Accepted for/Published in: JMIR Pediatrics and Parenting
Date Submitted: May 30, 2024
Date Accepted: Nov 26, 2024
Chatbot-Based Oral Health Care for Young Children: Development and Evaluation of Effectiveness, Usability, and Acceptability
ABSTRACT
Background:
Chatbots have been accepted, particularly in promoting public health due to their ability to replicate human-like communication and provide scalable services around the clock. The prevalence of dental caries in children highlights the critical necessity for early intervention.
Objective:
The objectives were to elucidate the development of the 30-Day FunDee chatbot and to evaluate the effectiveness, usability, and acceptability in providing oral health education to caregivers of children aged 6 to 36 months.
Methods:
The chatbot was developed using the Artificial Intelligence (AI) Chatbot Behavior Change Model, which encompassed the design and evaluation aspects, and incorporated behavioral change theories into the content development process for 3-5 minutes daily over a 30-day period. A pre-post experimental study was carried out in Hat Yai District, Songkhla Province and Maelan District, Pattani Province, Thailand during December 2021 to February 2022, involving a total of fifty-eight caregivers. Online questionnaires were administered to the caregivers at the start of the study and again 30 days after the intervention to evaluate their knowledge, perceptions based on the Protection Motivation Theory (PMT), and tooth-brushing practices. Furthermore, during the assessment phase, engagement, user satisfaction, and features that were favorable and unfavorable regarding the chatbot were also evaluated.
Results:
The chatbot was developed based on all four major AI Chatbot Behavior Change Model com-ponents with an excellent content validity from 3 experts. The participants had an average age of 34.5 years (SD=8.6). There was a significant improvement in the frequency of tooth brushing by the children's caregivers, increasing from 72.4% at baseline to 93.1% after the intervention (P = .006). A significant increase in the participants' perceptions based on the PMT, with a mean score of 4.01 (SD = 0.61) at baseline and 4.47 (SD = 0.57) after the intervention (P < .001) were shown. Overall, the chatbot received a satisfaction rating of 4.68 out of 5 (SD = 0.51). Participants, on average, engaged with the chatbot for 24.7 days out of the 30 days (SD = 7.24). The average number of days engaged per week was 5.77 (SD = 1.69). Participants found that the content's value, empathetic communication, and media to be the most commendable attributes. Participants considered the lengthy duration of the chatbot and messaging system to be the most unfavorable feature.
Conclusions:
The use of the 30-day FunDee chatbot among caregivers led to effectiveness in their perceptions regarding oral health care, and tooth brushing behavior for children aged 6-36 months. Additionally, the chatbot was highly accepted in terms of user satisfaction and engagement. This finding should be further confirmed through a large-scale, randomized controlled trial. Clinical Trial: TCTR20210927004
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