HealthLINE: A messaging chatbot for supporting chronic disease self-management

Chronic diseases such as hypertension and diabetes require ongoing lifestyle management, but traditional health education methods are limited by accessibility and resource constraints. Digital health tools, particularly chatbots embedded in widely used messaging platforms like LINE, offer scalable and continuous support for self-management.

This study aimed to design, implement, and evaluate HealthLINE, a LINE-based chatbot, to support self-management among individuals with hypertension or diabetes.

An 8-week action research study was conducted with 40 adults diagnosed with hypertension or type 2 diabetes. Participants used HealthLINE, a LINE-based chatbot, which provided medication reminders, diet and exercise logging, health education, and emotional support. Health behavior adherence, system acceptance (Technology Acceptance Model), and physiological indicators (systolic blood pressure and fasting glucose) were assessed pre- and post-intervention. Data were analyzed using descriptive statistics and paired-sample t-tests.

Participants interacted with the chatbot an average of 4.2 times per day. System acceptance was high, with perceived usefulness (M = 4.3), ease of use (M = 4.5), and 95% expressing willingness to continue using the system. Health behavior adherence significantly improved (from 3.1 to 4.0, p < 0.01), and exercise frequency more than doubled (p < 0.05). Systolic blood pressure decreased by 6.5 mmHg (p = 0.04), while fasting glucose showed a non-significant reduction.

The HealthLINE chatbot demonstrated effectiveness in enhancing health behavior adherence and user engagement, with positive effects on physiological outcomes. Embedding digital health interventions into familiar messaging platforms may provide a practical, scalable approach to chronic disease management. Longer-term trials with control groups are recommended to validate these preliminary findings.