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User Perspectives on Conversational Agents in Preventive Alcohol Self-Help: A Qualitative Exploration
ABSTRACT
Background:
Alcohol use remains a major public health concern, and although digital self-help interventions aim to reduce the treatment gap, they continue to face challenges of low engagement and high attrition. Conversational agents (CAs), powered by artificial intelligence (AI), may enhance engagement by offering personalized guidance and 24/7 availability. Yet user perspectives on CAs in preventive alcohol self-help care are largely unexplored.
Objective:
This study aimed to gain a deeper understanding of factors shaping the adoption of CAs in preventive alcohol self-help by qualitatively exploring users’ expectations and concerns, complemented by descriptive questionnaire data on perceived usefulness, intention to use, comfort, and trust.
Methods:
This qualitative, exploratory study included adults recruited from a Dutch online alcohol self-help program and a client advisory board. Data were collected during an online focus group (N=8), four semi-structured interviews (N=4), and a brief questionnaire among all of them (N=12) in April-May 2025.
Results:
Qualitative findings showed that participants appreciated the 24/7 availability, practical guidance, and non-judgmental stance of CAs, but doubted their capacity for genuine empathy and authenticity. They emphasized that tone was important: CAs should be supportive without being overly pleasing, and could only be confrontational once trust had been established. Concerns about undue influence arose occasionally, while privacy was rarely seen as a major issue. Descriptive questionnaire results showed that most participants had prior experience with CAs and considered them potentially useful for reducing alcohol use, yet few expressed strong intentions to use one themselves. Comfort and trust ratings were largely neutral, reflecting a cautious but generally open attitude toward CA use.
Conclusions:
CAs appear to hold promise as complementary tools for preventive alcohol self-help, while they are not perceived as replacements for human contact. Future design efforts should emphasize personalized design, an appropriate conversational tone - supportive yet not overly agreeable - and transparent communication about data use to enhance engagement and acceptance.
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Copyright
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