Scholarlink

<p>Equity in digital health is commonly assessed through enrolment and coverage. For interventions requiring sustained participation, enrolment can substantially overstate access. We report a convergent mixed-methods optimisation study of a chatbot-based behaviour change intervention for caregivers (ParentText) delivered via WhatsApp and Facebook Messenger across three low- and middle-income countries: Jamaica, Malaysia, and the Philippines (<i>N</i> = 1293). Using engagement logs, participant and implementer interviews, and a structured consensus process, we examined attrition patterns and explored optimisations. Median engagement was two days and one module; 93.8% of participants completed less than 25% of available content over the five-week intervention. Fewer than one in five participants remained active at Day 7 in two of three sites. Structural barriers included platform policies restricting follow-up after non-response, high message burden, and onboarding design. A consensus panel identified 23 barriers and generated 29 optimisations (69% rated highly feasible within LMIC contexts), currently being tested in a subsequent trial. We introduce <i>effective access</i> as a complementary construct for digital health interventions requiring repeated participation and propose three design principles: 1) test whether users can resume participation under platform constraints; 2) reduce message burden without removing content; and 3) treat re-engagement as a core feature.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Chatbot-based health interventions in low- and middle-income countries: effective access, early attrition, and design strategies from a mixed-methods study

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年7月21日

查看全文
  • Max C. Klapow,
  • Paula Zinser,
  • Chiara Facciola,
  • Qing Han,
  • Maria da Graça Ambrósio,
  • Francisco Antonio Calderón Alfaro,
  • Bernice Mamauag,
  • Jennel Reyes,
  • Camille Habacon,
  • Liane Peña Alampay,
  • Samantha Erika Mendez,
  • Rumaya Binti Juhari,
  • Zainal Madon,
  • Farah Zeehan Mohd Nadzri,
  • Moa Schafer,
  • Lily Clements,
  • David Stern,
  • Jamie M. Lachman

摘要

Equity in digital health is commonly assessed through enrolment and coverage. For interventions requiring sustained participation, enrolment can substantially overstate access. We report a convergent mixed-methods optimisation study of a chatbot-based behaviour change intervention for caregivers (ParentText) delivered via WhatsApp and Facebook Messenger across three low- and middle-income countries: Jamaica, Malaysia, and the Philippines (N = 1293). Using engagement logs, participant and implementer interviews, and a structured consensus process, we examined attrition patterns and explored optimisations. Median engagement was two days and one module; 93.8% of participants completed less than 25% of available content over the five-week intervention. Fewer than one in five participants remained active at Day 7 in two of three sites. Structural barriers included platform policies restricting follow-up after non-response, high message burden, and onboarding design. A consensus panel identified 23 barriers and generated 29 optimisations (69% rated highly feasible within LMIC contexts), currently being tested in a subsequent trial. We introduce effective access as a complementary construct for digital health interventions requiring repeated participation and propose three design principles: 1) test whether users can resume participation under platform constraints; 2) reduce message burden without removing content; and 3) treat re-engagement as a core feature.