Experiences of a Motivational Interview Delivered by a Robot: Qualitative Study
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Abstract
BACKGROUND: Motivational interviewing is an effective intervention for supporting behavior change but traditionally depends on face-to-face dialogue with a human counselor. This study addressed a key challenge for the goal of developing social robotic motivational interviewers: creating an interview protocol, within the constraints of current artificial intelligence, which participants will find engaging and helpful. OBJECTIVE: The aim of this study was to explore participants' qualitative experiences of a motivational interview delivered by a social robot, including their evaluation of usability of the robot during the interaction and its impact on their motivation. METHODS: NAO robots are humanoid, child-sized social robots. We programmed a NAO robot with Choregraphe software to deliver a scripted motivational interview focused on increasing physical activity. The interview was designed to be comprehensible even without an empathetic response from the robot. Robot breathing and face-tracking functions were used to give an impression of attentiveness. A total of 20 participants took part in the robot-delivered motivational interview and evaluated it after 1 week by responding to a series of written open-ended questions. Each participant was left alone to speak aloud with the robot, advancing through a series of questions by tapping the robot's head sensor. Evaluations were content-analyzed utilizing Boyatzis' steps: (1) sampling and design, (2) developing themes and codes, and (3) validating and applying the codes. RESULTS: Themes focused on interaction with the robot, motivation, change in physical activity, and overall evaluation of the intervention. Participants found the instructions clear and the navigation easy to use. Most enjoyed the interaction but also found it was restricted by the lack of individualized response from the robot. Many positively appraised the nonjudgmental aspect of the interview and how it gave space to articulate their motivation for change. Some participants felt that the intervention increased their physical activity levels. CONCLUSIONS: Social robots can achieve a fundamental objective of motivational interviewing, encouraging participants to articulate their goals and dilemmas aloud. Because they are perceived as nonjudgmental, robots may have advantages over more humanoid avatars for delivering virtual support for behavioral change.
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The overall conversational flexibility offered by AI chatbots offers a safe space to facilitate interactions with patients who feel or experience stigmatization while seeking health care services.
“The overall conversational flexibility offered by AI chatbots in terms of communicating at anytime from anywhere offers a safe space to facilitate interactions with patients who feel or experience stigmatization while seeking health care services [5].”
From Artificial Intelligence-Based Chatbots for Promoting Health Behavioral Changes: Systematic Review. (2023) · cites this paper as [5]
The Discussion (Principal Findings; page unavailable) reports that participants felt more comfortable discussing issues with a robot because they did not expect it to judge them. The Discussion (Limitations and Directions for Future Research; page unavailable) suggests this could encourage discussion of sensitive issues and earlier help-seeking. The study concerns a social robot, however, and does not establish that AI chatbots offer flexible conversation anytime from anywhere or specifically facilitate interactions for patients experiencing stigmatization while seeking health care. (LLM, conf=0.88)
Experimental — accuracy not yet measuredGalvão Gomes da Silva et al reported that NAO, a social robot, enhanced immediate motivation toward activities such as meeting friends and families and increasing willpower through mindfulness techniques.
“This study reported that NAO, a social robot, enhanced immediate motivation toward activities such as meeting friends and families and increasing willpower through mindfulness techniques.”
From Artificial Intelligence-Based Chatbots for Promoting Health Behavioral Changes: Systematic Review. (2023) · cites this paper as [5]
The Results (Participants’ Evaluation of the Intervention; page unavailable) identify doing activities with friends or family, mindfulness, and willpower as strategies participants mentioned for supporting motivation. The Discussion (Principal Findings; page unavailable) says participants found the NAO-delivered interview motivating, but does not report that the robot specifically increased their motivation for those activities or increased willpower through mindfulness. (LLM, conf=0.86)
Experimental — accuracy not yet measuredIn 20% (3/15) of studies, the humanistic yet nonhumanistic construct of AI chatbots provided a safe space for the users to discuss, share, and ask for information on sensitive issues.
“Third, in 20% (3/15) of studies, the humanistic yet nonhumanistic construct of AI chatbots provided a safe space for the users to discuss, share, and ask for information on sensitive issues [5,22,23,35].”
From Artificial Intelligence-Based Chatbots for Promoting Health Behavioral Changes: Systematic Review. (2023) · cites this paper as [5]
The Discussion (Principal Findings; page not provided) says many participants felt more comfortable discussing issues with the robot than with a human counselor because they did not expect it to judge them. The Conclusions suggest robots may help elicit talk about sensitive issues. The study concerns a social robot, however, and does not show that users asked it for information on sensitive issues; the 3/15 figure is the citing review’s tally, not a finding of this study. (LLM, conf=0.85)
Experimental — accuracy not yet measuredThese findings are consistent with previous systematic reviews that reported the use of AI chatbots for improvement in physical activity levels and improvement in medication adherence, treatment adherence, adherence to self-management practices, smoking cessation, and reduction in substance abuse.
“These findings are consistent with previous systematic reviews that reported the use of AI chatbots for improvement in physical activity levels and improvement in medication adherence [2,5], treatment adherence [14], adherence to self-management practices [1], smoking cessation [12], and reduction in substance abuse [12].”
