Identifying Which Relational Cues Users Find Helpful to Allow Tailoring of e-Coach Dialogues

Relational cues are extracts from actual verbal dialogues that help build the therapist–patient working alliance and stronger bond through the depiction of empathy, respect and openness. ECAs (Embodied conversational agents) are human-like virtual agents that exhibit verbal and non-verbal behaviours. In the digital health space, ECAs act as health coaches or experts. ECA dialogues have previously been designed to include relational cues to motivate patients to change their current behaviours and encourage adherence to a treatment plan. However, there is little understanding of who finds specific relational cues delivered by an ECA helpful or not. Drawing the literature together, we have categorised relational cues into empowering, working alliance, affirmative and social dialogue. In this study, we have embedded the dialogue of Alex, an ECA, to encourage healthy behaviours with all the relational cues (empathic Alex) or with none of the relational cues (neutral Alex). A total of 206 participants were randomly assigned to interact with either empathic or neutral Alex and were also asked to rate the helpfulness of selected relational cues. We explore if the perceived helpfulness of the relational cues is a good predictor of users’ intention to change the recommended health behaviours and/or development of a working alliance. Our models also investigate the impact of individual factors, including gender, age, culture and personality traits of the users. The idea is to establish whether a certain group of individuals having similarities in terms of individual factors found a particular cue or group of cues helpful. This will establish future versions of Alex and allow Alex to tailor its dialogue to specific groups, as well as help in building ECAs with multiple personalities and roles.