Search Results (39)

Understanding how users perceive and attend to the anthropomorphic appearance and empathic responses of artificial intelligence medical conversational agents (AIMCAs) can help reveal the key judgment cues underlying trust formation and use decisions, while also informing interface and dialog design. To this end, this study employs a 3 (appearance anthropomorphism: high, medium, low) × 2 (empathic response: present, absent) within-subject eye-tracking experiment, combined with subjective scales and brief post-task open-ended feedback. During a static prototype viewing task based on hypothetical consultation scenarios, we concurrently recorded trust, behavioral intention, and visual measures for key areas of interest (AOIs; appearance area, conversational content area, and overall interface area). Eye-tracking measures were normalized by AOI coverage proportion to improve cross-AOI comparability. The results show that both anthropomorphic appearance and empathic response significantly increased users’ trust in AIMCAs and their behavioral intention. An interaction between these two types of social cues was also observed, suggesting that when visual embodiment and linguistic style are aligned at the social level, users are more likely to form favorable overall judgments. At the level of visual processing, however, no interaction effect was found, and the eye-tracking measures showed only partial main effects, indicating that subjective synergy does not necessarily correspond to synergistic changes in attentional allocation. Overall, anthropomorphic appearance and empathic response exerted consistent facilitating effects on outcome variables, but displayed different patterns of attentional allocation and information prioritization at the visual level. Accordingly, AIMCA design should emphasize consistency between appearance cues and conversational strategies, optimize users’ initial judgments and interface comprehension, and use intention through verifiable information organization and clear boundary cues. Full article

Service robots have the potential to support cognitive and social well-being in long-term care facilities, yet their widespread adoption depends on intuitive interaction modalities that minimize user learning effort and the need for a technical expert on-ground. Spoken dialogue is a natural interface, and recent advances in large language models (LLMs) promise more flexible and engaging exchanges than traditional scripted systems. In this study, we implemented a modular speech-based architecture combining automatic speech recognition, text-to-speech synthesis, and a conversational agent capable of switching between a fully scripted and LLM-driven dialogue. The implemented architecture was embodied in a TIAGo robot (PAL Robotics) and tested to compare three conversational strategies: (1) scripted, pre-defined dialogue, (2) LLM-based free-form conversation, and (3) LLM-based conversation augmented with personal information provided through the prompt. Eighteen younger adults and eighteen older adults engaged in a five-minute interaction with the robot under all three conditions in a within-subject design, and subsequently completed the Almere model questionnaire. Across all subscales and both participant groups, differences between dialogue strategies were small and statistically non-significant, despite informal comments from several older participants indicating a perceived increase in intelligence or naturalness for the LLM conditions. The findings suggest that generative dialogue and basic personalization alone do not meaningfully shift perceived acceptance in brief, task-neutral encounters, underscoring the importance of longer-term deployment and functionally meaningful robot roles in future evaluations. Full article

Background: Positive and existential psychiatry are approaches to mental health that emphasize the promotion of well-being, resilience, and optimal functioning alongside the conventional management of mental illness. Research suggests that the development of self-regulatory metacompetencies is associated with positive mental health and well-being outcomes. Artificial intelligence (AI) technologies are increasingly being used as assistive tools in psychiatry. However, the integration of AI in therapeutic interventions remains underexplored. Objectives: Thus, this systematic review aimed to synthesize evidence from randomized controlled trials evaluating whether AI-based positive and existential psychiatry interventions contribute to improvements in mental and emotional health. A second objective was to examine whether the therapeutic components and psychological processes implemented in these interventions conceptually relate to self-regulatory metacompetencies that underpin sustainable mental health and human flourishing. Methods: The review was conducted according to PRISMA 2020 guidelines. Only experimental studies including randomized controlled trials (RCTs) published from 2015 to 2025 were included. Twenty-four studies met the inclusion criteria. Results: Across interventions using conversational AI chatbots, generative AI and AI-augmented reflective systems, embodied conversational agents, social and humanoid AI robots, consistent improvements were observed in depression, anxiety, negative affect, and loneliness. The interventions enhanced various metacompetencies such as emotional regulation, emotional awareness, self-reflection, and cognitive reappraisal. Conclusions: The findings suggest that AI-based positive and existential psychiatry interventions can support mental and emotional health, especially when fostering key metacompetencies. Although promising, further high-quality trials are needed to clarify long-term effects. The findings of this study can contribute to the discussion about the ways AI-supported interventions may promote sustainable mental health. Full article

