Designing and Personalising Hybrid Health Explanations for Lay Users
Bibliographic record
Abstract
Recommender systems are increasingly used in mobile health interventions, such as managing Chronic Musculoskeletal Pain (CMP). While researchers have highlighted the importance of explaining health-related recommendations to lay users, with benefits such as increased trust and a higher tendency to follow up on these recommendations, how to design explanations for lay users in critical contexts such as health remains largely unexplored. To address this gap, we develop a mobile health application to support users with CMP through coaching and personalised health recommendations delivered via a conversational rule-based recommender system. This article describes the three-phase iterative development of the RS, involving health experts and end users. In the first iteration, we conduct a preliminary validation study with \(N=282\) participants to ensure the app’s validity and improve the initial set of health recommendations. Next, two user studies are conducted centred around designing effective and understandable explanations for these recommendations. First, we design six explanation modalities tailored towards lay users, and through a qualitative study ( \(N=11\) ), extract initial design guidelines for explaining health recommendations, finding a strong preference towards feature importance explanations and identifying issues with modalities that highlight negative emotions. Given these results, we explore whether extending feature importance explanations with textual information into a ‘hybrid’ explanation could benefit end users, and whether these benefits depend on a user’s personal characteristics (need for cognition and ease-of-satisfaction). Through a mixed-methods study with \(N=262\) participants, we find that the hybrid modality significantly increased user trust, transparency, persuasiveness, usefulness and satisfaction compared to unimodal explanations. However, users with a higher need for cognition rate unimodal explanations more positively than hybrid ones.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.007 | 0.036 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.003 |
| Open science | 0.001 | 0.003 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.005 | 0.002 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".