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  <front>
    <journal-meta />
    <article-meta>
      <title-group>
        <article-title>Designing and Developing Lifelike, Engaging Lifestyle Coaching Agents and Scenarios for Multiparty Coaching Interaction</article-title>
      </title-group>
      <contrib-group>
        <contrib contrib-type="author">
          <string-name>Gerwin Huizing</string-name>
          <email>g.h.huizing@utwente.nl</email>
          <xref ref-type="aff" rid="aff0">0</xref>
        </contrib>
        <contrib contrib-type="author">
          <string-name>Randy Klaassen</string-name>
          <email>r.klaassen@utwente.nl</email>
          <xref ref-type="aff" rid="aff0">0</xref>
        </contrib>
        <contrib contrib-type="author">
          <string-name>Dirk Heylen</string-name>
          <email>d.k.j.heylen@utwente.nl</email>
          <xref ref-type="aff" rid="aff0">0</xref>
        </contrib>
        <aff id="aff0">
          <label>0</label>
          <institution>University of Twente</institution>
          ,
          <addr-line>Enschede</addr-line>
          ,
          <country country="NL">The Netherlands</country>
        </aff>
      </contrib-group>
      <fpage>25</fpage>
      <lpage>29</lpage>
      <abstract>
        <p>The use of Embodied Conversational Agents (ECAs) in the domain of lifestyle coaching has been the subject of many studies in the last decades. With ageing populations in many countries, the pressure on healthcare systems is increasing. ECAs can be a potential tool to help combat this pressure through the promotion of a healthier lifestyle among older adults, as well as through coaching and counselling of older adults on how to manage their health. Designing more lifelike and engaging ECAs is of key importance to further this goal, as this could help encourage self-disclosure by the users towards the ECAs, could make the ECAs more persuasive, and could increase engagement and enjoyment of the interactions by the users, among other things. The Council of Coaches project aims to provide users with virtual coaching done by several lifestyle coaching agents with diferent domains of expertise as well as varying backstories, personalities, mannerisms, motivations and looks, among other things. To work towards this goal, work has been done on character and personality design for an initial set of lifestyle coaching agents and defined initial interaction scenarios. These were inspired by literature on coaching and ECAs, videos of interactions between healthcare professionals and patient actors, conversations with healthcare professionals, and brainstorming sessions. This paper presents the work done within the project thus far and closes out by presenting our plans to address the question: What are the possible advantages and disadvantages of a multiple agent approach as compared to a single agent approach to coaching interactions with older adults?</p>
      </abstract>
    </article-meta>
  </front>
  <body>
    <sec id="sec-1">
      <title>CCS CONCEPTS</title>
      <p>• Human-centered computing → Human computer
interaction (HCI); User interface design; • Applied computing →
Psychology;</p>
    </sec>
    <sec id="sec-2">
      <title>INTRODUCTION</title>
      <p>This paper intends to showcase some of the work done on the
characters and scenarios for multiparty coaching interaction in
the Council of Coaches project, and elaborate on our plans to
investigate questions regarding the multiparty interaction between
lifestyle coaching agents and older adults. We will start by
elaborating why ECAs are a useful tool to help tackle issues associated with
the ageing population and their healthcare needs, specifically by
having ECAs give lifestyle advice to older adults and coach them.
We go on to explain why it could be interesting to look at the use
of multiple agents instead of a single agent to perform lifestyle
coaching. We follow this up by briefly discussing the Council of
Coaches project and the work that was done on the design of the
personalities and appearances of the characters, as well as the
scenarios in this project. Finally, we focus our attention on some of
the interesting questions to be asked about coaching dialogue and
interaction with older adults using multiple agents and our initial
plans to answer some of these questions in future work.
1.1</p>
    </sec>
    <sec id="sec-3">
      <title>The ageing population and healthcare challenges: ECAs as a potential tool</title>
      <p>
        The population of the world is ageing [
        <xref ref-type="bibr" rid="ref27">27</xref>
        ]. This ageing population
is putting pressure on current healthcare systems, organisations,
and professionals and is posing new challenges worldwide such
as a required shift in focus to managing chronic illnesses among
older adults and the increased need for long-term care [
        <xref ref-type="bibr" rid="ref22 ref29 ref36 ref38 ref4">4, 22, 29,
36, 38</xref>
        ]. Some of the ways to tackle the aforementioned challenges
are to promote a healthier lifestyle among older adults to prevent
and delay the onset of deterioration of health, and to improve
self-care in patients sufering from chronic illnesses [
        <xref ref-type="bibr" rid="ref12 ref18 ref36">12, 18, 36</xref>
        ].
