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Efficacy, Usability, and Acceptability of a Chatbot for Promoting COVID-19 Vaccination in Unvaccinated or Booster-Hesitant Young Adults: Pre-Post Pilot Study.
J Med Internet Res. 2022 10 04; 24(10):e39063.JM

Abstract

BACKGROUND

COVID-19 vaccines are highly effective in preventing severe disease and death but are underused. Interventions to address COVID-19 vaccine hesitancy are paramount to reducing the burden of COVID-19.

OBJECTIVE

We aimed to evaluate the preliminary efficacy, usability, and acceptability of a chatbot for promoting COVID-19 vaccination and examine the factors associated with COVID-19 vaccine hesitancy.

METHODS

In November 2021, we conducted a pre-post pilot study to evaluate "Vac Chat, Fact Check," a web-based chatbot for promoting COVID-19 vaccination. We conducted a web-based survey (N=290) on COVID-19 vaccination at a university in Hong Kong. A subset of 46 participants who were either unvaccinated (n=22) or were vaccinated but hesitant to receive boosters (n=24) were selected and given access to the chatbot for a 7-day trial period. The chatbot provided information about COVID-19 vaccination (eg, efficacy and common side effects), debunked common myths about the vaccine, and included a decision aid for selecting vaccine platforms (inactivated and mRNA vaccines). The main efficacy outcome was changes in the COVID-19 Vaccine Hesitancy Scale (VHS) score (range 9-45) from preintervention (web-based survey) to postintervention (immediately posttrial). Other efficacy outcomes included changes in intention to vaccinate or receive boosters and willingness to encourage others to vaccinate on a scale from 1 (not at all) to 5 (very). Usability was assessed by the System Usability Scale (range 0-100). Linear regression was used to examine the factors associated with COVID-19 VHS scores in all survey respondents.

RESULTS

The mean (SD) age of all survey respondents was 21.4 (6.3) years, and 61% (177/290) of respondents were female. Higher eHealth literacy (B=-0.26; P<.001) and perceived danger of COVID-19 (B=-0.17; P=.009) were associated with lower COVID-19 vaccine hesitancy, adjusting for age, sex, chronic disease status, previous flu vaccination, and perceived susceptibility to COVID-19. The main efficacy outcome of COVID-19 VHS score significantly decreased from 28.6 (preintervention) to 24.5 (postintervention), with a mean difference of -4.2 (P<.001) and an effect size (Cohen d) of 0.94. The intention to vaccinate increased from 3.0 to 3.9 (P<.001) in unvaccinated participants, whereas the intention to receive boosters increased from 1.9 to 2.8 (P<.001) in booster-hesitant participants. Willingness to encourage others to vaccinate increased from 2.7 to 3.0 (P=.04). At postintervention, the median (IQR) System Usability Scale score was 72.5 (65-77.5), whereas the median (IQR) recommendation score was 7 (6-8) on a scale from 0 to 10. In a post hoc 4-month follow-up, 82% (18/22) of initially unvaccinated participants reported having received the COVID-19 vaccine, whereas 29% (7/24) of booster-hesitant participants received boosters.

CONCLUSIONS

This pilot study provided initial evidence to support the efficacy, usability, and acceptability of a chatbot for promoting COVID-19 vaccination in young adults who were unvaccinated or booster-hesitant.

Links

PMC Free PDF

Authors+Show Affiliations

Luk TT
School of Nursing, The University of Hong Kong, Pokfulam, China (Hong Kong).
Lui JHT
School of Nursing, The University of Hong Kong, Pokfulam, China (Hong Kong).
Wang MP
School of Nursing, The University of Hong Kong, Pokfulam, China (Hong Kong).

MeSH

AdultCOVID-19COVID-19 VaccinesFemaleHealth Knowledge, Attitudes, PracticeHumansInfluenza VaccinesMaleParentsPatient Acceptance of Health CarePilot ProjectsVaccinationYoung Adult

