Accepted for/Published in: JMIR Pediatrics and Parenting
Date Submitted: Aug 4, 2025
Date Accepted: Nov 27, 2025
Increasing Utilization of Postpartum and Newborn Chatbot in Birthing Individuals and Caregivers: Implementation of a Digital Health Intervention
ABSTRACT
Background:
The 42 days following childbirth are a high-risk period for both birthing individuals and newborns. We created two rule-based chatbots – one for birthing individuals and one for newborn caregivers - to deliver information on warning signs and follow-up care during this high-risk period.
Objective:
This study examines strategies for implementing the chatbot following discharge from a large hospital center, initial chatbot reach, and subsequent reach after chatbot refinement based on end-user feedback.
Methods:
Reach was defined as the number of users opening the chatbot out of those who received it. Birthing individuals and newborns’ demographic and clinical characteristics were obtained from the medical record. Descriptive statistics, chi-square tests, t-tests, and multiple logistic regression models were used to describe and analyze the association between patient demographic characteristics, patient clinical characteristics, and chatbot refinement on reach.
Results:
5,020/7,766 (64.6%) newborn caregivers discharged between 8/31/2022 and 1/15/2025 opened the newborn chatbot, and 4,140/6,505 (63.6%) birthing individuals discharged between 11/21/2022 and 1/15/2025 opened the postpartum chatbot. Age over 30 years, White race, prenatal care within the healthcare system, and private insurance were significant predictors of higher chatbot reach. Newborn weight at birth, gestational age at birth, and newborn time in the hospital were also significant predictors of reach in the newborn chatbot logistic regression model. Including a Spanish version in the newborn chatbot improved reach among Spanish-preferring patients (from 56.9% to 66.1%), but additional iterative tailoring changes were not associated with a change in chatbot reach.
Conclusions:
While there were differences in chatbot reach by patient demographics, there was still reasonable reach of the chatbot to provide time-sensitive information and support to individuals from diverse racial and sociodemographic backgrounds. Future work should address additional ways to improve chatbot reach and explore the impact on targeted health outcomes.
Citation
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