This can be done by increasing the health information available to
older adults and persuading and motivating them to change their
health behaviours in a tailored and realisable way through coaching,
counselling and giving lifestyle advice [
        <xref ref-type="bibr" rid="ref18">18</xref>
        ].
      </p>
      <p>
        ECAs make for an interesting tool to employ to persuade and
motivate users to adopt a healthier lifestyle. Firstly, recent studies
have shown evidence to suggest that ECAs are treated like social
actors and can influence people [
        <xref ref-type="bibr" rid="ref10 ref13 ref16 ref17 ref19 ref2 ref20 ref21 ref23 ref25 ref28 ref3 ref30 ref31 ref32 ref34 ref39 ref6 ref7 ref8 ref9">2, 3, 6–10, 13, 16, 17, 19–21, 23, 25,
28, 30–32, 34, 39</xref>
        ], and more specifically have the ability to persuade
people and impact their motivation [
        <xref ref-type="bibr" rid="ref11 ref17 ref2 ref3 ref32 ref8">2, 3, 8, 11, 17, 32</xref>
        ]. Lastly and
most importantly, recent studies [
        <xref ref-type="bibr" rid="ref10 ref16">10, 16</xref>
        ] have already shown that
ECAs can help to improve health behaviours of people.
1.2
      </p>
    </sec>
    <sec id="sec-4">
      <title>Designing and developing efective ECAs</title>
      <p>
        It is important to pay close attention to the design and
development of efective ECAs when we want to employ them as lifestyle
coaching agents. As we previously established, ECAs are treated
like social actors. Just like how in human-human interactions many
factors about the other can change the way we interact with them,
this seems to be the case for ECAs as well. Previous studies have
shown that appearance [
        <xref ref-type="bibr" rid="ref2 ref33">2, 33</xref>
        ], verbal and nonverbal behaviours
[
        <xref ref-type="bibr" rid="ref13 ref17 ref19 ref34 ref35 ref39 ref5 ref6 ref8">5, 6, 8, 13, 17, 19, 34, 35, 39</xref>
        ], perceived personalities of the ECAs
[
        <xref ref-type="bibr" rid="ref30 ref34">30, 34</xref>
        ], and the modalities of interactions [
        <xref ref-type="bibr" rid="ref21 ref24 ref26">21, 24, 26</xref>
        ] can have
an efect on the interaction with users, the perceived user
experience, likeability and other aspects in many ways. In conclusion, as
many factors about ECAs have an efect on the interaction with
users, the users’ perceptions and the users themselves, it is of
importance to know what the goals of a system using ECAs are and
what user group it is targeting. This should inform design decisions
by developers of such systems.
1.3
      </p>
    </sec>
    <sec id="sec-5">
      <title>Multiparty coaching interaction</title>
      <p>
        The previous examples looked at interactions between a single
ECA and user. To the best of our knowledge, little work has been
done to examine the efects of interaction with multiple agents or
ECAs in a coaching setting. We are interested in investigating the
possible advantages and disadvantages of a multiple agent approach
to interaction with older adults in a lifestyle coaching setting, with
a focus on dialogue including verbal and nonverbal behaviour. We
postulate that there could be an added benefit to there being a group
of ECAs interacting with each other as well as the user when they
act as lifestyle coaching agents trying to persuade and motivate
users. It allows for discussion between agents regardless of user
input, which allows the system to inform and potentially engage the
user even when they are not responding. When the interaction with
the system involves diferent characters with diferent personalities,
appearances, backstories, motivations, solutions to issues and such,
it could make interactions with the system be more of an interactive
experience and thus make the interactions more engaging and fun.
Prior work [
        <xref ref-type="bibr" rid="ref1">1</xref>
        ] seems to give an indication that these benefits could
exist. Splitting out roles and functionality of the coaches could also
help improve motivation and retention of information [
        <xref ref-type="bibr" rid="ref2">2</xref>
        ]. Finally,
the diferent perspectives of the lifestyle coaching agents can show
users diferent approaches to tackle issues and could make them
reflect on what they think the best way to handle them could be.
This would be harder to do during a conversation with a single
coaching agent. Group interaction does further complicate matters,
as it could introduce new social phenomena to consider that have
been observed in group dynamics in human-human interactions.
Furthermore, for the coaches to efectively help the users, we might
want to consider literature on efective teamwork such as [
        <xref ref-type="bibr" rid="ref14 ref37">14, 37</xref>
        ] to
make sure the coaches work as one team to help the users. On top
of the aforementioned, we are also interested in looking into the
efects of the agents and the interaction being lifelike on the user.
