The association between the social presence and trust of chatbots and the sociodemographic characteristics of artificial intelligence chatbots users in general hospitals : focusing on sex and age

의료기관 인공지능 챗봇 이용자의 인구사회학적 특성과 챗봇의 사회적 실재감 및 신뢰감의 관련성 연구 - 성별과 연령 중심으로

  • Seung Won Jung (Department of Healthcare Management, Eulji University) ;
  • Seo Yeon Hwang (Department of Healthcare Management, Eulji University) ;
  • Gi Eun Choi (Department of Healthcare Management, Eulji University) ;
  • Eun Young Jo (Department of Healthcare Management, Eulji University) ;
  • Jin Wook Lee (Department of Healthcare Management, Eulji University) ;
  • Jin Young Nam (Department of Healthcare Management, Eulji University)
  • 정승원 (을지대학교 의료경영학과) ;
  • 황서연 (을지대학교 의료경영학과) ;
  • 최기은 (을지대학교 의료경영학과) ;
  • 조은영 (을지대학교 의료경영학과) ;
  • 이진욱 (을지대학교 의료경영학과) ;
  • 남진영 (을지대학교 의료경영학과)
  • Received : 2023.07.01
  • Accepted : 2023.09.12
  • Published : 2023.09.30

Abstract

Objectives: This study explores the impact of age groups on social presence and trust among users of medical artificial intelligence chatbots. Furthermore, we investigate the existence of gender differences within these relationships. Method: We collected data through a survey from people who had interacted with general hospital chatbot services, either by making reservations or seeking consultations. Multiple linear regression analysis was conducted to examine the relationship between general characteristics of study population and social presence and trust of artificial intelligence chatbots. Additionally, we conducted stratified analysis to confirm the presence of gender differences within these relationship. Results: Among 300 participants, those aged 50 and older had higher social presence of artificial intelligence chatbots and greater trust of artificial intelligence chatbots (social presence, 𝛽=0.543, p=0.003; trust, 𝛽=0.787, p=0.000). In stratified by sex, women aged 50 and older had higher social presence and trust of artificial intelligence chatbots compared to those in their 30s age group (social presence, 𝛽 = 0.925, p=0.002; trust, 𝛽=0.645, p=:0.007). However, there was no statistically significant relationship between age and chatbot social presence and trust in men. Conclusion: This study demonstrates that advanced age plays a significant roles in users' social presence and trust in medical artificial intelligence chatbots. Futhermore, our findings reveal gender differences with women aged 50 and older showing the most substantial levels of social presence and trust. Therefore, it is expected that this finding can serve as valuable evidence to enhance the satisfaction of medical institution service users, offering crucial insights into the effective utilization of chatbot services.

