This paper conducts a systematic literature review (SLR) to evaluate the effectiveness of computational persuasion technology (CPT) in the eHealth domain. Over the past fifteen years, CPT has been used in various scenarios, from promoting healthy diets to supporting chronic disease management. Despite the proliferation of intelligent systems and Web-based applications, the ethical and legal nuances of these technologies have become increasingly significant. The review follows a structured methodology, assessing 92 primary studies through sixteen research questions covering demographics, application scenarios, user requirements, objectives, functionalities, technologies, advantages, limitations, proposed solutions, ethical and legal implications, and the role of explainable AI (XAI). The findings indicate that while CPT holds promise in inducing behavioral change, many prototypes remain untested on a large scale (60% of surveyed studies only developed at a conceptual level), and long-term effectiveness is still uncertain (36% report attaining their goals, but none focuses on long-term assessment). The study highlights the need for more comparative analyses of persuasion models and tailored approaches to meet diverse user needs. Ethical and legal concerns, such as patient consent, data privacy, and potential for users’ manipulation, are under-explored and require deeper investigation. The paper recommends a bottom-up regulatory approach to create more effective and flexible ethical and legal guidelines for CPT applications.@en

The awareness about healthy lifestyles is increasing, opening to personalized intelligent health coaching applications. A demand for more than mere suggestions and mechanistic interactions has driven attention to nutrition virtual coaching systems (NVC) as a bridge between human–machine interaction and recommender, informative, persuasive, and argumentation systems. NVC can rely on data-driven opaque mechanisms. Therefore, it is crucial to enable NVC to explain their doing (i.e., engaging the user in discussions (via arguments) about dietary solutions/alternatives). By doing so, transparency, user acceptance, and engagement are expected to be boosted. This study focuses on NVC agents generating personalized food recommendations based on user-specific factors such as allergies, eating habits, lifestyles, and ingredient preferences. In particular, we propose a user-agent negotiation process entailing run-time feedback mechanisms to react to both recommendations and related explanations. Lastly, the study presents the findings obtained by the experiments conducted with multi-background participants to evaluate the acceptability and effectiveness of the proposed system. The results indicate that most participants value the opportunity to provide feedback and receive explanations for recommendations. Additionally, the users are fond of receiving information tailored to their needs. Furthermore, our interactive recommendation system performed better than the corresponding traditional recommendation system in terms of effectiveness regarding the number of agreements and rounds.

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Existing agent-based chatbot frameworks need seamless mechanisms to include explainable dialogic engines within the contextual flow. To this end, this paper presents a set of novel modules within the EREBOTS agent-based framework for chatbot development, including dialog-based plug-and-play custom algorithms, agnostic back/front ends, and embedded interactive explainable engines that can manage human feedback at run time. The framework has been employed to implement an explainable agent-based interactive food recommender system. The latter has been tested with 44 participants, who followed a nutrition recommendation interaction series, generating explained recommendations and suggestions, which were, in general, well received. Additionally, the participants provided important insights to be included in future work.

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As recommendation systems become increasingly prevalent in numerous fields, the need for clear and persuasive interactions with users is rising. Integrating explainability into these systems is emerging as an effective approach to enhance user trust and sociability. This research focuses on recommendation systems that utilize a range of explainability techniques to foster trust by providing understandable personalized explanations for the recommendations made. In line with this, we study three distinct explanation methods that correspond with three basic recommendation strategies and assess their efficacy through user experiments. The findings from the experiments indicate that the majority of participants value the suggested explanation styles and favor straightforward, concise explanations over comparative ones.

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People’s awareness about the importance of healthy lifestyles is rising. This opens new possibilities for personalized intelligent health and coaching applications. In particular, there is a need for more than simple recommendations and mechanistic interactions. Recent studies have identified nutrition virtual coaching systems (NVC) as a technological solution, possibly bridging technologies such as recommender, informative, persuasive, and argumentation systems. Enabling NVC to explain recommendations and discuss (argument) dietary solutions and alternative items or behaviors is crucial to improve the transparency of these applications and enhance user acceptability and retain their engagement. This study primarily focuses on virtual agents personalizing the generation of food recipes recommendation according to users’ allergies, eating habits, lifestyles, nutritional values, etc. Although the agent would nudge the user to consume healthier food, users may tend to object in favor of tastier food. To resolve this divergence, we propose a user-agent negotiation interacting over the revision of the recommendation (via feedback and explanations) or convincing (via explainable arguments) the user of its benefits and importance. Finally, the paper presents our initial findings on the acceptability and usability of such a system obtained via tests with real users. Our preliminary experimental results show that the majority of the participants appreciate the ability to express their feedback as well as receive explanations of the recommendations, while there is still room for improvement in the persuasiveness of the explanations.

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