Skip to main content
SpringerLink
Log in

Health Document Explanation by Virtual Agents

  • Conference paper
Book cover Intelligent Virtual Agents (IVA 2007)

Part of the book series: Lecture Notes in Computer Science ((LNAI,volume 4722))

Included in the following conference series:

Abstract

We describe the design and evaluation of a virtual agent that explains health documents to patients. The prevalence and impact of low health literacy is presented as a motivation for such agents, given that face-to-face interaction with health providers is cited as one of the most effective means of communicating with these patients. We analyze the form and distribution of pointing gestures used by experts in explaining health documents, and use this data to develop a computational model of agent-based document explanation. This model is evaluated in a randomized controlled trial. Preliminary results indicate that patients with low health literacy are more satisfied with health document explanation by a virtual agent compared to a human.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Ad Hoc Committee on Health Literacy for the Council on Scientific Affairs, A.M.A.: Health literacy: report of the Council on Scientific Affairs. JAMA 281(6) 552–557 (1999)

    Google Scholar 

  2. Allen, J., Core, M.: Draft of DMSL: Dialogue Act Markup in Several Layers (1997)

    Google Scholar 

  3. Andre, E., Rist, T., Muller, J.: Integrating reactive and scripted behaviors in a life-like presentation agent. In: Proceedings of AGENTS 1998, pp. 261–268 (1998)

    Google Scholar 

  4. Baker, D., Parker, R., Williams, M., Clark, S., Nurss, J.: The relationship of patient reading ability to self-reported health and use of services. Am. J. Public Health 87, 1027–1030 (1997)

    Article  Google Scholar 

  5. Beecher, H.K.: Ethics and clinical research. N. Engl. J. Med. 274(24), 1354–1360 (1966)

    Article  Google Scholar 

  6. Bickmore, T., Picard, R.: Establishing and Maintaining Long-Term Human-Computer Relationships. ACM Transactions on Computer Human Interaction 12(2), 293–327 (2005)

    Article  Google Scholar 

  7. Cassell, J., Ananny, M., Basu, A., Bickmore, T., Chong, P., Mellis, D., Ryokai, K., Smith, J., Vilhjálmsson, H., Yan, H.: Shared Reality: Physical Collaboration with a Virtual Peer. In: Proceedings of CHI 2000 (2000)

    Google Scholar 

  8. Cassell, J., Stocky, T., Bickmore, T., Gao, Y., Nakano, Y., Ryokai, K., Tversky, D., Vaucelle, C., Vilhjálmsson, H.: MACK: Media lab Autonomous Conversational Kiosk. Imagina 2002 (2002)

    Google Scholar 

  9. Cassell, J., Vilhjálmsson, H., Bickmore, T.: BEAT: The Behavior Expression Animation Toolkit. In: SIGGRAPH 2001, pp. 477–486 (2001)

    Google Scholar 

  10. Clark, H.H., Brennan, S.E.: Grounding in Communication. In: Resnick, L.B., Levine, J.M., Teasley, S.D. (eds.) Perspectives on Socially Shared Cognition, American Psychological Association, Washington, pp. 127–149 (1991)

    Google Scholar 

  11. Clinite, J., Kabat, H.: Improving patient compliance. J. Am. Pharm. Assoc. 16, 74–76 (1976)

    Google Scholar 

  12. Davidoff, F.: Time. Ann. Intern. Med. 127, 483–485 (1997)

    Google Scholar 

  13. Davis, T.C., Long, S.W., Jackson, R.H., Mayeaux, E.J., George, R.B., Murphy, P.W., Crouch, M.A.: Rapid estimate of adult literacy in medicine: a shortened screening instrument. Fam. Med. 25(6), 391–395 (1993)

    Google Scholar 

  14. Doak, C., Doak, L., Root, J.: Teaching patients with low literacy skills, 2nd edn., JB Lippincott, Philadelphia, PA (1996)