The collection of patient-reported outcome measures (PROMs) is a key measurement tool for patient-centred care. At the same time, collecting these measures poses obstacles for many patients, leading to these groups being underrepresented in the data. We have therefore developed a multimodal, AI-driven assistance system to support patients in collecting these data. The interface of the system comprised a digital tablet containing the PROM questionnaire items and the assistant in three forms of embodiment: A virtual avatar, a physical avatar, and a voice-only agent. To evaluate the users’ experience and ratings of the system, two separate studies were implemented in two rehabilitation centers with 195 patients. A mixed within–between RCT was conducted at an outpatient clinic, where patients completed PROMs both with and without an assistant, and a between-subject design at an inpatient clinic comparing routine PC-based care with avatar- and robot-assisted PROM administration. Our results suggest a preference for the non-assisted tablet-only condition in Clinic A, whereas, in Clinic B, both agent conditions were preferred over routine care. We have further analyzed aspects such as trust and social presence in this study to gain a more thorough understanding of the users’ experience. Our analysis shows a higher trust rating for the voice-only assistant, whereas the robot, virtual avatar, and the voice-only conditions were perceived as more socially present. The impact of demographic factors and affinity for technology on the user ratings was also thoroughly studied. Our findings shed light on the role of agent embodiment in PROM assistance and contribute to the future design and evaluation of effective, engaging, and trustworthy systems for data collection in healthcare settings. Full article

Virtual museums delivered through immersive virtual reality (VR) function as information environments where users access interpretive content while navigating spatially. With the integration of generative artificial intelligence (AI), conversational assistants can dynamically mediate information interaction; however, evidence remains limited regarding how different AI interface representations affect user experience. This study compares three generative AI interface modalities in a VR virtual museum: voice only, voice with synchronized text, and voice with an embodied AI avatar. A controlled experiment with 75 participants examined their effects on user engagement, perceived information quality, and subjective cognitive workload while holding informational content constant. The results indicate that the voice-and-text modality produced the highest perceived information quality, whereas the embodied AI avatar modality yielded the highest user engagement. No significant differences were observed in cognitive workload across modalities. These findings suggest that AI interface modalities play complementary roles in VR-based information interaction and provide design guidance for selecting appropriate AI representations in immersive information systems. Full article

Background: Generative AI and synthetic media have enabled realistic human Embodied Conversational Agents (ECAs) or avatars. A subset of this technology replicates faces and voices to create realistic likenesses. When combined with avatars, these methods enable the creation of “digital twins” of physicians, offering patients scalable, 24/7 clinical communication outside the immediate clinical environment. This study evaluated surgical patient perceptions of an AI-generated surgeon avatar for postoperative education. Methods: We conducted a pilot feasibility study with 30 plastic surgery patients at Mayo Clinic, USA (July–August 2025). A bespoke interactive surgeon avatar was developed in Python using the HeyGen IV model to reproduce the surgeon’s likeness. Patients interacted with the avatar through natural voice queries, which were mapped to predetermined, pre-recorded video responses covering ten common postoperative topics. Patient perceptions were assessed using validated scales of usability, engagement, trust, eeriness, and realism, supplemented by qualitative feedback. Results: The avatar system reliably answered 297 of 300 patient queries (99%). Usability was excellent (mean System Usability Scale score = 87.7 ± 11.5) and engagement high (mean 4.27 ± 0.23). Trust was the highest-rated domain, with all participants (100%) finding the avatar trustworthy and its information believable. Eeriness was minimal (mean = 1.57 ± 0.48), and 96.7% found the avatar visually pleasing. Most participants (86.6%) recognized the avatar as their surgeon, although many still identified it as artificial; voice resemblance was less convincing (70%). Interestingly, participants with prior exposure to deepfakes demonstrated consistently higher acceptance, rating usability, trust, and engagement 5–10% higher than those without prior exposure. Qualitative feedback highlighted clarity, efficiency, and convenience, while noting limitations in realism and conversational scope. Conclusions: The AI-generated physician avatar achieved high patient acceptance without triggering uncanny valley effects. Transparency about the synthetic nature of the technology enhanced, rather than diminished, trust. Familiarity with the physician and institutional credibility likely played a key role in the high trust scores observed. When implemented transparently and with appropriate safeguards, synthetic physician avatars may offer a scalable solution for postoperative education while preserving trust in clinical relationships. Full article

Generating realistic and contextually appropriate gestures is crucial for creating engaging embodied conversational agents. Although speech is the primary input for gesture generation, adding controls like gesture velocity, hand height, and emotion is essential for generating more natural, human-like gestures. However, current approaches to controllable gesture generation often utilize a limited number of control parameters and lack the ability to activate/deactivate them selectively. Therefore, in this work, we propose the Cont-Gest model, a Transformer-based gesture generation model that enables selective control activation through masked training and a control fusion strategy. Furthermore, to better support the development of such models, we propose a novel evaluation-driven development (EDD) workflow, which combines several iterative tasks: automatic control signal extraction, control specification, visual (subjective) feedback, and objective evaluation. This workflow enables continuous monitoring of model performance and facilitates iterative refinement through feedback-driven development cycles. For objective evaluation, we are using the validated Kinetic–Hellinger distance, an objective metric that correlates strongly with the human perception of gesture quality. We evaluated multiple model configurations and control dynamics strategies within the proposed workflow. Experimental results show that Feature-wise Linear Modulation (FiLM) conditioning, combined with single-mask training and voice activity scaling, achieves the best balance between gesture quality and adherence to control inputs. Full article

