Design and validation of a Chatbot-Based Cervical Cancer Screening Decision Aid for Disadvantaged Women in France: A User-Centered Approach
ABSTRACT
Background:
Cervical cancer screening participation remains suboptimal among vulnerable populations in France. This study aimed to develop and evaluate AppDate-You, a chatbot-based decision aid to support informed decision-making about cervical cancer screening, particularly HPV self-sampling, among women from disadvantaged areas in the Occitanie region.
Objective:
This study aimed to assess the effectiveness of a chatbot-based decision aid to improve women’s participation in the HPV self-sampling (HPVss) detection-based cervical cancer screening (CCS) care pathway.
Methods:
The chatbot was developed following Coulter's framework based on the International Patient Decision Aid Standards. The process included qualitative research with women and healthcare professionals, followed by 'alpha' testing with both groups and 'beta' testing with women only. AppDate-You was accessible through WhatsApp and Facebook Messenger, offering text-based and voice-based interactions and multimedia content.
Results:
The exploratory phase identified key barriers to screening and preferences for digital tools. Prototype testing revealed high user satisfaction with the chatbot's performance, educational value, and content quality. Contrary to healthcare professionals' expectations, women from diverse backgrounds, including older and socioeconomically disadvantaged individuals, demonstrated willingness and ability to engage with the tool. Users found AppDate-You innovative, user-friendly, and informative, even those with limited digital literacy. In the 'beta' testing, 12 out of 15 participants expressed interest in using HPV self-sampling. Some chatbot’s limitations were identified, such as occasional repetitive responses and the need for clearer explanations of some medical terminology.
Conclusions:
This study demonstrates the potential of AI chatbots in improving health education and promoting cervical screening behaviors among underserved populations. The user-centered development process resulted in a tool that effectively meets the needs of the target population. Clinical Trial: ClinicalTrials.gov NCT05286034; https://clinicaltrials.gov/ct2/show/NCT05286034?term=NCT05286034
Citation
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Copyright
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