Psychological, economic, and ethical factors in human feedback for a chatbot-based smoking cessation intervention
Abstract Integrating human support with chatbot-based behavior change interventions raises three challenges: (1) attuning the support to an individual’s state (e.g., motivation) for enhanced engagement, (2) limiting the use of the concerning human resources for enhanced efficiency, and (3) optimizin...
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| Format: | Article |
| Language: | English |
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Nature Portfolio
2025-05-01
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| Series: | npj Digital Medicine |
| Online Access: | https://doi.org/10.1038/s41746-025-01701-3 |
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| author | Nele Albers Francisco S. Melo Mark A. Neerincx Olya Kudina Willem-Paul Brinkman |
| author_facet | Nele Albers Francisco S. Melo Mark A. Neerincx Olya Kudina Willem-Paul Brinkman |
| author_sort | Nele Albers |
| collection | DOAJ |
| description | Abstract Integrating human support with chatbot-based behavior change interventions raises three challenges: (1) attuning the support to an individual’s state (e.g., motivation) for enhanced engagement, (2) limiting the use of the concerning human resources for enhanced efficiency, and (3) optimizing outcomes on ethical aspects (e.g., fairness). Therefore, we conducted a study in which 679 smokers and vapers had a 20% chance of receiving human feedback between five chatbot sessions. We find that having received feedback increases retention and effort spent on preparatory activities. However, analyzing a reinforcement learning (RL) model fit on the data shows there are also states where not providing feedback is better. Even this “standard” benefit-maximizing RL model is value-laden. It not only prioritizes people who would benefit most, but also those who are already doing well and want feedback. We show how four other ethical principles can be incorporated to favor other smoker subgroups, yet, interdependencies exist. |
| format | Article |
| id | doaj-art-3fc96cc59fdc4e3e8780d70793abcdf6 |
| institution | OA Journals |
| issn | 2398-6352 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | npj Digital Medicine |
| spelling | doaj-art-3fc96cc59fdc4e3e8780d70793abcdf62025-08-20T02:03:39ZengNature Portfolionpj Digital Medicine2398-63522025-05-018111410.1038/s41746-025-01701-3Psychological, economic, and ethical factors in human feedback for a chatbot-based smoking cessation interventionNele Albers0Francisco S. Melo1Mark A. Neerincx2Olya Kudina3Willem-Paul Brinkman4Department of Intelligent Systems, Delft University of TechnologyINESC-ID and Instituto Superior Técnico, Universidade de LisboaDepartment of Intelligent Systems, Delft University of TechnologyDepartment of Values, Technology and Innovation, Delft University of TechnologyDepartment of Intelligent Systems, Delft University of TechnologyAbstract Integrating human support with chatbot-based behavior change interventions raises three challenges: (1) attuning the support to an individual’s state (e.g., motivation) for enhanced engagement, (2) limiting the use of the concerning human resources for enhanced efficiency, and (3) optimizing outcomes on ethical aspects (e.g., fairness). Therefore, we conducted a study in which 679 smokers and vapers had a 20% chance of receiving human feedback between five chatbot sessions. We find that having received feedback increases retention and effort spent on preparatory activities. However, analyzing a reinforcement learning (RL) model fit on the data shows there are also states where not providing feedback is better. Even this “standard” benefit-maximizing RL model is value-laden. It not only prioritizes people who would benefit most, but also those who are already doing well and want feedback. We show how four other ethical principles can be incorporated to favor other smoker subgroups, yet, interdependencies exist.https://doi.org/10.1038/s41746-025-01701-3 |
| spellingShingle | Nele Albers Francisco S. Melo Mark A. Neerincx Olya Kudina Willem-Paul Brinkman Psychological, economic, and ethical factors in human feedback for a chatbot-based smoking cessation intervention npj Digital Medicine |
| title | Psychological, economic, and ethical factors in human feedback for a chatbot-based smoking cessation intervention |
| title_full | Psychological, economic, and ethical factors in human feedback for a chatbot-based smoking cessation intervention |
| title_fullStr | Psychological, economic, and ethical factors in human feedback for a chatbot-based smoking cessation intervention |
| title_full_unstemmed | Psychological, economic, and ethical factors in human feedback for a chatbot-based smoking cessation intervention |
| title_short | Psychological, economic, and ethical factors in human feedback for a chatbot-based smoking cessation intervention |
| title_sort | psychological economic and ethical factors in human feedback for a chatbot based smoking cessation intervention |
| url | https://doi.org/10.1038/s41746-025-01701-3 |
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