Insights of Parents and Parents‐To‐Be in Using Chatbots to Improve Their Preconception, Pregnancy, and Postpartum Health: A Mixed Studies Review

Abstract

IntroductionChatbots, which are also known as conversational or virtual agents, are digital programs that can interact with humans using voice, text, or animation. They have shown promise in providing preconception, pregnancy, and postpartum care. This review aims to consolidate the insights of parents and parents‐to‐be in using chatbots to improve their preconception, pregnancy, and postpartum health.MethodsSeven electronic databases were searched from their inception dates until April 2022 (PubMed, Embase, CINAHL, PsycINFO, Web of Science, Scopus, and ProQuest Dissertations and Theses Global) for relevant studies. English language primary studies that were conducted on parents or parents‐to‐be aged ≥18 years old who had undergone interventions involving the use of any type of chatbot were included in this review. The quality of included studies was appraised using the Mixed Methods Appraisal Tool. A convergent qualitative synthesis design for mixed studies reviews was used to synthesize the findings, and results were thematically analyzed.ResultsFifteen studies met the inclusion criteria: quantitative (n = 11), qualitative (n = 1), and mixed method (n = 3). Three main themes were identified: (1) welcoming a new health resource, (2) obstacles blocking the way, and (3) moving toward a digital health era.DiscussionParents and parents‐to‐be appreciated the informational, socioemotional, and psychological support provided by chatbots. Recommendations for technological improvements in the functionality of the chatbots were made that include training sessions for health care providers to familiarize them with this new digital technology. Multidisciplinary chatbot development teams could also be established to develop more comprehensive chatbot‐delivered health programs for more diverse populations.

Practical Guidance for the Development of Rosie, a Health Education Question-and-Answer Chatbot for New Mothers

“…Similarly, our experience demonstrating the Rosie app can serve as a guide to other developers on how to manage an iterative development process and maintain quality and scalability of the app. Chatbots can also protect users' privacy and provide a degree of confidentiality, which is important for reproductive health care and was a feature demonstration participants were curious and concerned about 8,17…”

“…Our community-driven approach helps ensure that Rosie is tailored to the needs of the community. 8 Likewise, chatbots facilitate a more interactive and iterative development of content and app features in a way that is more feasible than other health communication options, such as a Web site without interactive features or pamphlets. From this phase of our project, we have found users also appreciate the iterative development process and that their feedback is integrated into the app's answers.…”

“…Furthermore, chatbots can help pregnant women with concerns related to stress, sleep, and breastfeeding 8. Chatbots can positively affect childhood development by providing parents with detailed, continuous information on infant stages of development, vaccination information, and healthy dietary practices 8…”

“…7 In addition, women can feel they do not have adequate time with or access to providers. [8][9][10] They also worry about bothering the providers with or being judged for their questions. 7,11,12 As a result, many turn to the Internet for knowledge and reassurance during pregnancy and their child's infancy.…”

“…Lack of straightforward, medically accurate information during pregnancy and postpartum can be particularly challenging for women of color whose concerns are frequently dismissed by providers, making it difficult to self-advocate as a patient 7. In addition, women can feel they do not have adequate time with or access to providers 8–10. They also worry about bothering the providers with or being judged for their questions 7,11,12.…”