JMIR Publications

ABSTRACT

Background:

Automated conversational agents, or chatbots, have a role in reinforcing evidence-based guidance delivered through other media and offer an accessible, individually tailored channel for public health guidance. In early-to-mid-2021, young adults and Black and Hispanic community members in the U.S. were more likely to be hesitant toward COVID-19 vaccines, citing concerns regarding vaccine safety and effectiveness. Successful chatbot communication requires purposive understanding of user needs, and little is known about how vaccine messaging should be delivered by educational chatbots in health contexts.

Objective:

We sought to review the acceptability of messages to be delivered by a chatbot named VIRA from Johns Hopkins University. The study investigated which message styles were preferred by young, urban-dwelling Americans as well as public health workers, since we anticipated the chatbot would be used by the latter as a job aid.

Methods:

We conducted four virtual focus groups with 20 racially and ethnically diverse adults 18-61 years old living in or near eastern U.S. cities. We tested six message styles, asking participants to select a preferred response style for a chatbot answering common questions about COVID-19 vaccines. We transcribed, coded, and categorized emerging themes within discussions of message content, style, and framing.

Results:

Participants overwhelmingly preferred responses that began with an empathetic reflection of a user concern and concluded with a straightforward, fact-supported response. Most participants disliked moralistic or reasoning-based appeals to get vaccinated, although a subset of public health workers felt such strong statements were warranted. Responses containing humor, testimonials, or unsympathetic phrases did not appeal.

Conclusions:

To foster credibility, chatbots targeting young people should aim to build rapport with users by deploying empathic, reflective statements, followed by direct and comprehensive responses to user queries. Further studies are needed to inform the appropriate utilization of user-tailored testimonials and humor in the context of chatbot communication, since these strategies can effectively engage and influence users through social media and other digital communication media.