Department of Communication and Cognition, Tilburg School of Humanities and Digital Sciences, Tilburg University, Tilburg, Netherlands.
Behavioral Science Institute, Radboud University, Nijmegen, Netherlands.
J Med Internet Res. 2024 Aug 6;26:e53134. doi: 10.2196/53134.
Cigarette smoking poses a major public health risk. Chatbots may serve as an accessible and useful tool to promote cessation due to their high accessibility and potential in facilitating long-term personalized interactions. To increase effectiveness and acceptability, there remains a need to identify and evaluate counseling strategies for these chatbots, an aspect that has not been comprehensively addressed in previous research.
This study aims to identify effective counseling strategies for such chatbots to support smoking cessation. In addition, we sought to gain insights into smokers' expectations of and experiences with the chatbot.
This mixed methods study incorporated a web-based experiment and semistructured interviews. Smokers (N=229) interacted with either a motivational interviewing (MI)-style (n=112, 48.9%) or a confrontational counseling-style (n=117, 51.1%) chatbot. Both cessation-related (ie, intention to quit and self-efficacy) and user experience-related outcomes (ie, engagement, therapeutic alliance, perceived empathy, and interaction satisfaction) were assessed. Semistructured interviews were conducted with 16 participants, 8 (50%) from each condition, and data were analyzed using thematic analysis.
Results from a multivariate ANOVA showed that participants had a significantly higher overall rating for the MI (vs confrontational counseling) chatbot. Follow-up discriminant analysis revealed that the better perception of the MI chatbot was mostly explained by the user experience-related outcomes, with cessation-related outcomes playing a lesser role. Exploratory analyses indicated that smokers in both conditions reported increased intention to quit and self-efficacy after the chatbot interaction. Interview findings illustrated several constructs (eg, affective attitude and engagement) explaining people's previous expectations and timely and retrospective experience with the chatbot.
The results confirmed that chatbots are a promising tool in motivating smoking cessation and the use of MI can improve user experience. We did not find extra support for MI to motivate cessation and have discussed possible reasons. Smokers expressed both relational and instrumental needs in the quitting process. Implications for future research and practice are discussed.
吸烟对公众健康构成重大风险。由于聊天机器人具有高度的可及性和促进长期个性化互动的潜力，因此它们可能成为促进戒烟的一种有用工具。为了提高其有效性和可接受性，仍需要确定和评估这些聊天机器人的咨询策略，而这一方面在以前的研究中并未得到全面解决。
本研究旨在确定有效的聊天机器人咨询策略以支持戒烟。此外，我们还试图了解吸烟者对聊天机器人的期望和体验。
本混合方法研究结合了基于网络的实验和半结构化访谈。吸烟者（N=229）与采用动机式访谈（MI）风格（n=112，48.9％）或对抗性咨询风格（n=117，51.1％）的聊天机器人进行交互。评估与戒烟相关的（即戒烟意愿和自我效能感）和用户体验相关的结果（即参与度、治疗联盟、感知同理心和互动满意度）。对 16 名参与者（每组 8 名，各占 50％）进行了半结构化访谈，并使用主题分析对数据进行了分析。
多元方差分析的结果表明，参与者对 MI（与对抗性咨询相比）聊天机器人的总体评价更高。后续的判别分析表明，对 MI 聊天机器人的更好感知主要归因于用户体验相关的结果，而与戒烟相关的结果则起到了较小的作用。探索性分析表明，两种条件下的吸烟者在与聊天机器人互动后都报告了戒烟意愿和自我效能感的提高。访谈结果说明了几个构建（例如，情感态度和参与度），这些构建解释了人们对聊天机器人的先前期望以及对聊天机器人的及时和回顾性体验。
结果证实，聊天机器人是激励戒烟的有前途的工具，使用 MI 可以改善用户体验。我们没有发现 MI 可以在激励戒烟方面提供额外的支持，并讨论了可能的原因。吸烟者在戒烟过程中表达了关系和工具性需求。讨论了对未来研究和实践的影响。