In short, there are many interesting questions to be addressed with
regards to multiparty coaching interaction and dialogue with older
adults and we hope to address these in our future work (Section 3).
1.4
      </p>
    </sec>
    <sec id="sec-6">
      <title>Aim of this paper</title>
      <p>The aim of this paper is to present part of the work done so far in
the Council of Coaches project on lifestyle coaching agent design
and scenario development for multiparty interaction between
several lifestyle coaching agents and an older adult user, and discuss
the impact this could have on the interaction and user. The paper
also intends to give insight into our plans for future studies on
the multiparty interaction the coaches will have with older adults
with their goals of engaging them, and motivating and persuading
them to improve their health behaviours and management of their
chronic illnesses. When speaking of older adults in the context of
this paper, we mean people of the age of fifty years old and above.</p>
      <p>We will now outline the structure of the sections in this paper. In
Section 2 we briefly summarize the goals of the Council of Coaches
project and how the consortium set out to achieve them, the work
on designing virtual characters and their personalities thus far
(Section 2.1) and the work done on developing initial interaction
scenarios (Section 2.2). In Section 3 we will present our plans for
future research into multiparty coaching interaction.
2</p>
    </sec>
    <sec id="sec-7">
      <title>ONGOING PROJECT WORK</title>
      <p>The goal of the project is to develop a system employing a group
of agents fulfilling the role of lifestyle coaches that persuade and
motivate older adults to adopt a healthier lifestyle, improve their
social, physical, mental and cognitive health, and improve their
management of their chronic illnesses (diabetes type 2 and chronic
pain). To do so, the agents will use difering coaching techniques and
will all behave diferently in the interactions due to having their own
areas of expertise, personality, backstory, and mannerisms, among
other things. We intend to investigate the diferences between
these interactions and interactions with a single lifestyle coaching
agent, as well as investigate how to make the multiparty coaching
interactions feel natural and be persuasive and motivating for older
adults.</p>
      <p>When the Council of Coaches consortium started working on
the project, it was decided to first get inspiration for the design and
development work. This came from looking into literature regarding
coaching and ECAs, speaking to several healthcare professionals to
get their input on the role the coaches could play for older adults,
brainstorming sessions inspired by observations and discussion
about the kind of scenarios in which the coaches would interact
with older adults.</p>
      <p>
        Furthermore, the work was motivated by a related set of patient
interviews [
        <xref ref-type="bibr" rid="ref15">15</xref>
        ], conducted by partners in the Council of Coaches
project1. This material gave the consortium the opportunity to see
what interactions between multiple healthcare and coaching
professionals and a patient with the goal of changing patient behaviour
could look like (Figure 1).
2.1
      </p>
    </sec>
    <sec id="sec-8">
      <title>Virtual character and personality design</title>
      <p>Once the aforementioned steps were taken, the consortium set up
a Character Design Task Force (CDTF)2, which were tasked with
deciding on several initial characters. Using previous reading, talks
to professionals, observations and brainstorming sessions as
inspiration, the CDTF discussed what to describe about the coaches and
how to portray them. After some discussion, the members of the
CDTF were tasked with each describing one coach in their own
1The patient interviews were led by Alison Pease, Mark Snaith and Dominic De Franco
(arranging, co-ordinating and recording sessions) at the University of Dundee, in
collaboration with Tessa Beinema and Harm op den Akker (development of personas
and scenarios) from Roessingh Research and Development; Catherine Pelachaud,
Reshmashree Bangalore Kantharaju from Paris-Sorbonne University and Gerwin Huizing
(advice on recording equipment and setup) from the University of Twente, and Nicholas
Conway (organising and hosting) from the University of Dundee.
2The CDTF consisted of Harm op den Akker, Tessa Beinema, Marijke Broekhuis and
Silke ter Stal from Roessingh Research and Development, Catherine Pelachaud and
Reshmashree Bangalore Kantharaju from the Paris-Sorbonne University, Alison Pease
and Mark Snaith from the University of Dundee, and Jorien van Loon and Gerwin
Huizing from the University of Twente.
way. Some of the recurring information given about the coaches
were their names, coaching roles, genders, ages, mottos, general
background information, physical characteristics, backstory, main
strength and main weakness, mannerisms and personality.
