JMIR Publications

ABSTRACT

Background:

Chatbots have been increasingly considered for applications in the healthcare field. However, it remains unclear how a chatbot could assist users with complex health needs, such as parents of children with neurodevelopmental disorders (NDDs) who need ongoing support. Often this population must deal with complex and overwhelming health information, which could make parents less likely to use a software that might be very helpful. One approach to enhancing user engagement is incorporating game elements in non-game contexts, known as gamification. Gamification needs to be tailored to users, but there has been no previous assessment of gamification use in chatbots for NDDs.

Objective:

We sought to examine how gamification elements are perceived and whether their implementation in chatbots would be well-received among parents of children with NDDs. We discussed some elements in detail as the initial step of the project.

Methods:

We performed a narrative literature review of gamification elements, specifically those used in health and education. Among the elements identified in the literature, our health and social science experts in NDDs prioritized five for in-depth discussion: goal setting, customization, rewards, social networking, and unlockable content. We used a qualitative approach, which included focus groups and interviews with parents of children with NDDs (N = 21), to assess the acceptability of the potential implementation of these elements in an NDDs-focused chatbot. Parents were asked about their opinions on the five elements as well as rating them. Video and audio recordings were transcribed and summarized for emerging themes using deductive and inductive thematic approaches.

Results:

From 21 participants, we identified three main themes: 1) parents of children with NDDs were familiar with and had positive experiences with gamification; 2) a specific element was important to all parents (goal setting), whereas others (customization, rewards, and unlockable content) received more mixed opinions; and 3) the social networking element received positive feedback, but concerns about information accuracy were raised.

Conclusions:

We showed for the first time that parents of children with NDDs support gamification use in a chatbot for NDDs. Our study illustrates the need for a user-centred design in the medical domain and provides a foundation for researchers interested in developing chatbots for medically vulnerable populations. Future studies exploring a wider range of gamification elements with a larger number of potential users are needed to understand the impact of gamification elements in enhancing knowledge mobilization.