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International Journal of Human-Computer Interaction

ISSN: 1044-7318 (Print) 1532-7590 (Online) Journal homepage: https://www.tandfonline.com/loi/hihc20

Persuasive Strategies for Encouraging SocialInteraction for Older Adults

John Paul Vargheese, Somayajulu Sripada, Judith Masthoff & Nir Oren

To cite this article: John Paul Vargheese, Somayajulu Sripada, Judith Masthoff & Nir Oren (2016)Persuasive Strategies for Encouraging Social Interaction for Older Adults, International Journal ofHuman-Computer Interaction, 32:3, 190-214, DOI: 10.1080/10447318.2016.1136176

To link to this article: https://doi.org/10.1080/10447318.2016.1136176

Accepted author version posted online: 04Jan 2016.Published online: 16 Feb 2016.

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Intl. Journal of Human–Computer Interaction, 32: 190–214, 2016Copyright © Taylor & Francis Group, LLCISSN: 1044-7318 print / 1532-7590 onlineDOI: 10.1080/10447318.2016.1136176

Persuasive Strategies for Encouraging Social Interactionfor Older Adults

John Paul Vargheese, Somayajulu Sripada, Judith Masthoff, and Nir OrenDepartment of Computing Science, University of Aberdeen, Aberdeen, UK

Social isolation among older adults represents a significantsocietal challenge in which persuasion offers a potential solution.To develop a persuasive interactive system for this purpose, weconducted a modeling study with carers to discover how persua-sion is used to encourage social interaction among older adults.From an analysis of the results, we identified and defined effec-tive persuasive strategies grounded in theories of persuasion anddeveloped a computational model for applying them. This articlereports the findings from an evaluation of the generalizability ofthis model and presents a revised version based on these results.The article concludes with a discussion on possible domain-specificconceptual features between the model evaluated and the revisedmodel developed.

1. INTRODUCTIONSocial isolation represents a major challenge in society due

to the severe associated health risks and how they impact uponquality of life and well-being (Holley, 2007). Social isolationis widespread among older adults (Tremethick, 2001), who areparticularly vulnerable due to their reduced health and vital-ity (Bondevik & Skogstad, 1998). In addition to older adults,individuals with a disability or chronic illness have also beenreported to be at risk to social isolation and the consequentnegative impact on health and well-being (Biordi & Nicholson,2011). As the aging population continues to grow, social isola-tion is predicted to increase (Nicholson, 2009), which presentshealthcare providers with new challenges in response to increas-ing demands for delivering health and social care services(Parker & Hawley, 2013).

Technology-based interventions such as Telecare offer apotential solution to meet this increasing demand and reducethe burden on existing health care resources (Waterworth,Ballesteros, & Peter, 2009). However, there is a concern thatsuch services may increase social isolation among older adults(Sethi, Bagga, Carpenter, Azzi, & Khusainov, 2012), and

Address correspondence to John Paul Vargheese, Department ofComputing Science, University of Aberdeen, Room 829 MacRobertBuilding, King’s College, Aberdeen, AB24 5UA, United Kingdom.E-mail: jpvargheese@acm.org

Telecare systems providing these services have been criticizedfor not emphasising the significance of social activities andsocial connections for older adults (Sun, De Florio, Gui, &Blondia, 2009).

Social activities using a group format have been identifiedas an effective solution for resolving the problem of social iso-lation among older adults, by providing social interaction andthe opportunity for an expanded social network (Bolton, 2012).However, due to the nature of social isolation, older adults maylack sufficient motivation to participate.

Persuasion has been suggested as a means for increasingthe effectiveness of Telecare (Lee, Helal, Anton, De Deugd,& Smith, 2012; Lee, Helal, & Johnson, 2010), and Biordiand Nicholson (2011) argued that interventions designed tocounteract social isolation should be developed using “vali-dated, repetitive and recognizable strategies” (p. 99). Due tothe variety of factors that may result in social isolation (seesection 1.1), interventions that target social isolation are likelyto vary (Cattan, White, Bond, & Learmouth, 2005; Dickens,Richards, Greaves, & Campbell, 2011; Findlay, 2003; Holley,2007). However, as suggested by de la Cruz (1986), certainapproaches, techniques, and strategies for addressing this prob-lem can be generalized in developing interventions for those atrisk of social isolation.

Our research is focused on developing a model of persua-sion to be employed by a virtual agent for encouraging socialinteraction and lowering the risk of social isolation among olderadults. Figure 1 summarizes our approach and previous workleading to the evaluation studies reported in this article. In previ-ous work, we established a theoretical foundation (a) to conducta modeling study with formal carers for older adults in residen-tial care. The aim of this study (bi) was to discover how carersutilize persuasion as an effective solution for encouraging socialinteraction in order to address the problem of social isolationamong older adults (see the Persuasive Strategies section). Fromthe results of this study, we identified effective persuasive strate-gies grounded in persuasion and behavioral change theories anddeveloped a profile assessment model (PAM) for applying them.To verify these findings, we conducted a follow-up qualita-tive confirmation study (bii) with formal carers, the findings of

190

PERSUASIVE STRATEGIES FOR SOCIAL INTERACTION 191

FIG. 1. Summary of our approach and previous work leading to the evaluation reported in this article.

which confirmed the use of the strategies and assessment crite-ria of the PAM. Due to the complexity and varying factors thatmay result in social isolation, a further study (c) investigatedthe generalizability and perceived effectiveness of the strate-gies. This study was to identify the generic persuasive featuresof the strategies grounded in persuasion theories and distinguishthese from domain-specific contextual features. This study alsoallowed us to verify our understanding of how the strategies maybe effective (see Generalizability and Perceived Effectivenessof Persuasive Strategies section). In this article, we report ourfindings from two evaluation studies of the PAM with a gen-eral audience and with carers. From the results of these studies,we present an updated PAM and identify which features of thePAM are more suitable for a general audience and which aremore relevant to the care home domain.

1.1. Social Isolation Among Older AdultsSocial isolation can be defined as a condition or state

in which an individual has a limited number of social con-tacts, lacks engagement with others, and is unable to fulfillquality relationships (Nicholson, 2009; Waycott et al., 2015).As reported by Age UK (2010), social isolation among olderadults is widespread, with the most common reported rea-sons including the loss of a partner, loss of community, anaturally reduced social network, and physical and cognitivedecline (Grenade & Boldy, 2008; Hicks, 2000). These causesare relevant to both independent living older adults and thosein community and residential care (Hicks, 2000). These fac-tors have also been reported to result in social isolation amongother groups, including those with a disability or sufferingfrom a chronic illness (Biordi & Nicholson, 2011; Cudney,Butler, Weinert, & Sullivan, 2002; Hill & Weinert, 2004;Mukherjee, Reis, & Heller, 2003; Noyes et al., 1990; Riegel& Carlson, 2004; Tilden & Weinert, 1987; Woods, Haberman,& Packard, 1993). Severe health risks associated with socialisolation include increased mortality (Brummett et al., 2001;Seeman, Berkman, Blazer, & Rowe, 1994; Steptoe, Shankar,Demakakos, & Wardle, 2013; Uchino, Cacioppo, & Kiecolt-Glaser, 1996), dementia (Fratiglioni, Wang, Ericsson, Maytan,& Winblad, 2000), coronary disease (Ceria et al., 2001; Eng,Rimm, Fitzmaurice, & Kawachi, 2002), and cognitive decline(Barnes, Mendes de Leon, Wilson, Bienias, & Evans, 2004;Wilson et al., 2007).

Given these deleterious effects, interventions targeting socialisolation are clearly desirable. The importance of developingsuch interventions can be demonstrated by the ongoing interna-tional research and investment in this area.1 However, despitethe vast amount of research conducted, systematic reviewsfocusing on interventions designed to address social isolationhave consistently reported that there is a lack of evidence thatdemonstrates what interventions may be effective and why(Cattan et al., 2005; Dickens et al., 2011; Findlay, 2003).