    Google Scholar 

  15. Frankel, R.: Emotion and the Physician-Patient Relationship. Motivation and Emotion 19(3), 163–173 (1995)

    Article  Google Scholar 

  16. Graesser, A., et al.: AutoTutor: A simulation of a human tutor. Cognitive Systems Research 1 (1999)

    Google Scholar 

  17. Grosz, B., Sidner, C.: Attention, Intentions, and the Structure of Discourse. Computational Linguistics 12(3), 175–204 (1986)

    Google Scholar 

  18. Kalichman, S., Ramachandran, B., Catz, S.: Adherence to a combination antiretroviral therapies in HIV patients of low health literacy. J. Gen. Intern. Med. 14, 267–273 (1999)

    Article  Google Scholar 

  19. Katz, M.G., Jacobson, T.A., Veledar, E., Kripalani, S.: Patient Literacy and Question-asking Behavior During the Medical Encounter: A Mixed-methods Analysis. J. Gen. Intern. Med. (2007)

    Google Scholar 

  20. Kopp, S., Krenn, B., Marsella, S., Marshall, A.N., Pelachaud, C., Pirker, H., Thórisson, K., Vilhjálmsson, H.: Towards a Common Framework for Multimodal Generation: The Behavior Markup Language. In: Gratch, J., Young, M., Aylett, R., Ballin, D., Olivier, P. (eds.) IVA 2006. LNCS (LNAI), vol. 4133, Springer, Heidelberg (2006)

    Google Scholar 

  21. Lester, J., Towns, S., Callaway, C., Voerman, J., Fitzgerald, P.: Deictic and Emotive Communication in Animated Pedagogical Agents. In: Cassell, J. (ed.) Embodied Conversational Agents, MIT Press, Cambridge (2000)

    Google Scholar 

  22. Lester, J., Voerman, J., Towns, S., Callaway, C.: Deictic Believability: Coordinating Gesture, Locomotion, and Speech in Lifelike Pedagogical Agents. Applied Artificial Intelligence 13(4-5), 383–414 (1999)

    Article  Google Scholar 

  23. Madden, E.: Evaluation of outpatient pharmacy patient counseling. J. Am. Pharm. Ass. 13, 437–443 (1973)

    Google Scholar 

  24. Moreno, R., Lester, J.C., Mayer, R.E.: Life-Like Pedagogical Agents in Constructivist Multimedia Environments: Cognitive Consequences of their Interaction. In: ED-MEDIA, pp. 741–746 (2000)

    Google Scholar 

  25. Morris, L., Halperin, J.: Effects of Written Drug Information on Patient Knowledge and Compliance: A Literature Review. Am. J. Public Health 69(1), 47–52 (1979)

    Google Scholar 

  26. Nakano, Y.I., Reinstein, G., Stocky, T., Cassell, J.: Towards a Model of Face-to-Face Grounding. In: Annual Meeting of the Association for Computational Linguistics (2003)

    Google Scholar 

  27. Nakatani, C., Traum, D.: Coding discourse structure in dialogue (version 1.0). University of Maryland (1999)

    Google Scholar 

  28. Nielsen-Bohlman, L., Panzer, A.M., Hamlin, B., Kindig, D.A.: Institute of Medicine. Health Literacy: A Prescription to End Confusion. In: Committee on Health Literacy, Board on Neuroscience and Behavioral Health, National Academies Press, Washington, DC (2004)

    Google Scholar 

  29. Noma, T., Zhao, L., Badler, N.I.: Design of a virtual human presenter. Computer Graphics and Applications, IEEE 20(4), 79–85 (2000)

    Article  Google Scholar 

  30. Paasche-Orlow, M., Greene, S.M., Wagner, E.H.: How health care systems can begin to address the challenge of limited literacy. J. Gen. Intern. Med. 21(8), 884–887 (2006)

    Article  Google Scholar 

  31. Paasche-Orlow, M.K., Parker, R.M., Gazmararian, J.A., Nielsen-Bohlman, L.T., Rudd, R.R.: The prevalence of limited health literacy. J. Gen. Intern. Med. 20(2), 175–184 (2005)

