Abstract
Technological progress provides health professionals with an excellent opportunity to take advantage of these developments and contribute to the development of efficient ways of diagnosing, monitoring, treating and assisting users. The purpose of this work is to present the results of a study conducted to examine the quantitative equivalence of paper-and-pencil and a voice-based conversational assistant, popularly known as a “chatbot”, as means to administer tests. One hundred and eight undergraduate university students completed both versions of the De Jong Gierveld Loneliness Scale. The interval between the first and second administration was set at four days. Validity, internal structure, internal consistency and equivalence of chatbot administration mode were assessed. A confirmatory factor analysis was used to verify the factor structure and provided a two-factor structure. Validity and internal consistency are adequate. These results support the feasibility of using chatbots for loneliness assessment in a sample of undergraduate university students and other populations in future.
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Abd-Alrazaq, A. A., Rababeh, A., Alajlani, M., Bewick, B. M., & Househ, M. (2020). Effectiveness and safety of using Chatbots to improve mental health: Systematic review and meta-analysis. Journal of Medical Internet Research, 22(7), e16021. https://doi.org/10.2196/16021.
Alberdi, A., Weakley, A., Aztiria, A., Schmitter-Edgecombe, M., & Cook, D. J. (2018). Automatic assessment of functional health decline in older adults based on smart home data. Journal of Biomedical Informatics, 81, 119–130. https://doi.org/10.1016/j.jbi.2018.03.009.
Bazzano, A. N., Martin, J., Hicks, E., Faughnan, M., & Murphy, L. (2017). Human-centred design in global health: A scoping review of applications and contexts. PLoS One, 12(11), e0186744. https://doi.org/10.1371/journal.pone.0186744.
Barrigón, M. L., Rico-Romano, A. M., Ruiz-Gómez, M., Delgado-Gómez, D., Barahona, I., Aroca, F., & Baca-García, E. (2017). Comparative study of pencil-and-paper and electronic formats of GHQ-12, WHO-5 and PHQ-9 questionnaires. Revista de Psiquiatría y Salud Mental, 10, 160–167. https://doi.org/10.1016/j.rpsm.2016.12.002.
Bellagente, P., Crema, C., Depari, A., Ferrari, P., Flammini, A., Lanfranchi, G., Lenzi, G., Maddiona, M., Rinaldi, S., Sisinni, E., & Ziliani, G. (2018). Remote and non-invasive monitoring of elderly in a smart city context. In 2018 IEEE sensors applications symposium (SAS) (pp. 1-6). IEEE. https://doi.org/10.1109/SAS.2018.8336732.
Bentler, P. M. (2006). EQS 6 structural equations program manual (Vol. 6). Encino: Multivariate software.
Bonsaksen, T., Opseth, T. M., Misund, A. R., Geirdal, A. Ø., Fekete, O. R., & Nordli, H. (2019). The de Jong Gierveld loneliness scale used with Norwegian clubhouse members: Psychometric properties and associated factors. International Journal of Psychosocial Rehabilitation, 22(2), 88–100.
Browne, M. W. (1984). Asymptotically distribution-free methods for the analysis of covariance structures. British Journal of Mathematical and Statistical Psychology, 37(1), 62–83. https://doi.org/10.1111/j.2044-8317.1984.tb00789.x.
Cacioppo, J. T., & Cacioppo, S. (2018). The growing problem of loneliness. The Lancet, 391, 426. https://doi.org/10.1016/S0140-6736(18)30142-9.
Cacioppo, J. T., Cacioppo, S., & Boomsma, D. I. (2014). Evolutionary mechanisms for loneliness. Cognition & Emotion, 28(1), 3–21. https://doi.org/10.1080/02699931.2013.837379.
Caliskan, A., Bryson, J. J., & Narayanan, A. (2017). Semantics derived automatically from language corpora contain human-like biases. Science, 356(6334), 183–186. https://doi.org/10.1126/science.aal4230.
Chamorro-Premuzic, T., Winsborough, D., Sherman, R. A., & Hogan, R. (2016). New talent signals: Shiny new objects or a brave new world? Industrial and Organizational Psychology, 9(3), 621–640. https://doi.org/10.1017/iop.2016.6.
Courtin, E., & Knapp, M. (2017). Social isolation, loneliness and health in old age: A scoping review. Health and social Care in the Community, 25(3), 799–812. https://doi.org/10.1111/hsc.12311.
de Cock, C., Milne-Ives, M., van Velthoven, M. H., Alturkistani, A., Lam, C., & Meinert, E. (2020). Effectiveness of conversational agents (virtual assistants) in health care: Protocol for a systematic review. JMIR Research Protocols, 9(3), e16934. https://doi.org/10.2196/16934.
De Jong Gierveld, J., & Tesch-Romer, C. (2012). Loneliness in old age in eastern and Western European societies: Theoretical perspectives. European Journal of Aging, 9(4), 285–295. https://doi.org/10.1007/s10433-012-0248-2.
