AI HeartBot to Increase Women's Awareness and Knowledge of Heart Attacks: Nonrandomized, Quasi-Experimental Study

Heart disease remains a leading cause of death for women in the United States, but awareness and knowledge about it are declining. Artificial intelligence (AI) chatbots have great potential to educate women.

This study aimed to evaluate the potential efficacy of HeartBot to increase women's awareness and knowledge of heart attack symptoms and care-seeking behavior.

In this nonrandomized pilot, quasi-experimental study, 92 women aged ≥25 years without a history of heart disease completed the HeartBot interaction via SMS text messaging. The study was remotely conducted from October 2023 to January 2024. HeartBot, a fully automated AI chatbot, covered 15 topics of heart attack awareness, knowledge, symptoms, and care seeking in a single session. The mean length of the HeartBot interaction was 13.0 (SD 7.80) minutes. The primary outcomes consist of four questions: (1) recognizing signs and symptoms of a heart attack, (2) telling the difference between the signs and symptoms of a heart attack, (3) calling an ambulance or dialing 911 when experiencing heart attack symptoms, and (4) getting to an emergency room within 60 minutes after the onset of symptoms of a heart attack. Women were asked to answer the 4 questions before and after the HeartBot interaction on a scale of 1 to 4, with a higher score indicating higher levels of awareness and knowledge of heart attack risks and symptoms.

The mean age of the sample was 45.9 (SD 11.9) years. In total, 59.8% (55/92) of the sample identified as belonging to racial or ethnic minority groups. The mean length of the HeartBot interaction was 13.0 (SD 7.80) minutes. In ordinal logistic regression models, women showed significant improvements across the 4 self-reported outcomes (ie, heart attack symptoms and calling 911) even after controlling for potential confounding factors (outcome 1: adjusted odds ratio [aOR] 7.10, 95% CI 3.52-13.16; outcome 2: aOR 5.47, 95% CI 2.77-10.78; outcome 3: aOR 5.75, 95% CI 2.86-11.59; and outcome 4: aOR 2.85, 95% CI 1.54-5.25; P<.001 for all 4 outcomes).

HeartBot led to a substantial increase in awareness and knowledge of heart attack risks and symptoms in women. These findings suggest that HeartBot is a promising approach to improving heart health education. A randomized controlled trial of HeartBot is warranted to establish its efficacy and safety for the clinical setting.