The Effect of Design Features on Relationship Quality with Embodied Conversational Agents: A Systematic Review

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The Effect of Design Features on Relationship Quality with Embodied Conversational Agents: A Systematic Review Kate Loveys1   · Gabrielle Sebaratnam1   · Mark Sagar2   · Elizabeth Broadbent1  Accepted: 11 July 2020 © Springer Nature B.V. 2020

Abstract Embodied conversational agents (ECAs) are increasingly used in healthcare and other settings to improve self-management and provide companionship. Their ability to form close relationships with people is important for enhancing effectiveness and engagement. Several studies have looked at enhancing relationships with ECAs through design features focused on behaviours, appearance, or language. However, this evidence is yet to be systematically synthesized. This systematic review evaluates the effect of different design features on relationship quality with ECAs. A systematic search was conducted on electronic databases EMBASE, PsychInfo, PubMed, MEDLINE, Cochrane Library, SCOPUS, and Web of Science in January–February 2019. 43 studies were included for review that evaluated the effect of a design feature on relationship quality and social perceptions or behaviours towards an ECA. Results synthesize effective design features and lay a scientific framework for improving relationships with ECAs in healthcare and other applications. Risk of bias for included studies was generally low, however there were some limitations in the research quality pertaining to outcome measurement and the reporting of statistics. Further research is needed to understand how to make ECAs effective and engaging for all consumers. Keywords  Human–computer interaction · Embodied conversational agents · Relationship quality · Design features · Healthcare

1 Introduction An embodied conversational agent (ECA) is a computerbased dialogue system with a virtual embodiment (full body or face-only) that typically interacts with people using multimodal communication cues (e.g. speech, text, animated facial expressions or gestures) [1]. ECAs are increasingly used across a range of industries including healthcare, education, banking, and retail. This is made possible due to Electronic supplementary material  The online version of this article (https​://doi.org/10.1007/s1236​9-020-00680​-7) contains supplementary material, which is available to authorized users. * Kate Loveys [email protected] Elizabeth Broadbent [email protected] 1



Department of Psychological Medicine, the University of Auckland School of Medicine, Building 507, Level 3, 22‑30 Park Avenue, Grafton, Auckland 1023, New Zealand



Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand

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improvements over the last decade in computer processing power, computing techniques, data availability, storage, and security. ECAs show promise for improving the supply and quality of support services across a range of industries, as ECAs are scalable, inexpensive (in comparison to robots), customizable to user needs, portable to use in many environments, and available 24/7 for support. There are several areas w