JMIR Publications

ABSTRACT

Background:

Human papillomavirus (HPV) is the most common sexually transmitted infection globally, associated with various cancers, including cervical and oropharyngeal cancers. Despite the availability of effective vaccines, significant disparities in HPV vaccination rates persist, particularly among racial and ethnic minorities, such as Korean Americans. Cultural stigma, language barriers, and limited access to tailored health information contribute to these disparities.

Objective:

The aims of this study was to develop and evaluate the usability of K-Bot, a rule-based AI-powered chatbot designed to provide culturally sensitive, bilingual health information on HPV vaccination to Korean immigrants and Korean Americans.

Methods:

The development of a culturally tailored, bilingual Korean and English AI chatbot (K-Bot) followed a structured, iterative process involving chatbot design, expert evaluation, and usability testing to address HPV vaccination disparities among Korean Americans. Eligibility criteria included: (1) individuals aged 18-45 years, (2) possession of a mobile phone or computer with internet access, (3) residence in the United States, and (4) speak in English or Korean. A online survey was conducted prior to qualitative interviews to better understand participants’ demographics, HPV awareness, vaccination status, and experiences with technology (N = 21). Quantitative data were analyzed using descriptive statistics. The qualitative component involved six focus groups using semi-structured questions guided by Peter Morville’s Usability Framework. Discussions explored usability, cultural relevance, and content clarity, with thematic analysis conducted across six dimensions: Desirable, Accessible, Findable, Credible, Usable, and Useful.

Results:

Participants had a mean age of 23.67 years (SD = 4.66), with most being female (57.1%), second-generation (61.9%), and single (95.2%). HPV awareness was high (90.5%), vaccine knowledge was 81.8%, but only 52.4% were vaccinated. Feedback-driven refinements addressed usability challenges, including simplifying navigation and adding visual elements. Participants described K-Bot as a promising tool for promoting HPV vaccination among Korean and Korean American users, citing its bilingual functionality and culturally tailored content as key strengths. Evidence-based information was valued, but participants recommended visuals to improve engagement and reduce cognitive load. Accessibility concerns included broken links, and participants proposed enhancements such as animations, demographic-specific resources, and interactive features to improve usability and engagement further.

Conclusions:

Usability testing of K-Bot revealed its potential as a culturally tailored, bilingual tool for promoting HPV vaccination among Korean immigrants and Korean Americans. Participants valued its evidence-based information, cultural relevance, and bilingual functionality but recommended improvements such as enhanced navigation, visual elements, and interactive features to boost engagement and usability. These findings support the transformative potential of AI-driven tools in advancing health equity by addressing critical barriers to care. Further research is needed to rigorously evaluate their broader impact and optimize their design and implementation for underserved populations.