Keywords

References

  1. Radziwill N, Benton M. Evaluating Quality of Chatbots and Intelligent Conversational Agents. 2017;arXiv:1704.04579. 
  2. Seo G. Analysis of Domestic and Global Trends and Development Prospects of Artificial Intelligence-based Chatbot Service. National Inf Society Agency 2018;18(2):1-34. 
  3. Bae Y, Shin H. Corona19, accelerate the untact society. Gyeonggi Research Institute Issues & Diagnosis 2020;416:1-26. 
  4. Whang K. A Basic Study for Developing Korean Psychological Counseling Chatbot Service Model : Focusing on Overseas Case Analysis and Domestic Preference Survey [dissertation]. Seoul: Sookmyung Women's University;2020. 
  5. Chu S, Kang S, Yoo S. The influences of perceived value of AI medical counseling chatbot service on the use intention: focused on the usage purpose of chatbot counseling of obstetrics and gynecology. Health Service Management Review. 2021;15(3):41-59.  https://doi.org/10.18014/HSMR.2021.15.3.41
  6. Ashfaq M, Yun J, Yu S, Loureiro SMC. I, Chatbot: Modeling the determinants of users' satisfaction and continuance intention of AI-powered service agents Telematics and Informatics 2022;54:101473. 
  7. Kim S, Jeong O, Park C. Cases and analysis of chatbots. Proceedings of the Korea Society of IT Service Conference 2018;2018(1): 392-397. 
  8. CIO KOREA. Counselors and chatbots are both good KOREA. 2020 Jun 18; Sect. 13. 
  9. Cho J. The effect of Anthropomorphism and Regulatory Focus on Artificial Intelligence (AI) Chatbot on Consumer Response through Consumer Experience [dissertation]. Gyeonggi: Dankook University;2022. 
  10. Lee M, Park H. Exploring Factors Influencing Usage Intention of Chatbot - Chatbot in Financial Service. J Korean Soc Qual Manag 2019;47(4):755-765 
  11. Jeong S, Hur H, Choo H. The effect of fashion shopping chatbot characteristics on service acceptance intention - Focusing on anthropomorphism and personalization-. Journal of the Korean Society of Clothing and Textiles 2020;44(4):573-593.  https://doi.org/10.5850/JKSCT.2020.44.4.573
  12. Natarajan T, Balasubramanian SA, Kasilingam DL. Understanding the intention to use mobile shopping applications and its influence on price sensitivity. Journal of Retailing and Consumer Services 2017;37:8-22.  https://doi.org/10.1016/j.jretconser.2017.02.010
  13. Mun S, Lee J, Son J. A Study on Consumer's Acceptance Attitude according to Characteristics of Online and Offline Financial Services: Focusing on Mediating Effect of User Resistance and Comparison by Age. e-biz 2019;20(4):141-160.  https://doi.org/10.20462/TeBS.2019.8.20.4.141
  14. VAN BERKEL EZ. Chatbots do not have a gender, they are just a piece of code 2022. 
  15. Short J, Williams E, Christie B. The social psychology of telecommunications 1976. 
  16. Rice R. E. Media appropriateness: Using social presence theory to compare traditional and new organizational media. Human Communication Research 1993;19(4):451-484.  https://doi.org/10.1111/j.1468-2958.1993.tb00309.x
  17. Biocca F, Nowak K. Plugging your body into the telecommunication system: Mediated embodiment, media interfaces, and social virtual environments. Communication technology and society 2001;407-447. 
  18. Garrison D. R, Arbaugh J. B. Researching the community of inquiry framework: Review, issues, and future directions. The Internet and higher education 2007;10(3):157-172.  https://doi.org/10.1016/j.iheduc.2007.04.001
  19. BIOCCA F. The cyborg's dilemma: Progressive embodiment in virtual environments. Journal of computer-mediated communication 1997;3(2):JCMC324. 
  20. Yoo Y, Alavi M. Media and Group Cohesion: Relative Influences on Social Presence, Task Participation, and Group Consensus. MIS Quarterly. 2001;25(3):371-390.  https://doi.org/10.2307/3250922
  21. Lee K, Nass C. "Social-Psychological Origins of Feelings of Presence: Creating Social Presence With Machine-Generated Voices." Media Psychology 2005;7(1):31-45.  https://doi.org/10.1207/S1532785XMEP0701_2
  22. Hwang H, Park S. College student's usage of emo-ticons in mobile text-based messaging. Media, Gender & Cul-ture 2008;9:133-162. 