There are three consistent findings from previous researchconducted in this area. First, the literature agrees on the causesof social isolation and that these are relevant to both older adultsand the wider population. Second, for more than 25 years, thesevere health risks associated with social isolation have beenconsistently reported and acknowledged (Cacioppo, Cacioppo,Capitanio, & Cole, 2015). Third, interventions demonstratedto be effective share similar characteristics. These includeprovision of a social activity with or without group support(Dickens et al., 2011). Similar findings reported by Bolton(2012) and Cattan et al. (2005) indicate that interventions thatoffer social activities using a group format are effective in alle-viating isolation among older adults. Both of these approachesare supported by the findings of Steptoe et al. (2013), whichsuggest that such interventions reduce mortality and increasewell-being. This is similar to existing practices for addressingsocial isolation in residential care for older adults (Vargheese,Sripada, Masthoff, Oren, Schofield, et al., 2013) and amongthose with chronic illness (Holley, 2007). Further support ofthese approaches by Arnaert and Delesie (2007); Savolainen,Hanson, Magnusson, and Gustavsson (2008); and van derHeide, Willems, Spreeuwenberg, Rietman, and de Witte (2012)indicates how an increase in social activities is an effective tech-nique for preventing social isolation. Due to the varying causesof social isolation that are relevant to older adults and the widerpopulation, generalizing strategies and techniques proven to beeffective may offer beneficial insights in designing interventionsto address this major societal challenge (de la Cruz, 1986).

1For more details of research and investment regarding social iso-lation among older adults, please see Cacioppo and Cacioppo (2014);Economic & Social Committee (2009); European Commission (2008);Fratiglioni et al. (2000); Iredell, Grenade, Nedwetzky, Collins, andHowat (2004); Parigi and Henson (2014).

192 J. P. VARGHEESE ET AL.

1.2. Problem StatementTechnologies that provide support and social interaction for

users at risk of social isolation typically focus on increas-ing social contacts and facilitating social activities throughthe creation and distribution of digital content, for example,posting and replying on forums, and creating, sharing, and com-menting on video blogs, pictures, and other media (Alaoui &Lewkowicz, 2012; Harley & Fitzpatrick, 2012; Liu, Huh, Neogi,Inkpen, & Pratt, 2013; Pfeil & Zaphiris, 2009; Plaisant et al.,2006; Waycott et al., 2014; Waycott et al., 2013). We believethe provision of social activities offers only a partial solution,because not all older adults are equally motivated and willingto participate in such activities due to the varying impacts ofsocial isolation. Therefore, solutions to the problem of persuad-ing older adults to participate in social activities will have moreimpact than the sole provision of social activities.

Consider the example of a residential care home in which abingo game has been organized for residents and is due to startshortly in the lounge. Not all of the residents are in the lounge,so carers inform others that the bingo game is starting shortly.Tina, a carer, invites Joyce to take part. Joyce does not alwaysplay bingo and is considered at risk of social isolation.2 Tinais aware of the friendship between Joyce and Bill, another resi-dent, who is already in the lounge. Therefore, Tina persuadesJoyce to play bingo by informing her that Bill will also beplaying. To design a persuasive interactive system that appliespersuasive strategies such as those used by Tina, it is necessaryto identify what persuasive strategies are effective for encourag-ing older adults to participate in social activities and to discoverhow to apply them.

2. BACKGROUNDIn this section we review theoretical approaches to the design

of persuasive interactive systems, introduce our previous work,and discuss related work.

2.1. Theoretical ApproachThe study of persuasion has been extensively researched

over a vast amount of time with contributions made from a widerange of disciplines, including philosophy, psychology, sociol-ogy, linguistics, and artificial intelligence. Persuasion can bedefined as deliberate communication intended to bring abouta voluntary change in attitudes and or behavior (Chatterjee &Price, 2009; Fogg, 2003; Simons & Jones, 2011). The goals ofpersuasion can be categorized as attempting to form or shapean initial response to a persuasive communication, reinforcean existing response, or modify a response to the preferenceof the persuader (Fogg, 1998; Miller, 1980; Reardon, 1991;

2As reported in Vargheese, Sripada, Masthoff, Oren, Schofield,et al. (2013), carers do not force older adults to participate but activelyencourage those considered at risk of social isolation to participate inorganized social activities using persuasive strategies.

Zimbardo & Leippe, 1991). Persuasion is goal directed onthe basis that the persuader seeks to invoke a change in thetarget of persuasion’s attitude and/or behavior. Attitude andbehavioral change theories provide a means of understand-ing how to achieve the goals of persuasion by offering anexplanation as to how and why attitudes and behavior maychange within the context of persuasion. Table 1 provides abrief summary of several behavioral change and persuasiontheories.

A complete review of every theory of persuasion and behav-ioral change within the field of psychology, social sciences,and the persuasive interactive systems domain is beyond thescope of this article. The wide variety of theories available islargely due to the concept of persuasion being defined in termsof changing attitude, specifically how changing the target of per-suasion’s attitude may result in a change of behavior (Briñol &Petty, 2012; O’Keefe, 1990). Furthermore, the inherent com-plexity of human behavior inevitably results in a considerablenumber of theories to consider for designing a persuasiveinteractive system.

The UK Medical Research Council (MRC) outlines astepwise approach for the design and evaluation of complexinterventions (M. Campbell et al., 2000; N. C. Campbell et al.,2007). This framework proposes establishing a theoretical basisprior to modeling a proposed intervention, conducting pilotstudies for optimizing test measures, followed by a “defini-tive randomised controlled trial” and finally an implementationphase (N. C. Campbell et al., 2007). Similarly the persuasivesystems development (PSD) model (Figure 2) also outlines astepwise approach based on seven key premises of persua-sive interactive systems (Oinas-Kukkonen & Harjumaa, 2009).Michie, Johnston, Francis, Hardeman, and Eccles (2008) arguedthat behavioral change interventions designed in such a wayare more likely to be effective, provided the determinants ofbehavior are identified and the relationship between these deter-minants and target behavior are understood. Michie et al. (2008)further stated that both theories and interventions can only beevaluated and developed provided the intervention is based upon a theoretical foundation that provides a means of under-standing why a proposed solution is effective. Consequently thisoffers a means of refining theory and the potential to apply itacross alternate domains and contexts (Michie et al., 2008).

Oinas-Kukonen (2013) argued that despite the wide range oftheories available, there is a lack of “understanding and descrip-tive power” (p. 1225) for the design and features of a persuasiveinteractive system. Similarly, Michie et al. (2008) argued thatthere is a lack of guidance for how to apply theory in order todevelop behavioral change techniques.

To resolve these issues of complexity, Michie et al. (2008)proposed selecting a reduced number of theoretical concepts todraw upon followed by specifying what techniques are avail-able to assess behavioral determinants and developing a meansof selecting techniques mapped to behavioral determinants of apersuasion scenario.

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196 J. P. VARGHEESE ET AL.

FIG. 2. Persuasive systems development. Borrowed from Oinas-Kukkonen and Harjumaa (2009).

FIG. 3. Analysis of Persuasion scenario using features defined by persuasive systems development model and modelling phase of the Medical Research Councilframework.

2.2. Our Theoretical Framework and Modeling StudyWith Carers

For the purpose of our research, we used a combinedapproach utilizing the methodological recommendations dis-cussed previously as follows:

a. Establish theoretical framework (M. Campbell et al., 2000;N. C. Campbell et al., 2007) by focusing on a reduced num-ber of concepts prior to modeling a solution (Michie et al.,2008).

b. Analyze persuasion scenario as defined by the PSD model(Figure 2; Oinas-Kukkonen & Harjumaa, 2009).

c. Define persuasive strategies by modeling solution in accor-dance with established theoretical framework.

d. Refine definition of persuasive strategies by type.e. Categorize persuasive strategies according to generic persua-

sive design principles.

