Acceptability of an embodied conversational agent for type 2 diabetes self-management education and support via a smartphone app: A mixed-methods study

Abstract

Background and Aims: Embodied conversational agents (ECAs) have the potential to deliver self‐management support to people with type 2 diabetes (T2D). We evaluated the acceptability of an ECA, ‘Laura’ (see figure) for delivering self‐management support in the ‘My Diabetes Coach (MDC)’ smartphone app.

Methods: In a randomised controlled trial, participants allocated to use the MDC app completed a 6‐month post‐baseline survey assessing attitudes to and interactions with Laura. In‐depth qualitative interviews further explored users' experiences of Laura. Using an explanatory mixed‐methods approach, we analysed survey responses with descriptive statistics and integrated these findings with a thematic analysis of the interview data.

Results: Of the 67 survey respondents, 33 (50%) were women, aged 57 ± 9 years. Most (77%) endorsed positive descriptions of Laura (e.g. competent) and their reactions, following interactions with her (e.g. motivated). Fewer respondents (35%) described Laura negatively (e.g. boring) and a minority (12%) reported negative reactions to interactions with Laura (e.g. frustration). Interview participants (N = 19) included 8 (42%) women, aged 60 ± 8 years. Four themes emerged regarding Laura's acceptability: 1) Laura's perceived role as a “friendly coach”; 2) Laura's “value add” in providing motivational and emotional support; 3) Laura's “human‐like” nature being preferred to a non‐human character; 4) Dissonance in Laura's speech and body language is frustrating.