  23. Lee S, Lee J, Chung D. A Study on the Factors Affecting the Acceptance Intention of Chatbot Service in the Financial Industry. Journal of Korea technology innovation society. 2021;24(5):845-869.  https://doi.org/10.35978/jktis.2021.10.24.5.845
  24. James H. The Trust Paradox : A Survey of Economic Inquiries Into the Nature of Trust and Trustworthiness. Journal of Economic Behavior & Organization 2002;47(3):291-307.  https://doi.org/10.1016/S0167-2681(01)00214-1
  25. Poortinga W, Pidgeon N. Exploring the dimensionality of trust in risk regulation. Risk analysis : an official publication of the Society for Risk Analysis 2003;23(5):961-972.  https://doi.org/10.1111/1539-6924.00373
  26. Yuan W, Guan D, Lee S, Lee Y. The Role of Trust in Ubiquitous Healthcare. In 2007 9th International Conference on e-Health Networking, Application and Services. IEEE 2007;312-315. 
  27. Kim Y, Han S, Yoon Z, Heo E, Lee J, Kim J. Users' Perception and Behavioral Differences Depending on Chatbot Agent Identities. IFIP TC13 International Conference on Human-Computer Interaction 2017;12(4):45-55. 
  28. Alshurafat H. The usefulness and challenges of chatbots for accounting professionals: Application on ChatGPT. Available at SSRN 4345921 2023. 
  29. Gkinko L, Elbanna A. The appropriation of conversational AI in the workplace: A taxonomy of AI chatbot users. International J of Information Manag 2023;69:102568. 
  30. Palanica A, Flaschner P. Physicians' perceptions of chatbots in health care: cross-sectional web-based survey. J of medical Internet research, 2019;21(4):e12887. 
  31. Kim J, Muhic J, Robert LP, Park S. Designing chatbots with black americans with chronic conditions: Overcoming challenges against covid-19. In Proceedings of the 2022 CHI Conference on Human Factors in Computing Systems 2022;1-17. 
  32. Harrington, Christina N, Egede L. Trust, Comfort and Relatability: Understanding Black Older Adults' Perceptions of Chatbot Design for Health Information Seeking. In:Proceedings of the 2023 CHI Conference on Human Factors in Computing Systems. 2023;1-18. 
  33. Araujo T. Living up to the chatbot hype: The influence of anthropomorphic design cues and communicative agency framing on conversational agent and company perceptions. Computers in Human Behavior 2018;85:183-189.  https://doi.org/10.1016/j.chb.2018.03.051
  34. Cyr D, Hassanein K, Head M, Ivanov A. The role of social presence in establishing loyalty in e-Service environments. Interacting with Computers 2007:19(1):43-56.  https://doi.org/10.1016/j.intcom.2006.07.010
  35. Kao TWD, Lin WT. The relationship between perceived e-service quality and brand equity: A simultaneous equations system approach. Computers in Human Behavior 2016;57:208-218.  https://doi.org/10.1016/j.chb.2015.12.006
  36. Sevda D, Oyku YB, Ceyda DA. Tuketici yenilikciligi ve chatbot uygulamalarina guven arasindaki iliskinin incelenmesi: Turk bankacilik sektoru uzerine bir arastirma. Connectist: Istanbul University Journal of Communication Sciences 2022;(63):59-85. 
  37. Benbasat I, Dimoka A, Pavlou PA, Qiu L. The role of demographic similarity in people's decision to interact with online anthropomorphic recommendation agents: Evidence from a functional magnetic resonance imaging (fMRI) study. International Journal of Human-Computer Studies 2020;133:56-70.  https://doi.org/10.1016/j.ijhcs.2019.09.001
  38. KIM Y, Consumer Resistance Factor to Unmanned Order Payment System Based on Age, Gender, and Experience Difference. 2019;17(2):57-79.  https://doi.org/10.32956/kaoca.2019.17.2.57
  39. Qiu L, Benbasat I. A study of demographic embodiments of product recommendation agents in electronic commerce. International Journal of Human-Computer Studies 2010;68(10): 669-688.  https://doi.org/10.1016/j.ijhcs.2010.05.005
  40. Lee Y, Kim S, Hwang N, Lim J, Joo B, NamKung E, et al. National survey of older Koreans. Korea Institute for Health Social Affairs:Seoul, Republic of Korea 2020;261-303 
