Virtual health counselors offer the potential to provide users with information and counseling in complex areas such as disease management and health education. However, ensuring user engagement is challenging, particularly when the volume of information and length of counseling sessions increase. Agenda setting a clinical counseling technique where a patient and clinician collaboratively decide on session topics is an effective approach to tailoring discussions for individual patient needs and sustaining engagement. We explore the effectiveness of agenda setting in a virtual counselor system designed to counsel women for breast cancer genetic testing. In a between subjects study, we assessed three versions of the system with varying levels of user control in the system's agenda setting approach. We found that participants' knowledge improved across all conditions. Although our results showed that any type of agenda setting was perceived as useful, regardless of user control, interviews revealed a preference for more collaboration and user involvement in the agenda setting process. Our study highlights the importance of using patient-centered approaches, such as tailored discussions, when using virtual counselors in healthcare.
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