Mood mirroring with an embodied virtual agent: A pilot study on the relationship between personalized visual feedback and adherence

Simon Provoost, Jeroen Ruwaard, Koen Neijenhuijs, Tibor Bosse, Heleen Riper

Research output: Chapter in Book/Report/Conference proceedingConference contributionAcademicpeer-review

5 Citations (Scopus)
1 Downloads (Pure)


Human support is thought to increase adherence to internet-based interventions for common mental health disorders, but can be costly and reduce treatment accessibility. Embodied virtual agents may be used to deliver automated support, but while many solutions have been shown to be feasible, there is still little controlled research that empirically validates their clinical effectiveness in this context. This study uses a controlled and randomized paradigm to investigate whether feedback from an embodied virtual agent can increase adherence. In a three-week ecological momentary assessment smartphone study, 68 participants were asked to report their mood three times a day. An embodied virtual agent could mirror participant-reported mood states when thanking them for their answers. A two-stage randomization into a text and personalized visual feedback group, versus a text-only control group, was applied to control for individual differences (study onset) and feedback history (after two weeks). Results indicate that while personalized visual feedback did not increase adherence, it did manage to keep adherence constant over a three-week period, whereas fluctuations in adherence could be observed in the text-only control group. Although this was a pilot study, and its results should be interpreted with some caution, this paper shows how virtual agent feedback may have a stabilizing effect on adherence, how controlled experiments on the relationship between virtual agent support and clinically relevant measures such as adherence can be conducted, and how results may be analyzed.

Original languageEnglish
Title of host publicationHighlights of practical applications of agents, multi-agent systems, and complexity: The PAAMS collection
Subtitle of host publicationProceedings of the 16th InternationalInternational Workshops of PAAMS 2018, Toledo, Spain, June 20-22, 2018, Proceedings
EditorsJavier Bajo, Juan M. Corchado, Vicente Julian, Eneko Osaba Icedo, Patrycja Hoffa-Dabrowska, Ricardo Azambuja Silveira, Alberto Fernandez, Sylvain Giroux, Elena María Navarro Martínez, Philippe Mathieu, Antonio J. Castro, Nayat Sanchez-Pi, Elena del Val, Rainer Unland, Ruben Fuentes-Fernandez
Number of pages12
ISBN (Electronic)9783319947792
ISBN (Print)9783319947785
Publication statusPublished - 2018
Event16th International Conference on Practical Applications of Agents, Multi-Agent Systems, PAAMS 2018 - Toledo, Spain
Duration: 20 Jun 201822 Jun 2018

Publication series

NameCommunications in Computer and Information Science


Conference16th International Conference on Practical Applications of Agents, Multi-Agent Systems, PAAMS 2018


  • Adherence
  • Ecological momentary assessment
  • Feedback
  • Virtual agent

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