From Artificial Intelligence-Based Chatbots for Promoting Health Behavioral Changes: Systematic Review. (2023) · cites this paper as [5]
In the Introduction section on technology-delivered motivational interviewing (page not provided), the paper reports reduced smoking in a Video Doctor trial but says there was no clear effect on smoking abstinence. Its Discussion mentions addiction only as a potential target for future robot-delivered support; it does not report reduced substance abuse. This paper is a qualitative study, not a systematic review. (LLM, conf=0.84)
Experimental — accuracy not yet measuredOf the 15 studies, 7 (47%) targeted healthy lifestyles, and 5 (33%) assessed efficacy of AI chatbots in promoting healthy lifestyles.
“Out of the 15 studies, 7 (47%) studies [5,21,22,28,29,32,33] targeted healthy lifestyles, and 5 (33%) studies [21,22,28,32,33] assessed the efficacy of AI chatbots in promoting healthy lifestyles through (1) physical activity levels, (2) healthy diet, (3) blood pressure, and (4) BMI.”
From Artificial Intelligence-Based Chatbots for Promoting Health Behavioral Changes: Systematic Review. (2023) · cites this paper as [5]
The theory of motivational interviewing was used to devise interview questions addressed by NAO and motivation reinforcement messages provided by Bickmore et al's Chat1.
“The theory of motivational interviewing was also used to devise interview questions addressed by NAO [5] (the social robot) and the motivation reinforcement messages provided by Bickmore et al’s [33] Chat1.”
From Artificial Intelligence-Based Chatbots for Promoting Health Behavioral Changes: Systematic Review. (2023) · cites this paper as [5]
The qualitative study reported mixed results regarding the achievement of physical activity goals.
“However, the study reported mixed results regarding the achievement of physical activity goals.”
From Artificial Intelligence-Based Chatbots for Promoting Health Behavioral Changes: Systematic Review. (2023) · cites this paper as [5]
Participants reported that they felt more self-aware and were open to sharing their goals with others.
“The participants also reported that they felt more self-aware and were open to sharing their goals with others.”
From Artificial Intelligence-Based Chatbots for Promoting Health Behavioral Changes: Systematic Review. (2023) · cites this paper as [5]
Overall, 20% (3/15) of studies reported that AI platforms offered a nonjudgmental safe space for users to share detailed and sensitive information.
“Overall, 20% (3/15) of studies reported that the AI platforms offered a nonjudgmental safe space for users to share detailed and sensitive information [5,26,29].”
From Artificial Intelligence-Based Chatbots for Promoting Health Behavioral Changes: Systematic Review. (2023) · cites this paper as [5]
AI chatbots can collect data sets from diverse sources including electronic health records, unstructured clinical notes, real-time physiological data points using additional sensors, and user interactions.
“First, AI chatbots can collect data sets from diverse sources: electronic health records, unstructured clinical notes, real-time physiological data points using additional sensors (eye-movement tracking, facial recognition, movement tracking, and heartbeat), and user interactions [5,6].”
From Artificial Intelligence-Based Chatbots for Promoting Health Behavioral Changes: Systematic Review. (2023) · cites this paper as [5]
The Methods > Procedure passage says the robot interviews were not recorded; participants’ evaluations were collected later through a questionnaire. The Abstract > Methods describes face tracking and a head sensor, but neither it nor the passages retrieved for health records, clinical notes, physiological data, and interaction recording says that the robot collected datasets from those sources. (LLM, conf=0.76)
Experimental — accuracy not yet measured
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Haru in the Care Network: Stakeholder Perspectives on Privacy with Social Robots in Pediatrics
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Motivational Interviewing for the Prevention and Treatment of Pediatric Obesity
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- Authors
- Galvão Gomes da Silva, J., Kavanagh, D. J., Belpaeme, T., Taylor, L., Beeson, K., & Andrade, J.
- Affiliations
- Queensland University of Technology (AU)
- University of Plymouth (GB)
- Corresponding author
- Andrade, Jackie
- ORCID
- Venue
- Journal of Medical Internet Research
- Publisher
- JMIR Publications Inc.
- Published
- 2018-05-03
- Volume
- 20
- Issue
- 5
- Pages
- e116
- ISSN
- 1438-8871 (ISSN-L)
- PMC
- PMC5958282
- OpenAlex
- W2784499415
- Cited by
- 83
- References
- 42
- Citations by year
- 2026: 12 · 2025: 12 · 2024: 12 · 2023: 9 · 2022: 9 · 2021: 12 · 2020: 10 · 2019: 6 · 2018: 1
- FWCI
- 9.84
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- Journal of Medical Internet Research (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- QUT ePrints (Queensland University of Technology) (submittedVersion, cc-by)
- Ghent University Academic Bibliography (Ghent University) (submittedVersion, cc-by)
- PEARL (University of Plymouth) (submittedVersion, cc-by)
- PEARL (University of Plymouth) (submittedVersion)
- Funders
- European Commission (604764)
- FP7 People: Marie-Curie Actions (FP7-PEOPLE-2013-ITN, FP7-PEOPLE-2013)
- Topics
- Social Sciences › Psychology › Social Psychology › Social Robot Interaction and HRI
- Physical Sciences › Computer Science › Human-Computer Interaction › Innovative Human-Technology Interaction
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Keywords
- motivational interviewing, social robots, NAO robot, physical activity, behavior change, user experience, face tracking
- MeSH terms
- Humans, Robotics, Qualitative Research, Motivational Interviewing
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