Embodied Conversational Agents (ECAs) serve as digital twins (DTs), visually and behaviorally mirroring human counterparts in various roles, including healthcare coaching. While existing research primarily focuses on single-coach ECAs, our work explores the benefits of multi-coach virtual health sessions, where users engage with specialized diet, physical, and cognitive coaches simultaneously. ECAs require verbal relational cues—such as empowerment, affirmation, and empathy—to foster user engagement and adherence. Our study integrates Generative AI to automate the embedding of these cues into coaching dialogues, ensuring the advice remains unchanged while enhancing delivery. We employ ChatGPT to generate empathetic and collaborative dialogues, comparing their effectiveness against manually crafted alternatives. Using three participant cohorts, we analyze user perception of the helpfulness of AI-generated versus human-generated relational cues. Additionally, we investigate whether AI-generated dialogues preserve the original advice’s semantics and whether human or automated validation better evaluates their lexical meaning. Our findings contribute to the automation of digital health coaching. Comparing ChatGPT- and human-generated dialogues for helpfulness, users rated human dialogues as more helpful, particularly for working alliance and affirmation cues, whereas AI-generated dialogues were equally effective for empowerment. By refining relational cues in AI-generated dialogues, this research paves the way for automated virtual health coaching solutions. Full article

The adoption of kiosks in public spaces is steadily increasing, with a trend toward providing more natural user experiences through embodied conversational agents (ECAs). To achieve human-like interactions, ECAs should be able to appropriately gaze at the speaker. However, kiosks in public spaces often face challenges, such as ambient noise and overlapping speech from multiple people, making it difficult to accurately identify the speaker and direct the ECA’s gaze accordingly. In this paper, we propose a lightweight gaze control system that is designed to operate effectively within the resource constraints of kiosks and the noisy conditions common in public spaces. We first developed a speaker detection model that identifies the active speaker in challenging noise conditions using only a single camera and microphone. The proposed model achieved a 91.6% mean Average Precision (mAP) in active speaker detection and a 0.6% improvement over the state-of-the-art lightweight model (Light ASD) (as evaluated on the noise-augmented AVA-Speaker Detection dataset), while maintaining real-time performance. Building on this, we developed a gaze control system for ECAs that detects the dominant speaker in a group and directs the ECA’s gaze toward them using an algorithm inspired by real human turn-taking behavior. To evaluate the system’s performance, we conducted a user study with 30 participants, comparing the system to a baseline condition (i.e., a fixed forward gaze) and a human-controlled gaze. The results showed statistically significant improvements in social/co-presence and gaze naturalness compared to the baseline, with no significant difference between the system and human-controlled gazes. This suggests that our system achieves a level of social presence and gaze naturalness comparable to a human-controlled gaze. The participants’ feedback, which indicated no clear distinction between human- and model-controlled conditions, further supports the effectiveness of our approach. Full article

Embodied conversational agents (ECAs) are autonomous interaction interfaces designed to communicate with humans. This study investigates the impact of response delays and emotional facial expressions of ECAs on user perception and engagement. The motivation for this study stems from the growing integration of ECAs in various sectors, where their ability to mimic human-like interactions significantly enhances user experience. To this end, we developed an ECA with multimodal emotion recognition, both with voice and facial feature recognition and emotional facial expressions of the agent avatar. The system generates answers in real time based on media content. The development was supported by a case study of artwork images with the agent playing the role of a museum curator, where the user asks the agent for information on the artwork. We evaluated the developed system in two aspects. First, we investigated how the delay in an agent’s responses influences user satisfaction and perception. Secondly, we explored the role of emotion in an ECA’s face in shaping the user’s perception of responsiveness. The results showed that the longer response delay negatively impacted the user’s perception of responsiveness when the ECA did not express emotion, while the emotional expression improved the responsiveness perception. Full article

(1) Background: The mutual relationship between evolution and learning is a controversial argument among the artificial intelligence and neuro-evolution communities. After more than three decades, there is still no common agreement on the matter. (2) Methods: In this paper, the author investigates whether combining learning and evolution permits finding better solutions than those discovered by evolution alone. In further detail, the author presents a series of empirical studies that highlight some specific conditions determining the success of such combination. Results are obtained in five qualitatively different domains: (i) the 5-bit parity task, (ii) the double-pole balancing problem, (iii) the Rastrigin, Rosenbrock and Sphere optimization functions, (iv) a robot foraging task and (v) a social foraging problem. Moreover, the first three tasks represent benchmark problems in the field of evolutionary computation. (3) Results and discussion: The outcomes indicate that the effect of learning on evolution depends on the nature of the problem. Specifically, when the problem implies limited or absent agent–environment conditions, learning is beneficial for evolution, especially with the introduction of noise during the learning and selection processes. Conversely, when agents are embodied and actively interact with the environment, learning does not provide advantages, and the addition of noise is detrimental. Finally, the absence of stochasticity in the experienced conditions is paramount for the effectiveness of the combination. Furthermore, the length of the learning process must be fine-tuned based on the considered task. Full article