We begin by establishing a theoretical framework as sug-gested by the Medical Research Council framework (M.Campbell et al., 2000; N. C. Campbell et al., 2007) follow-ing recommendations by Michie et al. (2008) for reducing

complexity (a). We reduce complexity by focusing on behav-ioral determinants and their relationship to the target behavior(participating in social activities). This theoretical frameworkprovides the means to ground our findings from the problemdomain.

We elicited these components from a modeling study withformal carers for older adults to discover how carers usepersuasion3 to reduce the risk of social isolation (b). This stageof our methodology (see Figure 3) is comparable to the secondphase of the PSD model (Figure 2), analysis of the persuasioncontext (intent, event, strategy; Oinas-Kukkonen & Harjumaa,2009). We conceptualize the persuasion scenario with formalcarers and older adults by defining the goals of persuasion(intent) that is encouraging participation in social activities(event) by applying persuasive strategies (strategy). We thendefined persuasive strategies (c) by modeling the relationshipbetween behavioral determinants and the target behavior thatforms the content of a persuasive message (strategy). We further

3A brief example of how carers use persuasion to reduce the risk ofsocial isolation is provided in Section 1.2.

PERSUASIVE STRATEGIES FOR SOCIAL INTERACTION 197

refined our definition for each strategy by type (d), in terms ofdirect or indirect according to the elaboration likelihood model(Petty, 2013; Cacciopo et al., 1986), which is also a premise ofthe PSD model (Figure 2; Oinas-Kukkonen & Harjumaa, 2009).Finally, we categorized each persuasive strategy (e) accordingto generic persuasive design principles (Cialdini, 2001, 2009;Whalen, 2011). Using this approach, we identified, defined, andcategorized persuasive strategies used by carers for encouragingsocial interaction among older adults. The persuasive strategiesare listed in Table 2 and are further discussed in the “PersuasiveStrategies” section.

We conducted a follow-up study with formal carers4 for olderadults to confirm the use of the persuasive strategies, assessmentcriteria, and utility of the PAM. As in the case of the originalmodeling study, we used a semistructured interview approachto ensure that the carers understood our definition for each strat-egy and the criteria of the PAM. This study was also to discoverwhether carers agreed with our definitions for each strategy inregards to classification by category and type. We recruited twogroups of carers for the follow-up study. The first group con-sisted of seven carers who previously participated in the initialstudy, and the second group consisted of five carers who did not.We used two groups in order to ensure that both the strategiesand the PAM were not used only by participants from the ini-tial modeling study. The results of this study indicate that thestrategies as defined by our theoretical approach and the PAMare used by carers to encourage social interaction.

Persuasive StrategiesWe discuss each strategy by category and how they are

grounded in persuasion and behavioral change theories in thefollowing sections.

Strategy category: Social proof. The principle of socialproof states that an individual may determine what is suit-able, appropriate, or correct behavior based on the extent of thebehavior demonstrated by others. The more others perform acertain action, the more likely individuals considering their ownbehavior will view the others as appropriate, suitable, or cor-rect (Cialdini, 2009). These strategies are defined as direct, asthe message arguments for each strategy rely on the persuasiontarget activity scenario rather than on the delivery of the mes-sage or other incidental cues, such as a preference for whomis attempting to apply the strategy, message length, or dura-tion (Cialdini, 2009; Petty, 2013; Vargheese, Sripada, Masthoff,Oren, Schofield, et al., 2013; Whalen, 2011). The majorityof strategies discovered from the modeling study with formalcarers are categorized within the social proof category. This isbecause the carers often provided examples of how a strategymay be effective with reference to a group. Our preliminaryanalyses toward identifying, defining, and categorizing strate-gies included an overlap between behavioral determinants such

4For more details on this study, please see Vargheese, Sripada,Masthoff, Oren, and Dennis (2013).

as the presence of a friend, multiple friends, multiple potentialfriends, and so forth. Therefore, we decided to define individ-ual strategies based on four possible relationships between theolder adult to be persuaded and those present at the activity (seeTable 2 for persuasive strategies within the social proof categorythat are based on these four possible relationships).

Friend or friends present strategies. These strategies aim toincrease the appeal of participating in an activity by highlight-ing the opportunity to socialize with either a single or multiplefriends. Carers are aware of social networks that older adultsdevelop within the home, and this is recorded in the regularreporting of their life in the care home. For these strategies, thecarer motivates an older adult to participate by informing themthat a friend or friends of theirs will be present. The behavioraldeterminants of these strategies are whether a friend or multi-ple friends are present. The relationship between this behavioraldeterminant and participating in the activity is the awareness ofthe friendship between the older adults, one who will be present,and the target of persuasion, who is more likely to attend if afriend or friends of theirs will be present.

Potential friend or potential friends present strategies. Incases where an older adult does not have a friend or friends par-ticipating with an activity, carers explained that it is possible tomatch an older adult with a potential friend. This is achieved bycomparing biographical information of residents5 and matchingthose with similar backgrounds. For example, this may includeolder adults who have previously worked in similar occupa-tions, grown up or lived in a similar area, or share interests orhobbies. This strategy is also applicable where more than onepotential friend may be present at the activity. The behavioraldeterminants of these strategies is whether a potential friend ormultiple potential friends are present. The relationship betweenthis behavioral determinant and participating in an activity isthe carer’s awareness that the older adult may enjoy socializingwith another resident with a similar background, thus increasingthe appeal of the activity.

Facilitator friend or facilitator friends present strategies.For these strategies, carers rely upon their own relationshipwith an older adult to increase the appeal of participating. Thebehavioral determinant in these cases is whether a carer ormultiple carers whom the older adult considers as a friend(s)will be facilitating or joining in the activity. The relationshipbetween this and participating in the activity is the assurancethat the older adult will not be alone for the duration of theactivity. In addition, the carer or carers may ask the older adultto assist with facilitating the activity, for example, assistinganother resident with completing a bingo card, or forming ateam for the quiz.

Acquaintances present strategy. In the case where neitherof the previous strategies within the social proof category is

5This information is acquired during the admission process andis used to provide a general background of an older adult’s lifestylepreferences.

198 J. P. VARGHEESE ET AL.

TABLE 2Persuasive Strategies and Associated Attributes

Category TypePersuasiveStrategy

PAMAttribute Symbol Summary

Social Proof Direct Friend present FP Resident is persuaded to attend as carerinforms resident that a friend will be present.The friend may be a fellow resident, visitoror carer.

Potential friendpresent

PFP Resident is persuaded to attend as carerinforms resident that he or she may make anew friend as another resident attendingshares similar background or interests.

Facilitator friendpresent

FFP Resident is persuaded to attend as carerinforms resident that a friend is organizing orfacilitating the activity.

Friends present MFP Resident is persuaded to attend as carerinforms resident that friends of theirs will bepresent. Friends may be fellow residents,visitors or carers.

Potential friendspresent

MPF Resident is persuaded to attend as carerinforms resident that he or she may makenew friends as other residents attending sharesimilar background or interests.

Facilitator friendspresent

MFF Resident is persuaded to attend as carerinforms resident that friends of theirs will beorganizing or facilitating the activity.

Acquaintancespresent

SOC Resident is persuaded to attend as carerinforms resident that attendees include otherswhom the resident typically socializes with,for example, other residents at meal times orduring other events.

Likability &Aesthetics

Direct Fun Incentive INT Resident is persuaded to attend the activity onthe grounds that the activity will be fun as itfalls within the resident’s current or previousinterests.

ICN Resident is persuaded to attend the activity onthe grounds that the activity offers anincentive.

Effort Indirect Reassure supportrole

Indirectstrategies

Carer offers to assist with the activity or carerrequests support from resident to facilitatethe activity or provide assistance to anotherresident.

Commitment Indirect Observe withoutparticipating

Indirectstrategies

Carer informs resident that they are notrequired to participate and may simplyobserve the activity.

