Computational persuasion technologies, explainability, and ethical-legal implications: A systematic literature review

This paper conducts a systematic literature review (SLR) to evaluate the effectiveness of computational persuasion technology (CPT) in the eHealth domain. Over the past fifteen years, CPT has been used in various scenarios, from promoting healthy diets to supporting chronic disease management. Despite the proliferation of intelligent systems and Web-based applications, the ethical and legal nuances of these technologies have become increasingly significant. The review follows a structured methodology, assessing 92 primary studies through sixteen research questions covering demographics, application scenarios, user requirements, objectives, functionalities, technologies, advantages, limitations, proposed solutions, ethical and legal implications, and the role of explainable AI (XAI). The findings indicate that while CPT holds promise in inducing behavioral change, many prototypes remain untested on a large scale (60% of surveyed studies only developed at a conceptual level), and long-term effectiveness is still uncertain (36% report attaining their goals, but none focuses on long-term assessment). The study highlights the need for more comparative analyses of persuasion models and tailored approaches to meet diverse user needs. Ethical and legal concerns, such as patient consent, data privacy, and potential for users’ manipulation, are under-explored and require deeper investigation. The paper recommends a bottom-up regulatory approach to create more effective and flexible ethical and legal guidelines for CPT applications. In conclusion, significant advancements have been made in CPT for eHealth, but ongoing research is essential to address current limitations, enhance user acceptability and adherence, and ensure ethical and legal soundness. • A systematic review of computational persuasion technology (CPT) in eHealth. • Elaborated 92 studies on CPT technologies, explicability, ethical-legal implications. • Gaps identification in large-scale testing and long-term effectiveness of CPT. • Autonomy, manipulation, and responsibility are under-explored ethical concerns. • Recommendations for tailored approaches and bottom-up regulatory guidelines in CPT.