Abstract
Participant usage patterns of a pretest cancer genetics education chatbot
Lauren Kaiser-Jackson, B.S.1, Adrian Harris, MS2, Daniel Chavez-Yenter, PhD3, Molly Volkmar, B.S.1, Jemar Bather, PhD2, Kansaku Kawamoto, M.D., Ph.D, M.H.S3, Guilherme Del Fiol, MD, PhD4, Melody Goodman, PhD5, Rachel Monahan, BA6, Meenakshi Sigireddi, MD7, Richard Bradshaw, PhD3, Wendy Kohlmann, MS, CGC8, Rachelle Chambers, MS, CGC9, Saundra Buys, MD3 and Kimberly Kaphingst, ScD3
(1)Huntsman Cancer Institute, Salt Lake City, UT, (2)New York University, New York, NY, (3)University of Utah, Salt Lake City, UT, (4)University of Utah/Huntsman Cancer Institute, Salt Lake City, UT, (5)New York, NY, (6)NYU Langone Health, New York, NY, (7)New York University Langone Health, New York, NY, (8)VA National TeleOncology, Salt Lake City, UT, (9)Laura and Isaac Perlmutter Cancer Center, New York, NY
APHA 2024 Annual Meeting and Expo
Introduction
The use of chatbot technology in healthcare settings has grown dramatically. Prior studies have examined the acceptability of chatbots for delivering genetic services. Yet, limited research has explored chatbot usage patterns.
Methods
As part of a trial conducted in two large healthcare systems, we analyzed user interactions with a chatbot that delivered pretest genetics education to participants without cancer who were identified as eligible for cancer genetic evaluation. Participants were shown core content, received multiple decision prompts to reach expanded information, and could ask open-ended questions. Descriptive statistics for completion status, prompt decisions, time interval of completion, number of prompts selected and open-ended questions, genetic testing decision, and sociodemographic characteristics were examined using SPSS.
Results
537 participants started the chat; 77% were female, 99% preferred English, 74% were White, with a mean age of 44 years. About 83% completed the chat and entered a decision about pursuing genetic testing. The most common usage patterns were selecting one of the prompts for expanded information (43%), asking no open-ended questions (89%), and completing the chat between 6pm-10pm (33%). For those who did not complete the chat, 77% stopped prior to any decision prompts.
Conclusions
The findings of a high completion rate suggested that the chat is acceptable. In addition, we found that most participants only examined core content, indicating the importance of providing adequate information to support informed decision-making in this content. Further, many participants completed the chat outside of business hours, suggesting that this technology may expand access to services.
Communication and informatics Provision of health care to the public Public health or related research
Abstract
A whatsapp-based chatbot intervention to promote childhood vaccination:findings from a quasi-experiment in the slum areas of varanasi, India
Rajiv Rimal, PhD1, Rohini Ganjoo2, Amelia Jamison, MAA, MPH, PhD3, Khushee Prasad4, Sidharth Rath5, Manoj Parida6, Madhushree Pandey7, Bikash Kumar Panda6, Shruti Pandey7, Saraniya Tharmarajah, MSc3, Ananya Bhaktaram, MHS4, Neil Alperstein8, Meghana Tallam4, Paola Pascual-Ferra8, Satyanarayan Mohanty6 and Daniel Barnett4
(1)Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, (2)Ashburn, VA, (3)Baltimore, MD, (4)Johns Hopkins University, Baltimore, MD, (5)Swasthya Plus, Bhubaneshwar, India, (6)DCOR Consulting, Bhubaneshwar, India, (7)Sarthak, Varanasi, India, (8)Loyola University Maryland, Baltimore, MD
APHA 2024 Annual Meeting and Expo
Background. Despite India’s gains in childhood vaccination, disparities exist between the general population and people living in slum areas. Significant workloads among caregivers and frontline workers pose substantial barriers in children’s vaccination. This study asked whether a WhatsApp-based chatbot could serve as reminders, acknowledge vaccination through congra.tulatory messages, and ease the workload among frontline workers, resulting in greater vaccine confidence and vaccination intentions.Methods. A three-arm longitudinal quasi-experiment was conducted in six slum areas in Varanasi, India: a no-intervention waitlist control (N=602), a vaccination (N=626), and a wellness (N=651) arm. Over three months, on a weekly basis, participants in the Vaccine arm received chatbot-based messages about vaccines only; Wellness group received messages about vaccines, handwashing, breastfeeding, and nutrition. Participants provided data before and, three months later, after the “Happy Baby” intervention. Difference-in-difference models assessed improvements in vaccine confidence and vaccination intentions in treatment, compared to control, arms through analysis of covariance models that controlled for demographics.Results. Relative to Control, the Vaccine (P<.01), but not the Wellness, arm improved in vaccine confidence (267% gain) and both the Vaccine (375% gain, P<.01) and Wellness (258% gain, P<.05) arms improved in vaccination intentions. Vaccine confidence was significantly associated with intention (P<.001).Conclusion. The Happy Baby program improved vaccine confidence in one intervention arm and intentions in both arms. Consistent with health communication principles, simpler messages (focusing exclusively on vaccines) appear more effective than those addressing a wider group of wellness variables. Improving vaccine confidence is an important factor in promoting vaccination intentions.
