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Chatbot -assisted self-assessment (CASA): Co-designing an AI -powered behaviour change intervention for ethnic
Tom Nadarzynski1, Nicky Knights1, Deborah Husbands1
1School of Social Sciences, University of Westminster, London, United Kingdom.
PLOS Digital Health
|February 13, 2025
Summary
Conversational artificial intelligence (AI) chatbots are acceptable for sexual health self-assessment among diverse populations. User anonymity is crucial for engagement and disclosure of sensitive health information.
Area of Science:
- Digital health
- Artificial intelligence in healthcare
- Sexual health
Background:
- Digital health tools offer new avenues to address sexual health disparities affecting ethnic and sexual minorities.
- Conversational artificial intelligence (AI) chatbots can deliver personalized health education and facilitate referrals for medical consultations.
- This study explored design principles for a culturally sensitive, chatbot-assisted self-assessment intervention focusing on health information disclosure.
Purpose of the Study:
- To investigate user comfort and willingness to disclose health information to sexual health chatbots.
- To identify factors influencing information disclosure and user perceptions of chatbot-led health assessments.
- To explore design principles for a culturally sensitive chatbot intervention for sexual health.
Main Methods:
- An online survey (N=1,287) of an ethnically diverse UK sample assessed health information disclosure and reactions to chatbot risk appraisal.
- Follow-up interviews (N=41) explored perceptions of chatbot-led health assessment, focusing on acceptability and utilization.
- Data were analyzed using ANOVAs, linear regression, and thematic analysis.
Main Results:
- Participants generally held neutral-to-positive attitudes towards chatbots and were comfortable disclosing demographic and sensitive health data.
- Chatbot awareness, prior experience, and positive attitudes significantly predicted information disclosure.
- Qualitative analysis revealed key themes including the chatbot as a health advisor, information disclosure dynamics, trust-building strategies, and acting on self-assessment outcomes.
Conclusions:
- Chatbots are an acceptable tool for sexual health self-assessment in ethnically diverse populations.
- User comfort with disclosing sensitive information is high, contingent on ensuring user anonymity.
- Chatbots show potential as supplementary tools for health education and screening eligibility assessment, with future research needed on their impact on screening uptake in minoritized communities.
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