Furthermore, the members all added some visuals of existing characters
and people to showcase what they imagined their coach would look
like. This was done to give a clear idea to the rest of the consortium
about the possibilities there were for the coaches to be diverse and
lifelike characters with diferent ways of interacting with the users
and diferent coaching approaches.</p>
      <p>In this first step of the process we worked on Helen, the
cognitive coach. We envisioned and described her as a recently retired
psychologist that used to have her own practice. We imagined her
to be living in a smaller town close to nature in England, as she
loves nature. Nature would be a topic she would enjoy to discuss,
and she could also involve solutions to issues involving nature. Her
motivation would be to want to understand what drives people
to do what they do. She would be a good listener and would not
spend much time on chitchat, but instead dive in deep with a lot
of questions. She would have an easy time talking about personal
things, and would open up easily. We envisioned her poking and
prodding at the ideas people have to help them change their minds
and consequently their lives, while having a healthy amount of
respect for what someone feels and thinks due to her background. We
imagined she would feel quite wise due to her life experience and
would not have much experience with teamwork. This could lead
to her needing quite some explaining and convincing to consider
the viewpoints of fellow coaches. Furthermore, we gave her some
tendencies befitting of a retired psychologist, such as summarizing
what someone else said to show understanding. This information
was intended to give a clear idea of what kind of coach Helen would
be and how she would act.</p>
      <p>Once the initial coaches were defined, the CDTF set out to
showcase what interactions with them could look like. To do so they
developed dialogue trees for introductory dialogue including some
gesturing and facial expressions. These scripted interactions
included content such as the coach introducing themselves, giving
the user a brief backstory about themselves, telling the user a bit
about their hobbies, trying to coach the user on a health-related
topic and responding to perceived silence by the user. In all branches
of the tree the dialogue was inspired by the original description
of the coaches while attempting to make them feel as lifelike as
possible. These scripted interactions had the function of showing
of the characters in interaction as more than just flat descriptions,
and to show the efects of some of the diferent aspects that were
defined about them on their interaction with the users. We worked
on these dialogues for Helen, as well as Hank.</p>
      <p>Besides fleshing out the coaches by means of showcasing an
interaction with them, the CDTF also worked on initial visual
representations of the coaches using 3D character models (Figure 2)3.</p>
      <p>These were inspired by the visuals and description of physical
characteristics included in the initially defined characters. The coaches
were physically diverse with the purpose of having a diverse and
interesting cast of coaches for the user to interact with, as well as
have their appearance align with their difering backgrounds.
Furthermore, it could be of interest to see the efects of these diferent
appearances on the user during the multiparty interaction.
2.2</p>
    </sec>
    <sec id="sec-9">
      <title>Scenario Development</title>
      <p>Meanwhile, the consortium partners of the Council of Coaches
project worked on specifying several initial scenarios for the coaches
to interact with the user in. A total of seven scenarios were discussed
during a meeting and each highlighted diferent aspects to focus
on, such as use of humour, showcasing diferences in perspective
between the coaches, diferences in their personalities and coaching
styles, language use, using storytelling to get a point across, using
motivational interviewing techniques, and using behaviour change
strategies. The CDTF decided on starting with an introductory
scenario with three of the developed coaches leading into the coaches
using the behaviour change strategy goal setting. The goal was to
showcase the varying coaches with diferent backstories, hobbies
and ways of interacting as well as show goal setting as a behaviour
change strategy and to show how negotiation about goals could be
done by the user as well as by other coaches.
3</p>
    </sec>
    <sec id="sec-10">
      <title>OUR PLANS</title>
      <p>Now that an initial set of lifestyle coaching agents to coach older
adults and initial scenarios for them to interact in with the users
3These 3D models were made by Reshmashree Bangalore Kantharaju from the
ParisSorbonne University and validated with the members of the CDTF that designed each
of these coaches.
have been defined, we will be able to study what the efects of the
many aspects of the characters and scenarios could be on the user
as well as the interaction itself in multiparty interaction.</p>
      <p>The question we intend to address is: What are the possible
advantages and disadvantages of a multiple agent approach as
compared to a single agent approach to coaching interactions with
older adults? As previously mentioned, we are not aware of
previous studies into this topic and we postulate that it is interesting to
investigate the impact interaction with multiple coaching agents
could have. Thus, our goals by doing studies into the efects of the
defined coaches and scenarios in multiparty interaction is to find
out in what ways a multiparty interaction difers from a one on
one interaction with a lifestyle coaching agent, which variables
could have an efect on how older adults experience multiparty
interaction as feeling more or less natural and engaging, could have
an efect on how lifelike each of the individual coaches feel to the
older adults, could have an efect on how persuasive and motivating
the coaches are to older adults, could an efect on the trust of users
in individual coaches as well as the coaching team as a whole, and
could have an efect on how interesting and engaging the coaches
are, among other things. Some of the variables we are considering
to study are the amount of coaches participating in the interaction,
backstory, perceived personality, body language, appearance, use
of interpersonal social behaviour, presentation of diferent
perspectives, the form disagreement between coaches as well as between
coaches and the user takes in their interactions (e.g. having a fierce
discussion as compared to trying to come to a solution both parties
can agree to), and coaching strategies employed, among others.
