mindless anthropomorphism as well as social presence. Furthermore, mindless anthropomorphism and social presence significantly promoted patients' trust in CAs, and mindful anthropomorphism and social presence decreased privacy concerns. It is also worth noting that trust was an important antecedent and determinant of patients' acceptance of CAs, including their satisfaction, intention to disclose information, and intention to continuously use CAs.
过去十年见证了医疗保健会话代理（CA）的快速发展；然而，要使医疗保健 CA 值得患者信赖并被患者接受，仍然存在很大的挑战。
本研究聚焦于智能引导 CA，这是一种用于基于网络的患者分诊的医疗保健 CA，旨在探讨拟人化线索如何影响患者对这类 CA 的感知拟人化和社会存在感，并评估这些感知如何促进他们的信任建立过程和接受行为。
为了检验研究假设，使用视频片段方法评估了患者对各种智能引导 CA 的感知和接受程度。通过 103 名参与者的 3×2 被试内因子实验来操纵 CA 的拟人化线索，其中因素包括代理外观（高、中、低拟人化水平）和语言线索（拟人化和机器化语言线索）作为被试内变量。
2 因素重复测量方差分析表明，代理外观的高拟人化水平显著增加了有意的拟人化（高水平>中水平：4.57 比 4.27；P=.01；高水平>低水平：4.57 比 4.04；P<.001；中水平>低水平：4.27 比 4.04；P=.04）、无意识的拟人化（高水平>中水平：5.39 比 5.01；P<.001；高水平>低水平：5.39 比 4.85；P<.001；中水平>低水平：5.01 比 4.04；P=.04）和社会存在感（高水平>中水平：5.19 比 4.83；P<.001；高水平>低水平：5.19 比 4.72；P<.001），而语言线索的高拟人化水平显著增加了有意的拟人化（4.83 比 3.76；P<.001）、无意识的拟人化（5.60 比 4.57；P<.001）和社会存在感（5.41 比 4.41；P<.001）。同时，代理外观和语言线索之间存在显著的交互作用（.004）。其次，偏最小二乘结果表明，社会存在感（β=-.375；t=4.494）和有意的拟人化（β=-.112；t=1.970）对隐私关注有负面影响。隐私关注（β=-.273；t=9.558）、社会存在感（β=.265；t=4.314）和无意识的拟人化（β=.405；t=7.145）预测了对 CA 的信任，这进一步促进了披露信息的意图（β=.675；t=21.163）、持续使用 CA 的意图（β=.190；t=4.874）和满意度（β=.818；t=46.783）。
研究结果表明，代理外观和语言线索的高拟人化水平可以提高有意的拟人化和无意识的拟人化以及社会存在感的感知。此外，无意识的拟人化和社会存在感显著促进了患者对 CA 的信任，而有意的拟人化和社会存在感降低了隐私关注。值得注意的是，信任是患者接受 CA 的重要前提和决定因素，包括他们的满意度、披露信息的意图和持续使用 CA 的意图。