Try no obligation Indirectstrategies

Resident is persuaded to attend as carerinforms resident that they may try the activitybut are not obliged to remain and continue ifthey would prefer not to and wish to leave.

Note. FP: Friends present, PFP: Potential friends present, FFP: Facilitator friend present, MFP: Multiple friends present, MPF: Multiplepotential friends, MFF: Multiple facilitator friends, SOC: Socialize, INT: Interests, ICN: Incentive.

PERSUASIVE STRATEGIES FOR SOCIAL INTERACTION 199

appropriate, carers encourage the older adult to participate bystating that others will be present who—although perhaps notconsidered a friend—are nonetheless a part of their social net-work. This may include other residents with whom the olderadult shares meals at the same time or who similarly spend timetogether in other common areas throughout the day. The behav-ioral determinant associated with this strategy is whether suchacquaintances will be present, and the relationship between thisand participating in the activity is based on the older adult feel-ing more comfortable attending the activity in the present ofthose whom they are already familiar with. In addition, carersalso stated that this may increase the appeal of participating ifthe older adult feels that he or she may be missing out, whileknowing others with whom they typically spend time are alsowilling to participate.

Strategy category: Likability and aesthetics. The princi-ple of the likability and aesthetics category is simply that anindividual is more inclined to agree with a belief or actionthat they know and like (Cialdini, 2009). The strategies usedby carers in this category are based on the carers’ aware-ness of what activities older adults currently or previouslyenjoyed. This information is usually acquired during the admis-sion process and is regularly updated as part of the dailyreporting by carers of the residents’ life in the home. Thesestrategies are also considered direct on the basis that mes-sage arguments are centered on the activity scenario and areanticipated to be considered via the central or direct route.In addition, these strategies use persuasive variables compa-rable with perceived or anticipated outcomes in social cogni-tive theory (Bandura, 1997, 2001), perceived benefits in thehealth belief model (Rosenstock, 1974), and rewarding activ-ity in compliance-gaining techniques (Marwell & Schmitt,1967).

Fun strategy. The behavioral determinant of this strategy iswhether an activity falls within an older adult’s current or pre-vious interests. The relationship between this and participatingin the activity is the carers’ awareness that older adults are morelikely to participate in an activity that falls within their currentor previous interests. Examples provided by carers include thearts and crafts activity, where carers encouraged older adultswith such skills gained from their working life to participate.Similarly, older adults who used to sing in a choir were per-suaded to participate in the themed sing-a-long activity usingthis strategy. In each case, the activities provide an enjoyablecontext that an older adult can relate to, which is often sufficientmotivation for participating.

Incentives strategy. The behavioral determinant of thisstrategy is the provision of an incentive for participating. Therelationship between this and participating in the activity is theappeal and fun of the activity with the provision of an incen-tive. Carers explained that in some cases, older adults who arecompetitive may feel more motivated to participate if they canwin a prize, which they either want for themselves or wish togive to a friend, family member, and even carers. In other cases,

an incentive of a prize is offered for activities such as bingo ora quiz, but all who participate are given an incentive just forparticipating.

Strategy category: Effort. The principle of the effort cate-gory is to make the acceptance of a belief or action as easy aspossible for the target of persuasion. This is achieved by reduc-ing the effort of the target of persuasion to do so (Cialdini,2009; Whalen, 2011). This intention aims to increase motiva-tion by emphasizing support available, which is designed toreduce perceived challenges in accepting a belief or action.This is comparable to perceived behavioral control in the the-ory of planned behaviour (Ajzen, 1991), perceived self-efficacyin social cognitive theory (Bandura, 1997, 2001), and perceivedbarriers in the health belief model (Rosenstock, 1974). Thestrategy within this category is considered indirect on the basisthat the message arguments are not centered upon the activityitself and, therefore, act as a peripheral cue anticipated to beconsidered via the indirect/peripheral route.

Reassure support role strategy. The behavioral determinantof this strategy is related to one of the roles that carers performwith the activities, the provision of support with an activity. Therelationship between this and participating is the reassurance toan older adult that the carers will assist them with the activity—for example, helping an older adult to update a bingo card asnumbers are called out and providing assistance to and fromthe activity in the case that this assistance is required due torestricted mobility of the older adult.

Strategy category: Commitment. The principle of the com-mitment category is to increase the motivation toward acceptinga belief or action by emphasizing the minimum level of com-mitment required to do so. This category differs from effortin regards to the emphasis on the minimum level of commit-ment required of the target of persuasion to accept a belief oraction. Again, this is comparable to perceived behavioral con-trol in the theory of planned behaviour (Ajzen, 1991) perceivedself-efficacy in social cognitive theory (Bandura, 1997, 2001),and perceived barriers in the health belief model (Rosenstock,1974).

Observe without participating strategy. The behavioraldeterminant of this strategy is the option for an older adult tosimply observe the activity without actively taking part. Therelationship between this and participating is the carer’s aware-ness that an older adult is more likely to attend an activityand subsequently take part if they are informed that they arenot actively required to participate and may simply observe theactivity instead. Carers explained that this strategy is effectivefor those who may feel daunted by the prospect of participatingin an activity and that choosing to simply observe would allowthem to feel a part of the group and would eventually lead tothem participating once they felt comfortable with the activity.

Try no obligation strategy. The behavioral determinant ofthis strategy is the option for an older adult to try the activityand leave at any time. The relationship between this behavioraldeterminant and participating, is the carer’s awareness that the

200 J. P. VARGHEESE ET AL.

older adult is more likely to attend the event and participate ifit is emphasized that they are not required to stay if they do notwish to or are not enjoying themselves. Although this is the casefor all activities taking place in the care home, carers explainedthat emphasizing that an older adult can leave after minimalparticipation is effective for encouraging attendance and, aftersome degree of participation, usually results in the older adultremaining for the whole activity.

Generalizability and Perceived Effectiveness of PersuasiveStrategies

We conducted two evaluation studies to assess thegeneralizability and perceived effectiveness of the strategiesdiscovered from our initial study. In the first evaluation, we con-ducted a focus group study with nine groups each containing sixstudents. The aim of this study was to assess the generalizabilityof the strategies related to their perceived effectiveness andthe feasibility of conducting larger scale empirical evaluations.By investigating the generalizability of our strategies, we aimedto discover whether the techniques used by carers for encour-aging social interaction could be applied to other groups assuggested by de la Cruz (1986).

The persuasive strategies discovered in the modeling studywith formal carers were defined by identifying behavioral deter-minants within a persuasion scenario and their relationship tothe desired target behavior. Strategies were then categorizedaccording to generic persuasive design principles that describehow and why a strategy may be effective for encouraging anindividual to adopt the target behavior (Cialdini, 2001, 2009).We abstracted and generalized the strategies6 by modifyingthe persuasion scenario to include behavioral determinants andtarget behavior that are applicable to a general audience.

We can assume a generalized strategy to be comparableto the original provided the relationship between the behav-ioral determinants and target behavior adhere to the persuasivedesign principles of the original. Therefore, it should be possibleto categorize a generalized strategy using the same category andtype of the original. In addition, it is also necessary to ensurethe goals of the generalized strategies remain the same as theoriginal, which in our case is participating in a social activity.

We assumed that if participants were provided with a suitablepersuasion scenario and target behavior that they could relateto, it would be possible for them to comment on how effec-tive the strategies would be for encouraging the target behavior.Consequently we anticipated that participants would also beable to provide examples of how the strategies were appli-cable to other scenarios. The results from this study indicatethat participants were able to identify each strategy, provideexamples of their usage, and assess their perceived effective-ness. We, therefore, concluded that our approach to generalizing

6Persuasive strategies are listed in Table 2 and an example of apersuasion scenario is included in Section 1.2.

the strategies was appropriate and proceeded with the sec-ond evaluation (empirical evaluation of the strategies perceivedeffectiveness).

