Designing for Adolescent Voice in Health Decisions: Embodied Conversational Agents for HPV Vaccination

2026-03-05

AI Summary

This study addresses the gap in existing digital interventions for HPV vaccination, which predominantly target parents while neglecting adolescents as active agents in health decision-making. To rectify this, the authors developed a mobile-based embodied conversational agent system that innovatively engages adolescents in shared decision-making. Parents receive motivational interviewing and education through an animated physician avatar, while adolescents interact with age-appropriate physician characters or narrative fantasy games to learn about HPV. Integrating personalized embodied agents, motivational interviewing techniques, and gamified storytelling, the system empowers adolescents to express preferences and exercise autonomy in vaccine-related decisions. A clinical pilot involving 21 parent–adolescent dyads demonstrated significant improvements in HPV knowledge and vaccination intent, alongside high user satisfaction.

Technology Category

• Multiagent Systems: Adversarial Agents
• Intelligent Robots: Embodied AI
• Humans and AI: Game Design — Virtual Humans, NPCs and Autonomous Characters

Application Category

• User Modeling, Personalization and Recommendation: User privacy protection in personalized systems
• Responsible Web: Machine-in-the-loop, human agency and autonomy
• Systems and Infrastructure for Web, Mobile and WoT: Decentralized Web and Fediverse systems

Abstract

Adolescents are directly affected by preventive health decisions such as vaccination, yet their perspectives are rarely solicited or supported. Most digital interventions for Human Papillomavirus (HPV) vaccination are designed exclusively for parents, implicitly treating adolescents as passive recipients rather than stakeholders with agency. We present the design and evaluation of a mobile intervention that gives adolescents a voice in HPV vaccination decisions alongside their parents. The system uses embodied conversational agents tailored to each audience: parents interact with an animated physician using education and motivational interviewing techniques, while adolescents can choose between an age-appropriate doctor or a narrative fantasy game that conveys HPV facts through play. We report findings from a clinic-based pilot study with 21 parent-adolescent dyads. Results indicate high satisfaction across both audiences, improved HPV knowledge, and increased intent to vaccinate. We discuss design implications for supporting adolescent participation, choice, and agency in decisions about their health.

Problem

• adolescent voice
• HPV vaccination
• health decision-making
• digital intervention
• youth agency

Innovation

• embodied conversational agents
• adolescent agency
• HPV vaccination
• motivational interviewing
• gamified health intervention