  41. Nissen M, Ruegger D, Stieger M, Fluckiger C, Allemand M, v Wangenheim F, et al. The Effects of Health Care Chatbot Personas With Different Social Roles on the Client-Chatbot Bond and Usage Intentions: Development of a Design Codebook and Web-Based Study. Journal of Medical Internet Research 2022;24(4):e32630. 
  42. Parmar D, Olafsson S, Utami D, Bickmore T. Looking the part: The effect of attire and setting on perceptions of a virtual health counselor. In Proceedings of the 18th international conference on intelligent virtual agents 2018;301-306. 
  43. Ogonowski A, Montandon A, Botha E, Reyneke M. Should new online stores invest in social presence elements? The effect of social presence on initial trust formation. Journal of Retailing and Consumer Services 2014;21(4):482-491.  https://doi.org/10.1016/j.jretconser.2014.03.004
  44. Toader DC, Boca G, Toader R, Macelaru M, Toader C, Ighian D, et al. The effect of social presence and chatbot errors on trust. Sustainability 2019;12(1):256. 
  45. Hancock PA, Billings DR, Schaefer KE, Chen JY, De Visser EJ, Parasuraman R. A meta-analysis of factors affecting trust in human-robot interaction. Human factors 2011;53(5):517-527.  https://doi.org/10.1177/0018720811417254
  46. De Cicco R, da Costa e Silva, SCL, Palumbo R. Should a chatbot disclose itself? Implications for an online conversational retailer. In Chatbot Research and Design: 4th International Workshop, CONVERSATIONS 2020, Virtual Event, November 23-24, 2020, Revised Selected Papers 4. Springer International Publishing 2021;3-15. 
  47. Damiano L, Dumouchel P. Anthropomorphism in Human-Robot Co-evolution. Frontiers in Psychology 2018;9:468. 
  48. Waytz A, Heafner J, Epley N. The mind in the machine: Anthropomorphism increases trust in an autonomous vehicle. Journal of Experimental Social Psychology 2014;52:113-117.  https://doi.org/10.1016/j.jesp.2014.01.005
  49. Airenti G. The cognitive bases of anthropomorphism: From relatedness to empathy. International Journal of Social Robotics 2015;7(1):117-127.  https://doi.org/10.1007/s12369-014-0263-x
  50. Ghafurian M, Budnarain N, Hoey J. Improving humanness of virtual agents and users' cooperation through emotions. arXiv 2019;1903.03980. 
  51. Natarajan M, Gombolay M. Effects of Anthropomorphism and Accountability on Trust in Human Robot Interaction. 2020 15th ACM/IEEE International Conference on Human-Robot Interaction (HRI) 2022;33-42. 
  52. Van den Hende EA, Mugge R. Investigating gender-schema congruity effects on consumers' evaluation of anthropomorphized products. Psychology & Marketing 2014;31(4):264-277  https://doi.org/10.1002/mar.20693
  53. Go E, Sundar SS. Humanizing chatbots: The effects of visual, identity and conversational cues on humanness perceptions. Computers in Human Behavior 2019;97:304-316.  https://doi.org/10.1016/j.chb.2019.01.020
  54. Sheehan B, Jin HS, Gottlieb U. Customer service chatbots: Anthropomorphism and adoption. Journal of Business Research 2020;115:14-24.  https://doi.org/10.1016/j.jbusres.2020.04.030
  55. De Cicco R, e Silva SC, Alparone FR. Millennials' attitude toward chatbots: an experimental study in a social relationship perspective. International Journal of Retail & Distribution Management 2020;48(11):1213-1233.  https://doi.org/10.1108/IJRDM-12-2019-0406
  56. Zogaj A, Mahner PM, Yang L, Tscheulin DK. It' sa Match! The effects of chatbot anthropomorphization and chatbot gender on consumer behavior. Journal of Business Research 2023;155:113412. 
  57. Bastiansen MH, Kroon AC, Araujo T. Female chatbots are helpful, male chatbots are competent? The effects of gender and gendered language on human-machine communication. Publizistik 2022;67(4):601-623.  https://doi.org/10.1007/s11616-022-00762-8
  58. Tay B, Jung Y, Park T. When stereotypes meet robots: The double-edged sword of robot gender and personality in human-robot interaction. Computers in Human Behavior 2014;38:75-84.  https://doi.org/10.1016/j.chb.2014.05.014
  59. Lee H, Yoon N. Factors driving Fashion Chatbot Reliability-Focusing on the Mediating Effect of Perceived Intelligence and Positive Cognition. Fashion & Textile Research Journal 2022;24(2):229-240. https://doi.org/10.5805/SFTI.2022.24.2.229