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Previously submitted to: JMIR Formative Research (no longer under consideration since Jun 26, 2026)

Date Submitted: Sep 24, 2025

Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.

Chatbot-based Intervention for Education and Access to at-home COVID-19 Testing in the SCALE-UP II Trial: a Descriptive Log Analysis Study

  • Joni Pierce; 
  • Jian Tao; 
  • Tatyana Kuzmenko; 
  • Kimberly Kaphingst; 
  • Leticia Stevens; 
  • Adriana Rush; 
  • Ryzen Benson; 
  • Emerson Borsato; 
  • Bryan Gibson; 
  • Kensaku Kawamoto; 
  • Andy King; 
  • Brian Orleans; 
  • Jonathan Chipman; 
  • Tom Greene; 
  • Ray Meads; 
  • Tracey Siaperas; 
  • Shlisa Hughes; 
  • Alan Pruhs; 
  • Courtney Pariera Dinkins; 
  • Cho Lam; 
  • Ryan Cornia; 
  • Richard Bradshaw; 
  • Jorie Butler; 
  • Chelsey Schlechter; 
  • David Wetter; 
  • Guilherme Del Fiol

ABSTRACT

Background:

Promoting at-home tests (e.g., for COVID-19) using chatbots may be a novel and scalable way to improve uptake across diverse populations.

Objective:

The objective of this study was to assess patients’ navigational patterns (i.e., sequence of interactions) when using a chatbot designed to provide education on COVID-19 testing and to order free at-home COVID-19 test kits.

Methods:

The study was a secondary analysis of the SCALE-UP II trial, which compared different digital health strategies (i.e., chatbots versus simple text messages) to deliver free at-home COVID-19 test kits to minority populations in Utah. We analyzed chatbot usage logs to understand user behavior.

Results:

Of 1,051 patients randomized to the chatbot intervention, 309 (29%) launched the chatbot and 196 (63%) interacted with it. Among those who interacted, 170 (87%) completed a test kit order. One patient (0.3%) accessed the chatbot educational content.

Conclusions:

Ordering of COVID-19 test kits among patients who interacted with the chatbot was high. Patients placed orders without reviewing educational content. Chatbot design should minimize the number of steps for patients to achieve a goal.


 Citation

Please cite as:

Pierce J, Tao J, Kuzmenko T, Kaphingst K, Stevens L, Rush A, Benson R, Borsato E, Gibson B, Kawamoto K, King A, Orleans B, Chipman J, Greene T, Meads R, Siaperas T, Hughes S, Pruhs A, Pariera Dinkins C, Lam C, Cornia R, Bradshaw R, Butler J, Schlechter C, Wetter D, Del Fiol G

Chatbot-based Intervention for Education and Access to at-home COVID-19 Testing in the SCALE-UP II Trial: a Descriptive Log Analysis Study

JMIR Preprints. 24/09/2025:84771

DOI: 10.2196/preprints.84771

URL: https://preprints.jmir.org/preprint/84771

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