TY  - JOUR
AU  - Thunström, Almira Osmanovic
AU  - Carlsen, Hanne Krage
AU  - Ali, Lilas
AU  - Larson, Tomas
AU  - Hellström, Andreas
AU  - Steingrimsson, Steinn
PY  - 2024
DA  - 2024/4/29
TI  - Usability Comparison Among Healthy Participants of an Anthropomorphic Digital Human and a Text-Based Chatbot as a Responder to Questions on Mental Health: Randomized Controlled Trial
JO  - JMIR Hum Factors
SP  - e54581
VL  - 11
KW  - chatbot
KW  - chatbots
KW  - chat-bot
KW  - chat-bots
KW  - text-only chatbot, voice-only chatbot
KW  - mental health
KW  - mental illness
KW  - mental disease
KW  - mental diseases
KW  - mental illnesses
KW  - mental health service
KW  - mental health services
KW  - interface
KW  - system usability
KW  - usability
KW  - digital health
KW  - machine learning
KW  - ML
KW  - artificial intelligence
KW  - AI
KW  - algorithm
KW  - algorithms
KW  - NLP
KW  - natural language processing
AB  - Background: The use of chatbots in mental health support has increased exponentially in recent years, with studies showing that they may be effective in treating mental health problems. More recently, the use of visual avatars called digital humans has been introduced. Digital humans have the capability to use facial expressions as another dimension in human-computer interactions. It is important to study the difference in emotional response and usability preferences between text-based chatbots and digital humans for interacting with mental health services. Objective: This study aims to explore to what extent a digital human interface and a text-only chatbot interface differed in usability when tested by healthy participants, using BETSY (Behavior, Emotion, Therapy System, and You) which uses 2 distinct interfaces: a digital human with anthropomorphic features and a text-only user interface. We also set out to explore how chatbot-generated conversations on mental health (specific to each interface) affected self-reported feelings and biometrics. Methods: We explored to what extent a digital human with anthropomorphic features differed from a traditional text-only chatbot regarding perception of usability through the System Usability Scale, emotional reactions through electroencephalography, and feelings of closeness. Healthy participants (n=45) were randomized to 2 groups that used a digital human with anthropomorphic features (n=25) or a text-only chatbot with no such features (n=20). The groups were compared by linear regression analysis and t tests. Results: No differences were observed between the text-only and digital human groups regarding demographic features. The mean System Usability Scale score was 75.34 (SD 10.01; range 57-90) for the text-only chatbot versus 64.80 (SD 14.14; range 40-90) for the digital human interface. Both groups scored their respective chatbot interfaces as average or above average in usability. Women were more likely to report feeling annoyed by BETSY. Conclusions: The text-only chatbot was perceived as significantly more user-friendly than the digital human, although there were no significant differences in electroencephalography measurements. Male participants exhibited lower levels of annoyance with both interfaces, contrary to previously reported findings. 
SN  - 2292-9495
UR  - https://humanfactors.jmir.org/2024/1/e54581
UR  - https://doi.org/10.2196/54581
UR  - http://www.ncbi.nlm.nih.gov/pubmed/38683664
DO  - 10.2196/54581
ID  - info:doi/10.2196/54581
ER  -