Emotional Reactions and Likelihood of Response to Questions Designed for a Mental Health Chatbot Among Adolescents: Experimental Study

Abstract

Background Psychological distress increases across adolescence and has been associated with several important health outcomes with consequences that can extend into adulthood. One type of technological innovation that may serve as a unique intervention for youth experiencing psychological distress is the conversational agent, otherwise known as a chatbot. Further research is needed on the factors that may make mental health chatbots destined for adolescents more appealing and increase the likelihood that adolescents will use them. Objective The aim of this study was to assess adolescents’ emotional reactions and likelihood of responding to questions that could be posed by a mental health chatbot. Understanding adolescent preferences and factors that could increase adolescents’ likelihood of responding to chatbot questions could assist in future mental health chatbot design destined for youth. Methods We recruited 19 adolescents aged 14 to 17 years to participate in a study with a 2×2×3 within-subjects factorial design. Each participant was sequentially presented with 96 chatbot questions for a duration of 8 seconds per question. Following each presentation, participants were asked to indicate how likely they were to respond to the question, as well as their perceived affective reaction to the question. Demographic data were collected, and an informal debriefing was conducted with each participant. Results Participants were an average of 15.3 years old (SD 1.00) and mostly female (11/19, 58%). Logistic regressions showed that the presence of GIFs predicted perceived emotional valence (β=–.40, P<.001), such that questions without GIFs were associated with a negative perceived emotional valence. Question type predicted emotional valence, such that yes/no questions (β=–.23, P=.03) and open-ended questions (β=–.26, P=.01) were associated with a negative perceived emotional valence compared to multiple response choice questions. Question type also predicted the likelihood of response, such that yes/no questions were associated with a lower likelihood of response compared to multiple response choice questions (β=–.24, P=.03) and a higher likelihood of response compared to open-ended questions (β=.54, P<.001). Conclusions The findings of this study add to the rapidly growing field of teen-computer interaction and contribute to our understanding of adolescent user experience in their interactions with a mental health chatbot. The insights gained from this study may be of assistance to developers and designers of mental health chatbots.