Administer health education strategies, interventions and programs Conduct evaluation related to programs, research, and other areas of practice Implementation of health education strategies, interventions and programs Planning of health education strategies, interventions, and programs Program planning Public health or related education
Abstract
Determining the effect of role models and influencers delivering sexual and reproductive health messages on facebook to a west African audience: A randomized factorial trial.
Philip Massey, PhD1, Catherine Crespi, PhD1, Leona Ofei, MPH1, Nikolas Wienecki1, Deffa Wane2, Rabiatou Sangare2, Laurel Felt2, Alexandre Rideau2 and Mbathio Diaw2
(1)UCLA Fielding School of Public Health, Los Angeles, CA, (2)ONG RAES, Dakar, Senegal
APHA 2024 Annual Meeting and Expo
Background: The use of social media to promote sexual and reproductive health (SRH) is a promising strategy particularly in low- and middle-income countries (LMICs). This study examines the impact of SRH messages on Facebook when amplified by role models and influencers compared to typical message delivery.
Methods: Participants aged 15-24; residing in Senegal, Cote d'Ivoire, or Burkina Faso; using Facebook weekly; and speaking French were recruited through targeted Facebook ads. We randomized participants (n=492) to four conditions, including control, role model (RM), influencer (INF), and role model + influencer. From December 2023 – February 2024, participants joined private Facebook groups and completed a pre/post survey. Measures included: contraceptive knowledge, contraceptive self-efficacy, SRH digital service utilization.
Results: The 3 intervention groups demonstrated pre/post increase in the 12-item contraceptive knowledge scale (RM 7.0 to 7.9, p=.001; INF 6.1 to 7.2, p<.001; RM+INF 7.3 to 8.2, p=.007); no significant increase was observed in the control (6.4 to 7.0, p=0.67). While scores on the 14-item self-efficacy scale remained consistent from pre/post in the 3 intervention groups, participants in the control had significantly lower self-efficacy scores at endline (6.0 to 5.1, p=.006). No differences in digital SRH service utilization were observed between pre/post, and 65% of participants indicated using at least one service at endline compared to 62% at baseline.
Conclusion: With increasing digital engagement, the delivery of SRH content on social media through role models and influencers emerges as a promising strategy for public health communications, particularly in LMICs including West African nations.
Communication and informatics Conduct evaluation related to programs, research, and other areas of practice Diversity and culture Implementation of health education strategies, interventions and programs
Abstract
The power of a message: Optimizing digital engagement to close gaps in care
Smita Bhattacharya
mPulse Mobile, Ann Arbor, MI
APHA 2024 Annual Meeting and Expo
The Healthcare Effectiveness Data and Information Set (HEDIS) is a healthcare industry performance measure developed by the National Committee for Quality Assurance (NCQA). HEDIS includes over 90 measures in appropriateness of care, chronic condition management, behavioral health management, screening and prevention, and emergency department utilization/hospital readmissions. Our digital outreach platform is a powerful tool in closing gaps in care across HEDIS measures as it spreads health education in engaging ways, to reach a non-adherent or unengaged audience. With an omnichannel approach, we use 3 major modalities: short message service (SMS), interactive voice response (IVR), and email to promote health literacy, share resources to bridge social needs gaps, and reach more people, for improved health outcomes. When creating omnichannel campaigns, we utilize behavior science tools to maximize interactions that demystify health. We integrate a multicultural lens to provide communications in multiple languages with natural language understanding (NLU) to optimize cultural sensitivity. These messages aim to provide resources, education, and empower consumers to take healthy actions. Results show that SMS was the most utilized channel with campaigns in measures across immunizations (CIS, IMA, FLU), screenings (BCS, CCS, CBP, CDC), well-visits (ADV, PPC, AAP, WCV, W30), and more. Claims data from over 50 HEDIS measures show a combined impact of 35% improvement via SMS only, and 125% improvement when using all 3 modalities. Our results illustrate the scalability of digital health education program and indicate that short digital messages are powerful and promising tools to drive healthy actions.
Administer health education strategies, interventions and programs Advocacy for health and health education Diversity and culture Implementation of health education strategies, interventions and programs Social and behavioral sciences