De Jong Gierveld, J., & Van Tilburg, T. (2006). A 6-item scale for overall, emotional, and social loneliness: Confirmatory tests on survey data. Research on Aging, 28, 582–598. https://doi.org/10.1177/0164027506289723.
De Jong Gierveld, J., & Van Tilburg, T. (2010). The De Jong Gierveld short scales for emotional and social loneliness: Tested on data from 7 countries in the UN generations and gender surveys. European Journal of Ageing, 7(2), 121–130. https://doi.org/10.1007/s10433-010-0144-6.
De Jong Gierveld, J., Van Tilburg, T., & Dykstra, P. A. (2006). Loneliness and social isolation. In D. Perlman & A. Vangelisti (Eds.), The Cambridge handbook of personal relationships (pp. 485–500). Cambridge: Cambridge University Press.
Desideri, L., Ottaviani, C., Malavasi, M., di Marzio, R., & Bonifacci, P. (2019). Emotional processes in human-robot interaction during brief cognitive testing. Computers in Human Behavior, 90, 331–342. https://doi.org/10.1016/j.chb.2018.08.013.
Ercole, V., & Parr, J. (2020). Problems of loneliness and its impact on health and well- being. In: W. Leal, T. wall, A. Azul, L. Brandli & P. Özuyar (Eds.), Good Health and Well-Being. Encyclopedia of the UN Sustainable Development Goals. Basel, Switzerland: Springer nature Switzerland AG. https://doi.org/10.1007/978-3-319-69627-0_127-1.
Fokkema, T., De Jong Gierveld, J., & Dykstra, P. A. (2012). Cross-national differences in older adult loneliness. The Journal of Psychology, 146, 201–228. https://doi.org/10.1080/00223980.2011.631612.
Hajek A., & König H. (2017). The association of falls with loneliness and social exclusion: evidence from the DEAS German Ageing Survey. BMC Geriatrics 17(1), 204. https://doi.org/10.1186/s12877-017-0602-5.
Harari, G. M., Müller, S. R., Aung, M. S., & Rentfrow, P. J. (2017). Smartphone sensing methods for studying behavior in everyday life. Current Opinion in Behavioral Sciences, 18, 83–90. https://doi.org/10.1016/j.cobeha.2017.07.018.
Hewson, C. (2014). Conducting research on the internet-a new era. The Psychologist, 27(12), 946–950.
Hinton, G., Deng, L., Yu, D., Dahl, G. E., Mohamed, A. R., Jaitly, N., Senior, A., Vanhoucke, V., Nguyen, P., Sainath, T., & Kingsbury, B. (2012). Deep neural networks for acoustic modeling in speech recognition: The shared views of four research groups. IEEE Signal Processing Magazine, 29(6), 82–97.
Hu, L. T., & Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling: A Multidisciplinary Journal, 6(1), 1–55. https://doi.org/10.1080/10705519909540118.
Hughes, M. E., Waite, L. J., Hawkley, L. C., & Cacioppo, J. T. (2004). A short scale for measuring loneliness in large surveys: Results from two population-based studies. Research on Aging, 26(6), 655–672. https://doi.org/10.1177/0164027504268574.
Khosravi, P., Rezvani, A., & Wiewiora, A. (2016). The impact of technology on older adults’ social isolation. Computers in Human Behavior, 63, 594–603. https://doi.org/10.1016/j.chb.2016.05.092.
Kim, S., Lee, J., & Gweon, G. (2019). Comparing data from chatbot and web surveys: Effects of platform and conversational style on survey response quality. In Proceedings of the 2019 CHI Conference on Human Factors in Computing Systems (pp. 1-12).
Landis, J. R., & Koch, G. G. (1977). The measurement of observer agreement for categorical data. Biometrics, 33, 159.
Lara, E., Martín-María, N., De la Torre-Luque, A., Koyanagi, A., Vancampfort, D., Izquierdo, A., & Miret, M. (2019). Does loneliness contribute to mild cognitive impairment and dementia? A systematic review and meta-analysis of longitudinal studies. Ageing Research Reviews, 52, 7–16. https://doi.org/10.1016/j.arr.2019.03.002.
Laranjo, L., Dunn, A. G., Tong, H. L., Kocaballi, A. B., Chen, J., Bashir, R., Surian, D., Gallego, B., Magrabi, F., Lau, A., & Coiera, E. (2018). Conversational agents in healthcare: A systematic review. Journal of the American Medical Informatics Association, 25(9), 1248–1258. https://doi.org/10.1093/jamia/ocy072.
Lee, N., Madotto, A., & Fung, P. (2019). Exploring social Bias in Chatbots using stereotype knowledge. In Proceedings of the 2019 Workshop on Widening NLP (pp. 177-180).