In the second evaluation, 100 participants individually con-sidered the perceived effectiveness for each strategy fromthe perspective of the persuader and target of persuasion.We decided to use perceived effectiveness as a persuasionmetric and a general audience to avoid ethical and practicalchallenges involved with measuring actual effectiveness. Theseinclude having to deceive participants as to the aims of the eval-uation to prevent them from acting upon experimenter expec-tations and practical difficulties in organizing numerous socialactivities and recruiting a sufficient number of participants.Perceived effectiveness has been argued to be a significant indi-cator of attitude change (Dillard & Peck, 2000; Dillard, Weber,& Vail, 2007) and provides a means of understanding what mes-sage features are effective with the target of persuasion (Noar,Palmgreen, Zimmerman, Lustria, & Lu, 2010). Results fromthis study7 show a strong correlation between the target and per-suader ratings and indicate that direct strategies are perceived asmore effective compared to indirect strategies.

2.3. Related Work on Persuasive Technology and VirtualAgents

Recent studies have demonstrated the effectiveness of per-suasive technologies for encouraging users to increase physicalactivity. For example, UbiFit is a persuasive mobile applicationthat encourages physical activity using a dynamic display of agarden representing metrics of physical activity and user goals(Consolvo et al., 2008).

Similarly, the Fish’n’Steps application uses a dynamic imageof a virtual pet fish that changes in response to the number ofsteps made by a user (Lin, Mamykina, Lindtner, Delajoux, &Strub, 2006). Results from user trials of both applications reportpositive results and suggest that such metaphorical displays arecapable of motivating users to achieve and maintain the desiredtarget behavior (Consolvo et al., 2008; Lin et al., 2006).

Flowie is a persuasive virtual coach that also aims to increasephysical activity among older adults (Albaina, Visser, van derMast, & Vastenburg, 2009). Similar to UbiFit and Fish’n’Steps,Flowie also uses a dynamic image that changes based on auser’s activity level. Again, the authors of this study report pos-itive results from users’ trials, whereby older adults reportedfeeling more motivated to exercise after using the system(Albaina et al., 2009).

The ReadSteady application offers a combined approachusing a dynamic image display but also provides text-basedfeedback to consider users who may feel more motivated byeither type of feedback (Vankipuram, McMahon, & Fleury,2012). Results from an evaluation study show positive responsesfrom older adults in relation to the usability and acceptability

7For more details, please see Vargheese et al. (2014).

PERSUASIVE STRATEGIES FOR SOCIAL INTERACTION 201

of the application (McMahon, Vankipuram, Hekler, & Fleury,2014).

The examples of persuasive technology described so farapply techniques such as reduction, tailoring, and suggestion.These reduce the complexity of the process of behavior changeby providing a simple means of relaying information, calcula-tions, and measurements and highlighting progress toward usergoals. However, on their own these techniques lack the persua-siveness that comes from a relationship between the persuaderand target of persuasion.

The effectiveness of persuasive messages has been demon-strated to increase when there is a significant relationship(Cialdini & Goldstein, 2004) or minor relationship between thepersuader and target of persuasion (Burger, Soroka, Gonzago,Murphy, & Somervell, 2001). Bickmore, Schulman, and Yin(2010) argued that virtual agents that apply relational behav-iors are capable of creating a social bond with the user. Thissocial bond may provide the basis for increasing the effective-ness of persuasive messages and techniques while providing theopportunity to apply more advanced and sophisticated persua-sion strategies such as those demonstrated in our motivationalexample.

Related to the concept of a companionship role for virtualagents, a recent study has demonstrated how such agents arecapable of reducing feelings of loneliness among older adults(Ring, Barry, Totzke, & Bickmore, 2013). The authors of thisstudy argue that the provision of social support by virtual agentsfor older adults represents a significant opportunity to addressthe problems and consequences of social isolation by activelyengaging with the user to initiate interactions that result withreduced feelings of loneliness among the users (Ring et al.,2013). Further support is provided from another study withinthe persuasive technology domain, which suggests that userswho may feel socially excluded are more likely to engage witha virtual agent and are more susceptible to persuasive influencesof the system for encouraging behavioral change (Ruijten, Ham,& Midden, 2014).

Building upon related work discussed in this section, webelieve that a virtual agent provides a suitable platform for apersuasive interactive system that incorporates and applies thepersuasive strategies proposed in our work. Such a platform pro-vides this capability through a virtual agent’s ability to establisha social bond and companionship role with the user. However,to ensure that the system provides an effective solution alsorequires the ability to apply the most effective strategy for agiven persuasion scenario.

3. PAM EVALUATIONThe aim of this study was to evaluate the generalizability

of the PAM for selecting the most effective strategy. The origi-nal modeling study to inform the strategies and the PAM waslimited to two care homes. We cannot claim that these carehomes represent prototypical use of persuasive strategies to

alleviate social isolation. For example, older adults may liveindependently, with family or others. Therefore, our evalua-tion focuses on the generalizability of the PAM, building onthe results of our previous study (see the Generalizability andPerceived Effectiveness of Persuasive Strategies section). Ourevaluation methodology is designed to place participants in therole of the persuader. As the persuaders in our older people con-text (e.g., formal carers) have a wide variety of demographics,it is important that our study sample also varied. In addition,by conducting the evaluation with a general audience, as inthe case of our previous study (see the Generalizability andPerceived Effectiveness of Persuasive Strategies section), thiswould enable us to identify generic persuasive attributes ofthe PAM and distinguish these from those which are domainspecific.

3.1. Evaluation ProcedureThe evaluation was conducted using an online survey with

participants recruited from Amazon’s Mechanical Turk, whichis a crowdsourcing platform where workers (study partici-pants) are paid a sum to perform human intelligence tasksfor requesters (researchers). This approach has been widelyreported to be effective and reliable (Balling & Baayen,2012; Eskenazi, Levow, Meng, Parent, & Suendermann, 2013;Lane, Wainbel, Eck, & Rottmann, 2010; Marge, Banergee, &Rudnicky, 2010; McGraw, Cyphers, Pasupat, Liu, & Glass,2012; Parent & Eskenazi, 2010; Savolainen et al., 2008; Wang,Bohus, Kamar, & Horvitz, 2012; Yang et al., 2010). Eachworker has an acceptance rate that indicates how many humanintelligence tasks have been completed in a high-quality mannerand the payment approved by a requester. To participate in ourstudy, participants were required to have a 90% acceptance rateand be based in the United States. Participants were shown adescription of the study and had to provide their consent beforestarting the evaluation, and they were free to cease participatingat any time. Ethical approval for this study was granted by theUniversity of Aberdeen.

The online survey used for this evaluation was divided intotwo sections.8 First, participants’ personal data were gathered,including age, gender, and zip code (see Appendix A, FigureA1). Participants were also required to complete a Cloze test(Taylor, 1953) to test for English fluency. This test was toensure that participants would be able to fully understand theinstructions of the evaluation, scenario, and persuasive strate-gies. Second, participants were shown a user as persuaderscenario (see Appendix A, Figure A2) and asked to select fromtwo options, which strategy would be most effective for thepersuasion scenario (and could comment if they wished to).Each participant was shown a single persuasion scenario, andno indication of which strategy represented the PAM’s selec-tion was provided. We compared the decision-making process

8Screenshots for each stage of the evaluation are included inAppendix A.

202 J. P. VARGHEESE ET AL.

of the PAM to the participants by comparing the participant’sselection to what the PAM would propose for the same scenario.In the next section we describe how we designed the persuasionscenarios and selected which strategies to include as possibleoptions for the participants in the study.