    Article  Google Scholar 

  32. Person, N.K., Graesser, A.C., Bautista, L., Mathews, E.C.: Evaluating Student Learning Gains in Two Versions of AutoTutor. In: Moore, J.D., Redfield, C.L., Johnson, W.L. (eds.) Artificial intelligence in education: AI-ED in the wired and wireless future, pp. 286–293. IOS Press, Amsterdam (2001)

    Google Scholar 

  33. Qualls, C., Harris, J., Rogers, W.: Cognitive-Linguistic Aging: Considerations for Home Health Care Environments. In: Rogers, W., Fisk, A. (eds.) Human Factors Interventions for the Health Care of Older Adults, pp. 47–67. Lawrence Erlbaum, Mahwah (2002)

    Google Scholar 

  34. Richmond, V., McCroskey, J.: Immediacy. In: Nonverbal Behavior in Interpersonal Relations, pp. 195–217. Allyn & Bacon, Boston (1995)

    Google Scholar 

  35. Rickel, J., Johnson, W.L.: Animated Agents for Procedural Traning in Virtual Reality: Perception, Cognition and Motor Control. Applied Artificial Intelligence (1998)

    Google Scholar 

  36. Schillinger, D., Piette, J., Grumbach, K., Wang, F., Wilson, C., Daher, C.: Closing the loop: physician communication with diabetic patients who have low health literacy. Arch. Intern. Med. 163(1), 83–90 (2003)

    Article  Google Scholar 

  37. Sugarman, J., Lavori, P.W., Boeger, M., Cain, C., Edson, R., Morrison, V., Yeh, S.S.: Evaluating the quality of informed consent. Clinical Trials 2(1), 34 (2005)

    Article  Google Scholar 

  38. Tannen, D.: Framing in Discourse. Oxford University Press, New York (1993)

    Google Scholar 

  39. Weiss, B.: Illiteracy among Medicaid recipients and its relation to health care costs. J. Health Care Poor Underserved 4(5), 99–111 (1994)

    Google Scholar 

  40. Weiss, B., Hart, G., McGee, D., D’Estelle, S.: Health status of illerate adults: relation between literacy and health status among persons with low literacy skills. J. Am. Board Fam. Parct. 5, 254–257 (1992)

    Google Scholar 

  41. Williams, M., Parker, R., Baker, D., Coates, W., Nurss, J.: The impact of inadequate functional health literacy on patients understanding of diagnosis, prescribed medications, and compliance. Acad. Emerg. Med. 2, 386 (1995)

    Google Scholar 

  42. Woods, W.A.: Transition Network Grammars for Natural Language Analysis. In: Grosz, B.J., Jones, K.S., Webber, B.L. (eds.) Readings in Natural Language Processing, pp. 71–88. Morgan Kaufmann Publishers, Los Alamitos (1986)

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Northeastern University College of Computer and Information Science, 360 Huntington Ave WVH202, Boston, MA 02115,  

    Timothy W. Bickmore & Laura M. Pfeifer

  2. Boston University School of Medicine, 91 East Concord St, Suite 200, Boston, MA 02118,  

    Michael K. Paasche-Orlow

Authors
  1. Timothy W. Bickmore
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Laura M. Pfeifer
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Michael K. Paasche-Orlow
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Catherine Pelachaud Jean-Claude Martin Elisabeth André Gérard Chollet Kostas Karpouzis Danielle Pelé

Rights and permissions

Reprints and permissions

Copyright information

© 2007 Springer-Verlag Berlin Heidelberg

About this paper

Cite this paper

Bickmore, T.W., Pfeifer, L.M., Paasche-Orlow, M.K. (2007). Health Document Explanation by Virtual Agents. In: Pelachaud, C., Martin, JC., André, E., Chollet, G., Karpouzis, K., Pelé, D. (eds) Intelligent Virtual Agents. IVA 2007. Lecture Notes in Computer Science(), vol 4722. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-74997-4_18

Download citation

  • DOI: https://doi.org/10.1007/978-3-540-74997-4_18

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-74996-7

  • Online ISBN: 978-3-540-74997-4

  • eBook Packages: Computer ScienceComputer Science (R0)

Publish with us

Policies and ethics

Search

Navigation