Development and Preliminary Feasibility Evaluation of a Health Chatbot to Enhance Maternal Behaviors for Developmental Promotion in High-risk Infants: A Pilot Study
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Abstract
Objective: This study aimed to develop and conduct a preliminary feasibility evaluation of a health chatbot designed to enhance maternal behaviors in promoting high-risk infant development. Methods: This developmental research consisted of two phases. Phase 1 involved chatbot development, including content development, conceptual framework and conversational flow design based on Bandura's Social Cognitive Theory, system and interaction design, multimedia development, and content validation by experts. Phase 2 was a pilot study to evaluate the chatbot's preliminary feasibility. Five mothers of at-risk infants used the chatbot for 7 days. Feasibility was assessed in three domains: system functionality, user engagement, and preliminary outcomes. Maternal behaviors for promoting at-risk infant development were assessed using the Maternal Behavior for Promoting At-Risk Infant Development Questionnaire (CVI = .86, α = .97), and infant development was evaluated at 2 months of age using a standardized developmental assessment. Results: The developed chatbot delivered health information and guidance through text, infographics, and videos, based on social cognitive theory to enhance maternal self-efficacy. System testing demonstrated that the chatbot functioned as intended with satisfactory stability. In the pilot phase, all participants completed the 7-day program, although one participant reported unstable internet connectivity. Following the intervention, all mothers demonstrated engagement in developmental promotion behaviors across all five domains at least three days per week. Regarding preliminary developmental outcomes, three infants achieved age-appropriate development in all five domains, while the remaining infants achieved age-appropriate development in four and three domains, respectively. Conclusion: The development and preliminary feasibility evaluation demonstrated that the health chatbot was feasible for use in promoting maternal behaviors that support the development of at-risk infants. The chatbot showed satisfactory system functionality, user engagement, and promising preliminary outcomes. However, further research with larger sample sizes is needed to confirm feasibility and evaluate the long-term effectiveness of the chatbot.
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