Lucas, G. M., Rizzo, A. S., Gratch, J., Scherer, S., Stratou, G., Boberg, J., & Morency, L. P. (2017). Reporting mental health symptoms: Breaking down barriers to care with virtual human interviewers. Frontiers in Robotics and AI, 4, 51. https://doi.org/10.3389/frobt.2017.00051.
McDevitt-Murphy, M. E., Luciano, M. T., & Zakarian, R. J. (2018). Use of ecological momentary assessment and intervention in treatment with adults. Focus, 16(4), 370–375. https://doi.org/10.1176/appi.focus.20180017.
Miller, G. (2012). The smartphone psychology Manifiesto. Perspectives on Psychology Science, 7(3), 221–237.
Obermeyer, Z., Powers, B., Vogeli, C., & Mullainathan, S. (2019). Dissecting racial bias in an algorithm used to manage the health of populations. Science, 366(6464), 447–453. https://doi.org/10.1126/science.aax2342.
Okeke, F., Sobolev, M., & Estrin, D. (2018). Towards a framework for Mobile behavior change research. Proceedings of the technology, mind, and society, Washington, DC, USA.
Perlman, D., & Peplau, L. (1982). Theoretical approaches to loneliness. In: D. Perlman y L. Peplau (Eds.), Loneliness: A sourcebook of current theory, research and therapy (pp. 123–134). New York: Wiley.
Pickard, M. D., Roster, C. A., & Chen, Y. (2016). Revealing sensitive information in personal interviews: Is self-disclosure easier with humans or avatars and under what conditions? Computers in Human Behavior, 65, 23–30. https://doi.org/10.1016/j.chb.2016.08.004.
Rabbitt, S. M., Kazdin, A. E., & Scassellati, B. (2015). Integrating socially assistive robotics into mental healthcare interventions: Applications and recommendations for expanded use. Clinical Psychology Review, 35, 35–46. https://doi.org/10.1016/j.cpr.2014.07.001.
Salas, A. J., Reynolds, A., & Thomas, C. M. (2018). Technology Design for Frailty. In D. Chau & T. F. Osborne (Eds.), Using technology to improve Care of Older Adults (pp. 103–133). New York: Springer Publishing Company.
Vaidyam, A. N., Wisniewski, H., Halamka, J. D., Kashavan, M. S., & Torous, J. B. (2019). Chatbots and conversational agents in mental health: A review of the psychiatric landscape. The Canadian Journal of Psychiatry, 64(7), 456–464. https://doi.org/10.1177/0706743719828977.
Valtorta, N. K., Moore, D. C., Barron, L., Stow, D., & Hanratty, B. (2018). Older adults’ social relationships and health care utilization: A systematic review. American Journal of Public Health, 108(4), e1–e10. https://doi.org/10.2105/AJPH.2017.304256.
Victor, C. R., & Yang, K. (2012). The prevalence of loneliness among adults: A case study of the United Kingdom. The Journal of Psychology, 146(1–2), 85–104. https://doi.org/10.1080/00223980.2011.613875.
Weigold, A., Weigold, I. K., Drakeford, N. M., & Dykema, S. S. (2016). Equivalence of paper-and-pencil and computerized self-report surveys in older adults. Computers in Human Behavior, 54, 407–413. https://doi.org/10.1016/j.chb.2015.08.033.
Weigold, A., Weigold, I. K., & Natera, S. N. (2018). Mean scores for self-report surveys completed using paper-and-pencil and computers: A meta-analytic test of equivalence. Computers in Human Behavior, 86, 153–164. https://doi.org/10.1016/j.chb.2018.04.038.
Weiss, R. S. (1973). Loneliness: The experience of emotional and social isolation. Cambridge: MIT Press.
White, M. K., Maher, S. M., Rizio, A. A., & Bjorner, J. B. (2018). A meta-analytic review of measurement equivalence study findings of the SF-36® and SF-12® health surveys across electronic modes compared to paper administration. Quality of Life Research, 27(7), 1757–1767. https://doi.org/10.1007/s11136-018-1851-2.
World Health Organization (WHO) (2016). What are integrated people-centred health services? Retrieved from https://www.who.int/servicedeliverysafety/areas/people-centred-care/en/. Accessed 4 November 2019.
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We are grateful to the undergraduate university students from Universitat Jaume I who voluntarily participated in the study.
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This research was supported by the Ministry of Science and Innovation and the Spanish Foundation for Science and Technology (FECYT) with reference number: FCT-18-13677.
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Caballer, A., Belmonte, O., Castillo, A. et al. Equivalence of chatbot and paper-and-pencil versions of the De Jong Gierveld loneliness scale. Curr Psychol 41, 6225–6232 (2022). https://doi.org/10.1007/s12144-020-01117-0
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DOI: https://doi.org/10.1007/s12144-020-01117-0