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

36179132

Citation

Luk, Tzu Tsun, et al. "Efficacy, Usability, and Acceptability of a Chatbot for Promoting COVID-19 Vaccination in Unvaccinated or Booster-Hesitant Young Adults: Pre-Post Pilot Study." Journal of Medical Internet Research, vol. 24, no. 10, 2022, pp. e39063.
Luk TT, Lui JHT, Wang MP. Efficacy, Usability, and Acceptability of a Chatbot for Promoting COVID-19 Vaccination in Unvaccinated or Booster-Hesitant Young Adults: Pre-Post Pilot Study. J Med Internet Res. 2022;24(10):e39063.
Luk, T. T., Lui, J. H. T., & Wang, M. P. (2022). Efficacy, Usability, and Acceptability of a Chatbot for Promoting COVID-19 Vaccination in Unvaccinated or Booster-Hesitant Young Adults: Pre-Post Pilot Study. Journal of Medical Internet Research, 24(10), e39063. https://doi.org/10.2196/39063
Luk TT, Lui JHT, Wang MP. Efficacy, Usability, and Acceptability of a Chatbot for Promoting COVID-19 Vaccination in Unvaccinated or Booster-Hesitant Young Adults: Pre-Post Pilot Study. J Med Internet Res. 2022 10 4;24(10):e39063. PubMed PMID: 36179132.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Efficacy, Usability, and Acceptability of a Chatbot for Promoting COVID-19 Vaccination in Unvaccinated or Booster-Hesitant Young Adults: Pre-Post Pilot Study. AU - Luk,Tzu Tsun, AU - Lui,Judy Hiu Tung, AU - Wang,Man Ping, Y1 - 2022/10/04/ PY - 2022/04/26/received PY - 2022/09/23/accepted PY - 2022/07/01/revised PY - 2022/10/1/pubmed PY - 2022/10/7/medline PY - 2022/9/30/entrez KW - COVID-19 KW - Chinese KW - booster KW - booster hesitancy KW - chatbot KW - chatbot usability KW - conversational agent KW - coronavirus KW - health intervention KW - health promotion KW - immunization KW - pandemic KW - students KW - university students KW - vaccine KW - vaccine hesitancy KW - virtual assistant KW - web-based survey KW - young adult KW - youth SP - e39063 EP - e39063 JF - Journal of medical Internet research JO - J Med Internet Res VL - 24 IS - 10 N2 - BACKGROUND: COVID-19 vaccines are highly effective in preventing severe disease and death but are underused. Interventions to address COVID-19 vaccine hesitancy are paramount to reducing the burden of COVID-19. OBJECTIVE: We aimed to evaluate the preliminary efficacy, usability, and acceptability of a chatbot for promoting COVID-19 vaccination and examine the factors associated with COVID-19 vaccine hesitancy. METHODS: In November 2021, we conducted a pre-post pilot study to evaluate "Vac Chat, Fact Check," a web-based chatbot for promoting COVID-19 vaccination. We conducted a web-based survey (N=290) on COVID-19 vaccination at a university in Hong Kong. A subset of 46 participants who were either unvaccinated (n=22) or were vaccinated but hesitant to receive boosters (n=24) were selected and given access to the chatbot for a 7-day trial period. The chatbot provided information about COVID-19 vaccination (eg, efficacy and common side effects), debunked common myths about the vaccine, and included a decision aid for selecting vaccine platforms (inactivated and mRNA vaccines). The main efficacy outcome was changes in the COVID-19 Vaccine Hesitancy Scale (VHS) score (range 9-45) from preintervention (web-based survey) to postintervention (immediately posttrial). Other efficacy outcomes included changes in intention to vaccinate or receive boosters and willingness to encourage others to vaccinate on a scale from 1 (not at all) to 5 (very). Usability was assessed by the System Usability Scale (range 0-100). Linear regression was used to examine the factors associated with COVID-19 VHS scores in all survey respondents. RESULTS: The mean (SD) age of all survey respondents was 21.4 (6.3) years, and 61% (177/290) of respondents were female. Higher eHealth literacy (B=-0.26; P<.001) and perceived danger of COVID-19 (B=-0.17; P=.009) were associated with lower COVID-19 vaccine hesitancy, adjusting for age, sex, chronic disease status, previous flu vaccination, and perceived susceptibility to COVID-19. The main efficacy outcome of COVID-19 VHS score significantly decreased from 28.6 (preintervention) to 24.5 (postintervention), with a mean difference of -4.2 (P<.001) and an effect size (Cohen d) of 0.94. The intention to vaccinate increased from 3.0 to 3.9 (P<.001) in unvaccinated participants, whereas the intention to receive boosters increased from 1.9 to 2.8 (P<.001) in booster-hesitant participants. Willingness to encourage others to vaccinate increased from 2.7 to 3.0 (P=.04). At postintervention, the median (IQR) System Usability Scale score was 72.5 (65-77.5), whereas the median (IQR) recommendation score was 7 (6-8) on a scale from 0 to 10. In a post hoc 4-month follow-up, 82% (18/22) of initially unvaccinated participants reported having received the COVID-19 vaccine, whereas 29% (7/24) of booster-hesitant participants received boosters. CONCLUSIONS: This pilot study provided initial evidence to support the efficacy, usability, and acceptability of a chatbot for promoting COVID-19 vaccination in young adults who were unvaccinated or booster-hesitant. SN - 1438-8871 UR - https://www.unboundmedicine.com/medline/citation/36179132/Efficacy_Usability_and_Acceptability_of_a_Chatbot_for_Promoting_COVID_19_Vaccination_in_Unvaccinated_or_Booster_Hesitant_Young_Adults:_Pre_Post_Pilot_Study_ DB - PRIME DP - Unbound Medicine ER -