Chatbot for Social Need Screening and Resource Sharing With Vulnerable Families: Iterative Design and Evaluation Study.

chatbot conversational agent digital health evaluation feasibility implementation iterative design primary care social determinants of health social needs usability

Journal

JMIR human factors
ISSN: 2292-9495
Titre abrégé: JMIR Hum Factors
Pays: Canada
ID NLM: 101666561

Informations de publication

Date de publication:
19 Jul 2024
Historique:
received: 05 02 2024
accepted: 24 05 2024
revised: 03 05 2024
medline: 19 7 2024
pubmed: 19 7 2024
entrez: 19 7 2024
Statut: epublish

Résumé

Health outcomes are significantly influenced by unmet social needs. Although screening for social needs has become common in health care settings, there is often poor linkage to resources after needs are identified. The structural barriers (eg, staffing, time, and space) to helping address social needs could be overcome by a technology-based solution. This study aims to present the design and evaluation of a chatbot, DAPHNE (Dialog-Based Assistant Platform for Healthcare and Needs Ecosystem), which screens for social needs and links patients and families to resources. This research used a three-stage study approach: (1) an end-user survey to understand unmet needs and perception toward chatbots, (2) iterative design with interdisciplinary stakeholder groups, and (3) a feasibility and usability assessment. In study 1, a web-based survey was conducted with low-income US resident households (n=201). Following that, in study 2, web-based sessions were held with an interdisciplinary group of stakeholders (n=10) using thematic and content analysis to inform the chatbot's design and development. Finally, in study 3, the assessment on feasibility and usability was completed via a mix of a web-based survey and focus group interviews following scenario-based usability testing with community health workers (family advocates; n=4) and social workers (n=9). We reported descriptive statistics and chi-square test results for the household survey. Content analysis and thematic analysis were used to analyze qualitative data. Usability score was descriptively reported. Among the survey participants, employed and younger individuals reported a higher likelihood of using a chatbot to address social needs, in contrast to the oldest age group. Regarding designing the chatbot, the stakeholders emphasized the importance of provider-technology collaboration, inclusive conversational design, and user education. The participants found that the chatbot's capabilities met expectations and that the chatbot was easy to use (System Usability Scale score=72/100). However, there were common concerns about the accuracy of suggested resources, electronic health record integration, and trust with a chatbot. Chatbots can provide personalized feedback for families to identify and meet social needs. Our study highlights the importance of user-centered iterative design and development of chatbots for social needs. Future research should examine the efficacy, cost-effectiveness, and scalability of chatbot interventions to address social needs.

Sections du résumé

BACKGROUND BACKGROUND
Health outcomes are significantly influenced by unmet social needs. Although screening for social needs has become common in health care settings, there is often poor linkage to resources after needs are identified. The structural barriers (eg, staffing, time, and space) to helping address social needs could be overcome by a technology-based solution.
OBJECTIVE OBJECTIVE
This study aims to present the design and evaluation of a chatbot, DAPHNE (Dialog-Based Assistant Platform for Healthcare and Needs Ecosystem), which screens for social needs and links patients and families to resources.
METHODS METHODS
This research used a three-stage study approach: (1) an end-user survey to understand unmet needs and perception toward chatbots, (2) iterative design with interdisciplinary stakeholder groups, and (3) a feasibility and usability assessment. In study 1, a web-based survey was conducted with low-income US resident households (n=201). Following that, in study 2, web-based sessions were held with an interdisciplinary group of stakeholders (n=10) using thematic and content analysis to inform the chatbot's design and development. Finally, in study 3, the assessment on feasibility and usability was completed via a mix of a web-based survey and focus group interviews following scenario-based usability testing with community health workers (family advocates; n=4) and social workers (n=9). We reported descriptive statistics and chi-square test results for the household survey. Content analysis and thematic analysis were used to analyze qualitative data. Usability score was descriptively reported.
RESULTS RESULTS
Among the survey participants, employed and younger individuals reported a higher likelihood of using a chatbot to address social needs, in contrast to the oldest age group. Regarding designing the chatbot, the stakeholders emphasized the importance of provider-technology collaboration, inclusive conversational design, and user education. The participants found that the chatbot's capabilities met expectations and that the chatbot was easy to use (System Usability Scale score=72/100). However, there were common concerns about the accuracy of suggested resources, electronic health record integration, and trust with a chatbot.
CONCLUSIONS CONCLUSIONS
Chatbots can provide personalized feedback for families to identify and meet social needs. Our study highlights the importance of user-centered iterative design and development of chatbots for social needs. Future research should examine the efficacy, cost-effectiveness, and scalability of chatbot interventions to address social needs.

Identifiants

pubmed: 39028995
pii: v11i1e57114
doi: 10.2196/57114
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

e57114

Informations de copyright

©Emre Sezgin, A Baki Kocaballi, Millie Dolce, Micah Skeens, Lisa Militello, Yungui Huang, Jack Stevens, Alex R Kemper. Originally published in JMIR Human Factors (https://humanfactors.jmir.org), 19.07.2024.

Auteurs

Emre Sezgin (E)

Nationwide Children's Hospital, Columbus, OH, United States.

A Baki Kocaballi (AB)

Centre for Health Informatics, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia.

Millie Dolce (M)

Nationwide Children's Hospital, Columbus, OH, United States.

Micah Skeens (M)

Nationwide Children's Hospital, Columbus, OH, United States.

Lisa Militello (L)

The Ohio State University, Columbus, OH, United States.

Yungui Huang (Y)

Nationwide Children's Hospital, Columbus, OH, United States.

Jack Stevens (J)

Nationwide Children's Hospital, Columbus, OH, United States.

Alex R Kemper (AR)

Nationwide Children's Hospital, Columbus, OH, United States.

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