3.2. Scenario Design and Strategy Selection OptionsWe conducted eight studies that consisted of three to eight

scenarios each, a total of 48 scenarios, as specified in Table 3.The content for each scenario included a social activity, an indi-vidual to be persuaded, and three PAM attributes (see Table 4

TABLE 3Evaluation Scenario Specification

StudyScenariosPer Study PAR FP PFP FFP SOC INT ICN MFP MPF MFF

1 8 T T One of the above profile attributes2 7 T — T One of the above profile attributes3 6 T — — T One of the above profile attributes4 5 T — — — T One of the above profile attributes5 4 T — — — — T One of the above profile attributes6 3 T — — — — — T One of the above profile

attributes7 8 F Either one of the above profile

attributesT Or one of the above profile attributes

8 7 F Either one of the above profileattributes

— T Or one of the above profileattributes

Note. T: Profile attribute set to True, F: Profile attribute set to False, —: Profile attribute not included in scenario (assumed False by thePAM).

TABLE 4Persuasion Evaluation Text and Associated Attributes

Context/Behavioral DeterminantPAM

Attribute Scenario Text

Social activity (for all scenarios) N/A You are planning to take part in the local quiz night.User as persuader (for all

scenarios)N/A You are trying to persuade your neighbor Bill to join you.

Participated PAR Bill has previously/has not previously participated in thequiz.

Friend present FP Joe will also be present. Bill is a friend of Joe.Potential friend present PFP Rob will also be present. Bill and Rob both enjoy running.Facilitator friend present FFP The quiz master for the quiz night is John. John is a friend of

Bill.Typical social network present SOC Some of Bill’s work colleagues will also be present.Interest INT Bill enjoys quiz games.Incentive ICN All taking part in the quiz will receive a free gift voucher.Multiple friends present MFP Mark and Joe will also be present. Bill is friends with both.Multiple potential friends present MPF Rob and Dan will also be present. Bill, Rob, and Dan all

enjoy running.Multiple facilitator friends MFF Steve and Mike will be running the quiz. Steve and Mike are

both friends of Bill.

Note. PAM = profile assessment model; FP = a friend is present; PFP = a potential friend is present; PAR = the target of persuasion“Bill” has previously participated in the social activity; N/A: Not applicable; PAR: Participated; FP: Friends present; PFP: Potential friendspresent; FFP: Facilitator friend present; MFP: Multiple friends present; MPF: Multiple potential friends; MFF: Multiple facilitator friends;SOC: Socialize; INT: Interests; ICN: Incentive.

PERSUASIVE STRATEGIES FOR SOCIAL INTERACTION 203

TABLE 5Evaluation Persuasion Scenario With Annotated Attributes

Scenario You are planning to take part in the local quiz night. You are trying to persuade yourneighbor Bill to join you. Joe will also be present. Bill is a friend of Joe [FP]. Robwill be entering the quiz night. Bill and Rob both enjoy running [PFP]. Bill haspreviously participated in the quiz night [PAR].

Question posed to participant Read the two strategies below. Which one do you think would be most effective forencouraging Bill to attend the quiz night?

Default strategy Persuade Bill by informing him that Joe will be taking part in the quiz night.

Alternative strategy Persuade Bill by informing him that he may make a new friend by taking part inthe quiz night, referring to Rob.

Note. FP = a friend is present; PFP = a potential friend is present; PAR = the target of persuasion “Bill” has previously participated in thesocial activity.

for sentences used). We used a quiz as a social activity, as wefound in previous studies this activity to be plausible (amongparticipants from a general audience) for persuasion scenariosand as it would also provide suitable context for the Facilitatorfriend(s) present, and Fun attributes. For the Potential friend(s)present attributes, we used running as a common interest sharedbetween the Potential friend(s) and the individual to be per-suaded, for scenarios which required this context.

Regarding the choice of PAM attributes to use in the sce-narios (which is summarized in Table 3), we first decidedto exclude Capable, Clash, and Solitude to reduce scenariocomplexity and because these were more difficult to gen-eralize. Second, we decided to use all pairwise combina-tions of the remaining attributes for the case where theParticipated attribute is true. We decided not to considercombinations of more attributes to limit scenario complexityand because we believe we can deduce the preferred strat-egy participants would have chosen for these more compli-cated cases based on the pairwise comparisons. Third, forthe case where Participated is false, we decided to use allpairwise combinations where either the Interest or Incentiveattributes are true. We restricted the choice of attributes inthis way because these were most interesting given the struc-ture of the PAM, and otherwise far more participants would berequired.

For each persuasion scenario, participants were providedwith two persuasive strategy options and asked to select whichstrategy would be most effective. Strategy options are definedas either default or alternative. The default strategy relates towhich strategy the PAM would select as most effective byassessing all profile attributes and related behavioral deter-minants within a scenario. The alternative strategy relates towhich strategy the PAM would select in the absence of profileattributes and related behavioral determinants associated withthe default strategy only.

For example, consider the scenario in Table 5. Profileattributes from the PAM are annotated in bold ([FP], [PFP],[PAR]), which indicate the following behavioral determinantsare present in the persuasion scenario: a friend9 is present, apotential friend is present, and the target of persuasion “Bill”has previously participated in the social activity. The defaultpersuasive statement indicated is the Friend present strategybecause despite the Potential friend present attribute, we can seefrom the PAM (Figure 4) that this strategy would be selectedas the most effective. The alternative strategy provided is thePotential friend present because this is the strategy the PAMwould select if the Friend present attribute was set to false(not included in the scenario). It is important to note that if anattribute is not referred to or included in the scenario, a value offalse will be used by the PAM unless its value follows logicallyfrom another included attribute; for example, if multiple friendsare present, then also one friend will be present, and so forth.The hypotheses for this study are, for each scenario:

H1: There will be a difference between the default and alter-native count of persuasive strategies selected as mosteffective.

H2: The default count will be greater than the alternativecount of persuasive strategies selected as most effective byparticipants.

3.3. PAM Evaluation ResultsWe conducted the evaluation with 2,714 participants (∼45%

female, ∼55% male, < 1% gender undisclosed; 30% between16 and 25 years of age, 47% between 26 and 40, 21% between41 and 65, 1% were 65+, and less than 1% had an undisclosedage).

9Profile attributes such as Friend present are in relation to theindividual to be persuaded within the persuasion scenario.

204 J. P. VARGHEESE ET AL.

FIG. 4. Profile assessment model (PAM)10 for determining which persuasive strategy to apply. Note. Each PAM profile attribute is listed together with associatedpersuasive strategies in Table 2.

We used a binomial test to discover whether there was a sig-nificant difference between the count of default and alternativestrategies selected as most effective for each scenario by theparticipants. A binomial test was used because, for each sce-nario, participants were provided with only two strategy options(default or alternative) from which to select. The binomial testcan be used to check whether the count of either default oralternative strategies selected per scenario is significant. Thep values were calculated using a Bonferroni correction basedon the number of scenarios tested per study, which are listedin Table 3. Table 6 lists the count of default and alternativestrategies selected as most effective (where H2 is not sup-ported). Results for all scenarios are available in Appendix B,Table B1.

10See “Strategy category: Social proof” for more details on how thePAM in Figure 2 represents an expanded version of the PAM describedin Vargheese, Sripada, Masthoff, Oren, Schofield, et al. (2013) byinclusion of individual strategies within the social proof category.

The results indicate that for 25 of the 48 scenarios evaluated,our first hypothesis is supported, as there is a significant dif-ference between the count of default and alternative strategiesselected. Our second hypothesis is supported for 15 scenarios,where the count for the default persuasive strategies selected isgreater compared to the alternative (see all nonshaded rows inTable 6).

