JMIR Publications

ABSTRACT

Embodied Conversational Agents (ECAs) have emerged as a promising and innovative approach to deliver Motivational Interviewing (MI) for promoting the adoption of health-related behaviors. Through proactive facilitation of positive behavior changes, individuals can actively manage their health, pursue long-term well-being, and potentially prevent and reduce chronic diseases. Despite their potential, there remains limited comprehension of the design, development, implementation, evaluation, and overall effectiveness of these ECAs. To enhance this understanding, this scoping review covers the last 15 years and aims to summarize and analyze key characteristics of current ECAs designed to provide MI for fostering health-related behaviors. A total of 14 studies met the inclusion criteria. Among them, ECAs delivering MI were primarily deployed to assist in reducing alcohol use. The second most prevalent application was the encouragement of physical activity, healthy dietary habits, and women's preconception health. Findings from the reviewed studies generally indicate that ECAs providing MI elicit positive reactions and acceptance from users, suggesting a notable impact on users' motivation to continue using them for interventions and potentially supporting long-term usage. However, many of the reviewed studies lack comprehensive insights into the effective integration of MI principles, processes, and techniques within ECAs. Moreover, most ECAs currently lack the capability to automatically recognize user emotions for delivering empathetic responses, often depending on rules-driven dialogue mechanisms. To acquire a deeper understanding of ECAs' potential across diverse healthcare contexts, more randomized controlled trials (RCTs) are essential for thoroughly evaluating their long-term effectiveness.