Apart from being an economic struggle, migration is first of all a societal challenge; most migrants come from different cultural and social contexts, do not speak the language of the host country, and are not familiar with its societal, administrative, and labour market infrastructure. This leaves them in need of dedicated personal assistance during their reception and integration. However, due to the continuously high number of people in need of attendance, public administrations and non-governmental organizations are often overstrained by this task. The objective of the Welcome Platform is to address the most pressing needs of migrants. The Platform incorporates advanced Embodied Conversational Agent and Virtual Reality technologies to support migrants in the context of reception, integration, and social inclusion in the host country. It has been successfully evaluated in trials with migrants in three European countries in view of potentially deviating needs at the municipal, regional, and national levels, respectively: the City of Hamm in Germany, Catalonia in Spain, and Greece. The results show that intelligent technologies can be a valuable supplementary tool for reducing the workload of personnel involved in migrant reception, integration, and inclusion. Full article

Long outpatient waiting times pose a significant global challenge in healthcare, impacting children and families with implications for health outcomes. This paper presents the eHealth system called eADVICE (electronic Advice and Diagnosis Via the Internet following Computerised Evaluation) that is designed to address waiting list challenges for paediatricians. Initially designed for children’s incontinence, the system’s success in terms of health goals and user experience led to its adaptation for paediatric sleep problems. This paper focuses on user experiences and the development of a working alliance with the virtual doctor, alongside health outcomes based on a randomised controlled trial (N = 239) for incontinence. When reengineering eADVICE to sleep disorders, the promising results regarding the reciprocal relationship between user experience and building a working alliance encouraged a focus on the further development of the embodied conversational agent (ECA) component. This involved tailoring the ECA discussion to patient cognition (i.e., beliefs and goals) to further improve engagement and outcomes. The proposed eADVICE framework facilitates adaptation across paediatric conditions, offering a scalable model to enhance access and self-efficacy during care delays. Full article

This paper compares three methods for evaluating computer-generated motion behaviour for animated characters: two commonly used direct rating methods and a newly designed questionnaire. The questionnaire is specifically designed to measure the human-likeness, appropriateness, and intelligibility of the generated motion. Furthermore, this study investigates the suitability of these evaluation tools for assessing subtle forms of human behaviour, such as the subdued motion cues shown when listening to someone. This paper reports six user studies, namely studies that directly rate the appropriateness and human-likeness of a computer character’s motion, along with studies that instead rely on a questionnaire to measure the quality of the motion. As test data, we used the motion generated by two generative models and recorded human gestures, which served as a gold standard. Our findings indicate that when evaluating gesturing motion, the direct rating of human-likeness and appropriateness is to be preferred over a questionnaire. However, when assessing the subtle motion of a computer character, even the direct rating method yields less conclusive results. Despite demonstrating high internal consistency, our questionnaire proves to be less sensitive than directly rating the quality of the motion. The results provide insights into the evaluation of human motion behaviour and highlight the complexities involved in capturing subtle nuances in nonverbal communication. These findings have implications for the development and improvement of motion generation models and can guide researchers in selecting appropriate evaluation methodologies for specific aspects of human behaviour. Full article

The demand for kiosk systems with embodied conversational agents has increased with the development of artificial intelligence. There have been attempts to utilize non-verbal cues, particularly virtual human (VH) eye contact, to enable human-like interaction. Eye contact with VHs can affect satisfaction with the system and the perception of VHs. However, when rendered in 2D kiosks, the gaze direction of a VH can be incorrectly perceived, due to a lack of stereo cues. A user study was conducted to examine the effects of the gaze behavior of VHs in multi-party conversations in a 2D display setting. The results showed that looking at actual speakers affects the perceived interpersonal skills, social presence, attention, co-presence, and competence in conversations with VHs. In a second study, the gaze perception was further examined with consideration of the Mona Lisa effect, which can lead users to believe that a VH rendered on a 2D display is gazing at them, regardless of the actual direction, within a narrow range. We also proposed the camera rotation angle fine tuning (CRAFT) method to enhance the users’ perceptual accuracy regarding the direction of the VH’s gaze.The results showed that the perceptual accuracy for the VH gaze decreased in a narrow range and that CRAFT could increase the perceptual accuracy. Full article