It is possible that the conceptual differences between partic-ipants and the PAM are domain specific. For example, considerthe Participated attribute. Within the care home domain, thisattribute may yield additional information that could influ-ence the decision process for determining which strategy toapply. This could be related to interactions between the tar-get of persuasion, other residents, and activity facilitators, andtherefore may be highly significant with regards to selectingthe most effective strategy to apply. Similarly, the Solitudeattribute, which was not included in any scenario tested, maybe more significant to carers for older adults in residential

PERSUASIVE STRATEGIES FOR SOCIAL INTERACTION 205

TABLE 6Evaluation Results for Scenarios That Support Hypothesis 1

Study Study NP Scenario NP Scenario Default Alternative p

1240

30 1 26 4 0.00

30 3 23 7 0.04

30 6 27 0.00

30 7 0.00

2 448

64 9 7 57 0.00

64 10 15 49 0.00

64 13 56 8 0.00

64 14 58 6 0.00

64 15 19 0.01

3 360

60 16 48 12 0.00

60 17 42 18 0.02

60 19 48 12 0.00

60 20 10 50 0.00

60 21 49 11 0.00

4 310

62 22 46 16 0.00

62 25 50 12 0.00

62 26 57 5 0.00

5 240 60 27 17 43 0.00

6 18662 32 45 17 0.00

62 33 45 17 0.00

7 496

62 34 19 0.02

62 36 14 0.00

62 37 18 0.01

62 39 19 0.02

8 434 62 45 18 0.01

26

3

4

45

43

48

44

43

44

Note. In shaded cells, the count of alternative strategies is significantly greater than default. Study NP = totalnumber of participants in a study; scenario NP = number of participants per scenario; Default = default strategycount; Alternative = alternative strategy count

206 J. P. VARGHEESE ET AL.

care, particularly if the target of persuasion has only recentlyarrived at the care home. With regards to the Potential friend(s)present attributes, these may also be more relevant within thecare home domain, particularly for carers seeking to encouragesocial interaction between a newly arrived resident and otherswho share a common interest or background. These findings aresupported by the results from our previous work11 concerningthe perceived effectiveness of the strategies that indicate thesestrategies are considered the least effective among the directstrategies. This may account for why attributes related to thesestrategies are not considered as relevant by participants com-pared to the PAM.

3.4. Refining the PAMThe results of this study indicate that for 25 scenarios,

the count of default strategies selected by the participants isgreater (15 significantly) compared to the count for the alter-native. For 22 scenarios, the count of alternative strategiesselected is greater (10 significant) compared to the count forthe default. For a single scenario, the count between the defaultand alternative is equal (see Appendix B, Table B1, scenario11). From these results, we conclude that although it may bepossible to generalize the persuasive strategies discovered inour modeling study (see Section 2.2 and the Generalizabilityand Perceived Effectiveness of Persuasive Strategies section),the generalizability of the PAM requires greater considerationregarding how strategies are selected by a general audience.We hypothesize that the differences between the PAM and par-ticipants for selecting strategies may be due to domain specificconceptual features that determine the order in which behav-ioral determinants within a scenario are assessed (see Figure 4and Table 6 shaded rows). The PAM may also include a redun-dant attribute (Participated) to assess a behavioral determinantfor selecting strategies that are not considered as relevant by ageneral audience compared to carers. Therefore, to improve thegeneralizability of the PAM, we need to consider how to incor-porate these differences between the PAM and the participantsinto the model.

To achieve this, we developed a revised version of the PAM(see Figure 5) taking into account all significant results from thisstudy (listed in Table 6). This was to incorporate both the sim-ilarities and differences between the PAM and the participantsfor selecting a strategy.

3.5. PAM Evaluation With CarersWe conducted a further evaluation with formal carers for

older adults in residential care in order to discover whetherthe updated PAM could be used to determine the most effec-tive persuasive strategy for both a general audience and olderadults. We also wanted to discover whether the Participated

11See “Generalizability and perceived effectiveness of persuasivestrategies” and Vargheese et al. (2014).

attribute removed from the updated PAM is domain specificand, therefore, required in order to consider which strategy toapply.

We recruited 43 formal carers from three residential carehomes. Each carer considered which persuasive strategy toapply for scenarios where the results from the previous studyindicated a significant count in favor of the alternative strategyaccording to the original PAM. Again, we used a binomialtest to establish whether the count between the default andalternative strategy was significant. To ensure independence ofobservation, carers were provided with a single scenario at atime, and the order in which scenario was assessed was random-ized for each study participant. For each scenario, p values werecalculated using a Bonferroni correction for the total number ofscenarios independently assessed by the carers. The results forthe carer evaluation are shown in Table 7.

3.6. Carer Evaluation ResultsResults for only two of the scenarios in this study with carers

show a significant difference between the default and alternativestrategies. In both cases, this is in favor of the original PAM. Thelack of significance may be partly due to the smaller numberof participants. Considering the trends in the data, in half thescenarios the original PAM performed better, and in half theupdated PAM performed better. This is in contrast with the datafrom the general audience evaluation, where the updated PAMoutperforms the original. This result suggests that the profileattributes used by carers to select the most suitable strategy maywell differ from those of a more general audience, for example,whether the Participated attribute is required.

3.7. Evaluation LimitationsThe limitations of this study center on our use of perceived

effectiveness and hypothetical scenarios for evaluating the PAMwith a general audience. Regarding perceived effectiveness,the rationale for this was provided in the Generalizabilityand Perceived Effectiveness of Persuasive Strategies section.However, it remains an estimation of actual effectiveness.In Section 5, we discuss how we intend to resolve this limi-tation in future work by conducting an observational study withcarers and older adults, investigating the actual effectivenessof the strategies. Regarding the scenarios, it is difficult to con-trol for all contextual information, particularly the commonalitybetween the target of persuasion and potential friend (in our sce-narios, they both like running), social activity (in our scenarios,a quiz), and how this will influence the decision-making processof participants. We tried to limit this effect by basing these con-textual choices on our findings from the focus group study inthe Generalizability and Perceived Effectiveness of PersuasiveStrategies section. However, some effects may remain. Withregards to the carer evaluation, ideally we would have preferredto have conducted this study with a greater number of partici-pants with all the scenarios used in the evaluation with a general

PERSUASIVE STRATEGIES FOR SOCIAL INTERACTION 207

FIG. 5. Updated profile assessment model with Participated attribute removed and remaining profile attributes reordered to reflect the decision making processof participants for all significant results of the evaluation (results that support Hypothesis 1).

audience. However, this was not possible due to the limitednumber of carers available and time constraints for conductingthe evaluation with them.

4. DISCUSSIONOur research is focused on developing a model of persuasion

to be employed by a virtual agent for encouraging social inter-action among older adults at risk of social isolation. To achievethis, we conducted a modeling study with formal carers forolder adults to discover how persuasion is used to success-fully resolve the problem of social isolation. From the resultsof this study, we developed a model of persuasion that consistsof a set of strategies grounded in theories of persuasion and astrategy selection heuristic (PAM) for applying them. A sub-sequent follow-up study with carers confirmed the use of thestrategies, assessment criteria, and utility of the PAM. We arguethat the specific strategies and subsequent strategy selectionheuristic discovered from our modeling study are domain spe-cific. Therefore, these are specializations of generic strategies

and how to apply them. Therefore, our evaluations studies inves-tigated the generalizability of these findings to discover if ourmodel of persuasion could be applied to our specific older adultcare context and others. This may include, for example, olderadults living independently with family or others.

First, we investigated how the strategies may be generalizedand applied to a general audience. To achieve this, we conductedevaluation studies to investigate the strategies’ perceived effec-tiveness using persuasion scenarios, which included behavioraldeterminants and target behavior applicable to a general audi-ence. The persuasion scenario used for these studies maintainedthe goal of persuasion (encouraging social interaction) for eachstrategy. Results from these studies indicate that the strategiesare applicable to a general audience.

