There has been a remarkable growth in e-medicine. People are
trying to compensate for this lack of face-to-face time with doctors by
using online tools, which are becoming increasingly conversational.
Just like real doctors and nurses, online health tools with good -
but controlled - communication skills can promote healthier lifestyles,
according to researchers. However, if their tone is conversational,
these tools may lull users into a false sense of comfort, they add.
‘A more conversational tone in the messages may make users feel less susceptible to health risks such as obesity, diabetes and heart disease.’
In a study, people who experienced a back-and-forth interaction
with an online health risk assessment website were more likely to follow
the health behaviors suggested by the tool, according to S. Shyam
Sundar, Distinguished Professor of Communications and co-director of the
Media Effects Research Laboratory.
"This shows that delivering information on health risks through
dialogue can help users get engaged with the tool and may positively
affect their health," said Sundar. "In general, it speaks to the design
of interactive delivery of health information that it is not only
engaging, but also inspiring."
The researchers, who present their findings in the current issue of Human Communication Research
suggest that the display of interconnected questions and answers
promotes a feeling of contingency and that leads to better engagement
with the site. Better engagement, then, may increase the likelihood that
the user will adopt strategies for better health.
"When you are having this back and forth interaction with a
system - you are having a conversation with that system," said Sundar.
"We think that interactivity has been achieved when the system's output
is contingent on the user's input in a continuous threaded way."
Although the back-and-forth feel of a conversation could lead to
improved health intentions, a more conversational tone in the messages
may make users feel less susceptible to health risks such as obesity,
diabetes and heart disease, according to Sundar, who worked with
Saraswathi Bellur, assistant professor of communication, University of
The study found that when the online tool used short phrases,
such as "Mm-hmm" and "Go on" to promote an informal conversational tone,
users felt less susceptible to health risks, according to Bellur.
"This conversational tone may make them warm and fuzzy, but
that's not what you want to do with a health assessment tool," Bellur
said. "If you want people to stand up and take action, this type of
friendly turn-taking softens the effect. However, if the goal of the
interaction is to promote a sense of comfort among individuals, the same
conversational tone strategy could work well, with the online tool
acting like a virtual coach and providing reassurance," she added.
The researchers suggest that as more people become frustrated
with the lack of face-to-face interaction with their doctors, patients
may be more willing to try online health assessments and applications.
In 2012, 61% of people said they were dissatisfied with the time
doctors spent talking with patients, according to a poll conducted by
National Public Radio, the Robert Wood Johnson Foundation and the
Harvard School of Public Health.
The design of these e-health tools need not be highly sophisticated, according to the researchers.
"A simple instant-message-like feature that enables a dialogue
between the user and the system is sufficient to evoke rich perceptions
of interactivity, which, in turn, could favorably influence health
behaviors and attitudes," said Bellur. "Therein lies the power of
interactive health tools."
The researchers recruited 172 undergraduate students to take part
in the study. Participants were assigned to one of six versions of a
health risk assessment website. The sites were designed to have either
low, medium, or high interactivity with either conversational or no
Participants took part in a question and answer session delivered
through the website's instant messaging interface. The
low-interactivity site did not display any signs or visual cues that
there was an ongoing interaction between the user and the system. The
medium-interactivity site visually called out the user's response in a
box titled "Your response." In the high-interactivity condition, the
system referred to the user's previous answers by displaying
"previously, you mentioned" or "earlier, you reported" following his or
Websites with more conversational tone added phrases such as
"Let's move onto the next question" and "OK, let's talk about exercise"
during the question and answer session.