A collaborative approach to the evaluation of cognitive accessibility of a conversational agent for public healthcare
(2025) In Interacting with Computers 38(1). p.77-94- Abstract
Conversational agents are increasingly being introduced in healthcare to enhance access to healthcare and address limited healthcare resources. The aim of this study was to explore experiences of a conversational agent for symptom checking and triage tool assessing the urgency and appropriate level of care implemented in public healthcare from a cognitive accessibility perspective. With a Participatory Action Research approach, this study includes: (1) A Participatory Cognitive Barrier Walkthrough in workshops with people with cognitive impairment (n = 7), product owner representatives (n = 4), and researchers (n = 5), followed by a workshop for improvement suggestions; (2) a paired interview with healthcare system specialists (n = 2).... (More)
Conversational agents are increasingly being introduced in healthcare to enhance access to healthcare and address limited healthcare resources. The aim of this study was to explore experiences of a conversational agent for symptom checking and triage tool assessing the urgency and appropriate level of care implemented in public healthcare from a cognitive accessibility perspective. With a Participatory Action Research approach, this study includes: (1) A Participatory Cognitive Barrier Walkthrough in workshops with people with cognitive impairment (n = 7), product owner representatives (n = 4), and researchers (n = 5), followed by a workshop for improvement suggestions; (2) a paired interview with healthcare system specialists (n = 2). The data from the study were analyzed using reflexive thematic analysis, resulting in five themes: ‘The design of the eHealth service created expectations that were not met during interaction’; ‘The eHealth service uses a difficult language’; ‘The eHealth service triggers negative emotions and reactions’; ‘The layout and graphic design of the eHealth service is difficult and sometimes misleading’; and ‘The eHealth service lacks in trustworthiness’. The findings show the importance of including people with lived experience of cognitive impairment, to expose and find solutions for cognitive accessibility issues.
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- author
- Jonsson, Marika ; Gustavsson, Catharina ; Pettersson, Linda ; Gulliksen, Jan and Johansson, Stefan LU
- organization
- publishing date
- 2025-07-14
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Ehealth, interaction design, participatory action research, participatory design, process and methods, user evaluation
- in
- Interacting with Computers
- volume
- 38
- issue
- 1
- pages
- 18 pages
- publisher
- Oxford University Press
- external identifiers
-
- scopus:105024992032
- ISSN
- 0953-5438
- DOI
- 10.1093/iwc/iwaf034
- language
- English
- LU publication?
- yes
- additional info
- Publisher Copyright: © The Author(s) 2025. Published by Oxford University Press on behalf of The British Computer Society.
- id
- ee2b41fc-7dba-4462-a9a7-18b77e7bbf39
- date added to LUP
- 2026-03-30 13:35:46
- date last changed
- 2026-03-30 15:35:16
@article{ee2b41fc-7dba-4462-a9a7-18b77e7bbf39,
abstract = {{<p>Conversational agents are increasingly being introduced in healthcare to enhance access to healthcare and address limited healthcare resources. The aim of this study was to explore experiences of a conversational agent for symptom checking and triage tool assessing the urgency and appropriate level of care implemented in public healthcare from a cognitive accessibility perspective. With a Participatory Action Research approach, this study includes: (1) A Participatory Cognitive Barrier Walkthrough in workshops with people with cognitive impairment (n = 7), product owner representatives (n = 4), and researchers (n = 5), followed by a workshop for improvement suggestions; (2) a paired interview with healthcare system specialists (n = 2). The data from the study were analyzed using reflexive thematic analysis, resulting in five themes: ‘The design of the eHealth service created expectations that were not met during interaction’; ‘The eHealth service uses a difficult language’; ‘The eHealth service triggers negative emotions and reactions’; ‘The layout and graphic design of the eHealth service is difficult and sometimes misleading’; and ‘The eHealth service lacks in trustworthiness’. The findings show the importance of including people with lived experience of cognitive impairment, to expose and find solutions for cognitive accessibility issues.</p>}},
author = {{Jonsson, Marika and Gustavsson, Catharina and Pettersson, Linda and Gulliksen, Jan and Johansson, Stefan}},
issn = {{0953-5438}},
keywords = {{Ehealth; interaction design; participatory action research; participatory design; process and methods; user evaluation}},
language = {{eng}},
month = {{07}},
number = {{1}},
pages = {{77--94}},
publisher = {{Oxford University Press}},
series = {{Interacting with Computers}},
title = {{A collaborative approach to the evaluation of cognitive accessibility of a conversational agent for public healthcare}},
url = {{http://dx.doi.org/10.1093/iwc/iwaf034}},
doi = {{10.1093/iwc/iwaf034}},
volume = {{38}},
year = {{2025}},
}