Building on these results, we investigated thegeneralizability of the PAM. This was to discover whether theprocess for selecting a strategy for older adults could also beapplied to a general audience. This was necessary becausethe order by which behavioral determinants are assessed by

208 J. P. VARGHEESE ET AL.

TABLE 7Carer Evaluation Results Using Only Scenarios Where the Count of Alternative Is Significantly Greater Than the Count of

Alternative With a General Audience

NP Scenario Default Alternative p

43 9 32 11 .20

10 12 31 .50

15 12 31 .50

20 17 26 2.22

27 25 18 3.60

34 35 8 .00

36 26 17 2.20

37 11 32 .20

39 18 25 3.60

45 34 9 .00

Note. See Table 6. Bold text indicates support of H1 (default selected significantly greater than the alternative). NP = number of participantsfor study group; Default = default strategy (default for original profile assessment model [PAM]) count; Alternative = alternative strategy(default for updated PAM) count; p = Bonferroni corrected p value.

the PAM was determined by carers from our modeling studyand therefore specialized to the care home context, so theymay not be appropriate for older adults in other circumstances.Although our previous study demonstrated the generalizabilityof the strategies, this study did not take into account whetherthe process for selecting which strategy to apply was alsogeneralizable. This is because the PAM criteria and orderin which behavioral determinants are assessed was specifiedby carers from the results of our initial modeling study.Therefore, we evaluated the PAM with a general audience,using generalized strategies and persuasion scenarios.

The results from this study highlight conceptual differencesrelated to selecting which strategy to apply for a general audi-ence and for older adults in care. We, therefore, created anupdated PAM to better reflect the process for selecting whichstrategy to apply for a general audience. We hypothesized thatthese conceptual differences may be due to the domain-specificordering of the original PAM and that this original heuristic wasmore suitable to the care home domain. To investigate this fur-ther, we repeated the PAM evaluation with carers. We conductedthis evaluation using only scenarios for which a general audi-ence significantly disagreed with the original PAM. The resultsfrom this study confirmed that the original PAM is more suitablefor the care home domain and the updated PAM is applicable toa general audience.

In summary, we have demonstrated how the strategies aregrounded in theories of persuasion and therefore may be appli-cable to other audiences where the goal of persuasion isto encourage social interaction. We have demonstrated thatalthough the strategies may be generalized, the process for

selecting which strategy to apply requires further consideration.This is related to the order by which behavioral determinants ofa persuasion scenario are assessed and whether certain behav-ioral determinants should be included or excluded from this pro-cess. This has important implications for designing persuasiveinteractive systems for other users at risk of social isolation. Ourresearch provides a foundation for establishing what behavioraldeterminants should be considered for selecting a strategy andthe order by which these are assessed for a specified audience.We have demonstrated how the original PAM may be general-ized (updated PAM) to prevent model bias from the specific carehome domain.

5. CONCLUSION AND FUTURE WORKPersuasive interactive systems offer a novel approach to

resolving the problem of social isolation by encouraging indi-viduals to engage with social activities. We believe the effec-tiveness of technologies designed to facilitate and support socialinteraction can be increased by utilizing persuasion as used byformal carers for older adults. The persuasive strategies andPAM investigated in this article can be used by a virtual agent toencourage participation in social activities. In addition, the PAMcan be used as a recommender system for proposing strate-gies for carers to encourage those at risk of social isolation toparticipate in social activities.

In this article we reviewed our previous work and outlinedour theoretical approach to identifying and defining persuasivestrategies for encouraging social interaction grounded in theo-ries of persuasion. We discussed how we developed a strategy

PERSUASIVE STRATEGIES FOR SOCIAL INTERACTION 209

selection heuristic (the PAM) for determining the most suitablestrategy to apply. Building upon this work we investigated thegeneralizability of the PAM in an evaluation study designedto compare the decision-making process for selecting the mosteffective strategy to apply between the PAM and participantsfrom a general audience.

The results from this study indicate that the original PAMmay include domain-specific features more applicable to theformal carer scenario. To improve the generalizability of thePAM, we have revised the model to reflect the decision-makingprocess of participants using all the significant results acquiredduring the PAM evaluation. A preliminary assessment of thismodel using participant responses from the PAM evaluationsuggests that the updated PAM is more suitable for a generalaudience (achieving a 100% prediction of the study’s significantresults).

In future work, we plan to investigate this further by repeat-ing this study with formal carers for older adults. We intendto compare the decision-making process between the originalPAM, updated PAM, participants from a general audience(using the results from this study), and carers for selecting astrategy to investigate whether certain features of the PAM areindeed domain specific. To provide further insight, we intendto analyze qualitative data based on feedback (comments)received during the PAM evaluation and future work withcarers. We also plan to assess the actual effectiveness of thestrategies in an observational study involving formal carersand older adults in residential care. We intend to recruit carersfrom residential care homes who will be asked to maintain alog of which strategies are applied throughout a set period, theoutcome, and scenario details.

FUNDINGThis research is supported by the award made by the RCUK

Digital Economy program to the dot.rural Digital EconomyHub; award reference: EP/G066051/1.

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ABOUT THE AUTHORSJohn Paul Vargheese is a research fellow in ComputingScience at the University of Aberdeen. His primary researchinterests are within human–computer interaction, persuasivetechnology, user-centered intelligent healthcare interventions,and assistive living technology.

Somayajulu Sripada is a senior lecturer at the University ofAberdeen. His primary research interests are in natural languagegeneration, data mining, visual analytics, and in particular, onextending NLG models to design information presentations thatcombine information visualizations and natural language text.

Judith Masthoff is a chair in Computing at the Universityof Aberdeen. Her primary research interests lie in the areasof personalization and user modeling, digital behavior inter-ventions, intelligent user interfaces, affective computing, ande-Health.

Nir Oren is a senior lecturer at the University of Aberdeen.His primary research interests lie in the areas of formal argu-mentation and dialogue, and in particular, on using argument toexplain complex concepts to nontechnical users.

212 J. P. VARGHEESE ET AL.

APPENDIX A

FIG. A1. Profile assessment model evaluation screenshot, participant details, and English fluency test.

FIG. A2. PAM evaluation screen shot, scenario, and strategy selection view.

PERSUASIVE STRATEGIES FOR SOCIAL INTERACTION 213

APPENDIX BTABLE B1

Evaluation Full Results

Study Study NP Scenario NP Scenario Default Alternative p

1 240

30 1 26 4 0.000

30 2 11 19 1.600

30 3 23 7 0.040

30 4 18 12 2.896

30 5 17 13 4.680

30 6 27 3 0.000

30 7 26 4 0.000

30 8 27 13 4.680

2 448

64 9 7 57 0.000

64 10 15 49 0.000

64 11 32 32 7.000

64 12 26 38 1.183

64 13 56 8 0.000

64 14 58 6 0.000

64 15 19 45 0.014

3 360

60 16 48 120.000

60 17 42 180.018

60 18 40 200.078

60 19 48 120.000

60 20 10 500.000

60 21 49 110.000

4 310

62 22 46 16 0.000

62 23 41 21 0.075

62 24 38 24 0.490

62 25 50 12 0.000

62 26 57 5 0.000

214 J. P. VARGHEESE ET AL.

APPENDIX BTABLE B1(Continued)

Study Study NP Scenario NP Scenario Default Alternative p

5 240

60 2717 43 0.004

60 2828 32 2.796

60 2927 33 2.076

60 3029 31 3.588

6 186

62 31 24 38 0.294

62 32 45 17 0.000

62 33 45 17 0.000

7 496

62 34 19 43 0.024

62 35 33 29 5.632

62 36 14 48 0.000

62 37 18 44 0.008

62 38 38 24 7.840

62 39 19 43 0.024

62 40 41 21 0.120

62 41 29 33 5.632

8 434

62 42 27 35 2.618

62 43 41 21 0.105

62 44 22 40 0.210

62 45 18 44 0.007

62 46 39 23 0.392

62 47 32 30 6.293

62 4839 23 0.392

Note. Dark shaded cells indicate count of default strategies is significantly greater than alternative. Light shadedcells indicate count of alternative is significantly greater than default. Unshaded cells indicate no significant differ-ences. Plain text indicates that the default is greater than the alternative. Bold means that the default is less than thealternative. Italic means that the default equals the alternative. Study NP = total number of participants in a study; sce-nario NP = number of participants per scenario; Default = default strategy count; Alternative = alternative strategycount; p = Bonferroni-corrected p value.