Studying these efects could lead to new insights to be used in the
development of coaching applications for older adults as well as
other user groups in future work. To achieve our goals, we plan
to do a literature study, study recorded interactions, as well as do
stakeholder studies and user studies. We will shortly elaborate on
the use of each of these kinds of studies to further our goals and
present the ideas for future studies that we currently have.</p>
      <p>Firstly, we intend for our literature study to give us a better
understanding of the state of the art in the field of coaching
applications and ECAs, and specifically the use of ECAs as lifestyle
coaches. This will give us a solid foundation of knowledge to work
from when we further develop the coaches and scenarios, as well
as give us something to base our decisions on regarding what could
be of interest for our stakeholder studies and user studies.</p>
      <p>Secondly, we plan to further study recorded interactions such as
the aforementioned one made by our colleagues to find out what
kinds of aspects about the interaction could be relevant in a
multiparty coaching interaction for the coaches to not only be lifelike
and engaging, but also efective at persuading and motivating users
to change their health behaviours. We plan to look at verbal and
nonverbal behaviour in these recordings. We expect that this will
give us insight into the kind of behaviours agents might need to be
able to display in their interactions with older adult users.</p>
      <p>Thirdly, we will conduct stakeholder studies to give us insight
into best practice currently followed by healthcare and coaching
professionals when working with older adults and the strategies
and techniques they use when interacting with them. Furthermore,
they could give us further insight into our target group of older
adults and how the coaches should interact with them, specifically
the ones sufering from the chronic illnesses type 2 diabetes and
chronic pain. Finally, they could also help us evaluate the coaches
by interacting with them, or observing interactions with users and
giving us feedback on what could be done diferently to make the
interaction more engaging and make the coaches feel more lifelike
as well as be more persuasive, motivating and efective at changing
health behaviours of older adults.</p>
      <p>Fourthly and finally, we intend to conduct user studies to study
the efects the coaches, scenarios and interactions have on the users
and compare multiparty coaching interactions to interactions with
a single coaching agent. This will be done to try and discover what
aspects of them have an efect on the perceptions and behaviour
of the users. Our goals are to try to find the diferences in efect
between multiparty coaching interaction and interaction with a
single coaching agents, as well as what aspects could have an efect
on how engaging and natural feeling the multiparty interaction is,
and what variables could have an efect on the persuasiveness and
ability to motivate older adult users of the agents.</p>
      <p>The next step we plan to take is to investigate the efects of some
of the previously mentioned variables on the multiparty
coaching interaction through the use of several studies inspired by the
work done on the developed characters and some of the developed
interaction scenarios. One of the first studies we plan to do is a
wizard-of-Oz user study comparing having the same message being
delivered by one lifestyle coaching agent and by multiple agents (2
agents, 3 agents, et cetera) to investigate whether this has an efect
on older adult users. We expect this to give us insight into
advantages and disadvantages of using multiple agents. If any notable
efects are found, we could investigate these further through
evaluation methods such as questionnaires and interviews in a follow-up
study to further expand upon the causes of these efects. Another
study we plan to do is a study of recorded interactions to investigate
the verbal and nonverbal behaviour and group dynamics displayed
by healthcare and coaching professionals when performing the
role of coaches in a group coaching session with someone playing
the role of a patient. This study could help improve understanding
of key verbal and nonverbal behaviours and group dynamics for
lifestyle coaching agents to display in a multiparty interaction with
a user. We could then evaluate the efects of the behaviours and
group dynamics we observe in this study when they are displayed
by the agents in follow-up user studies. By doing so we intend
to investigate which of them are of interest when developing a
coaching system employing multiple agents.</p>
    </sec>
    <sec id="sec-11">
      <title>ACKNOWLEDGMENTS</title>
      <p>We are indebted to the Council of Coaches team, and specifically the
members of the CDTF for their work on character and personality
design of the coaches and scenario development.</p>
      <p>This project has received funding from the European Union’s
Horizon 2020 research and innovation programme under grant
Agreement Number 769553. This result only reflects the author’s view
and the EU is not responsible for any use that may be made of the
information it contains.</p>
    </sec>
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