User Evaluation of a Chat-Based Instant Messaging Support Health Education Program for Patients With Chronic Kidney Disease: Preliminary Findings of a Formative Study

Nai-Jung Chen; Chiu-Mieh Huang; Ching-Chih Fan; Li-Ting Lu; Fen-He Lin; Jung-Yu Liao; Jong-Long Guo

doi:10.2196/45484

User Evaluation of a Chat-Based Instant Messaging Support Health Education Program for Patients With Chronic Kidney Disease: Preliminary Findings of a Formative Study

JMIR Form Res. 2023 Sep 19:7:e45484. doi: 10.2196/45484.

Authors

Nai-Jung Chen^{1

2}, Chiu-Mieh Huang^#³, Ching-Chih Fan⁴, Li-Ting Lu⁵, Fen-He Lin³, Jung-Yu Liao¹, Jong-Long Guo^#¹

Affiliations

¹ Department of Health Promotion and Health Education, College of Education, National Taiwan Normal University, Taipei, Taiwan.
² Department of Nursing, Taiwan Adventist Hospital, Taipei, Taiwan.
³ Institute of Clinical Nursing, College of Nursing, National Yang Ming Chiao Tung University, Taipei, Taiwan.
⁴ Department of Community Medicine, En Chu Kong Hospital, New Taipei, Taiwan.
⁵ Department of Nursing, University of Kang Ning, Taipei, Taiwan.

^# Contributed equally.

PMID: 37725429
PMCID: PMC10548329
DOI: 10.2196/45484

Abstract

Background: Artificial intelligence-driven chatbots are increasingly being used in health care, but few chat-based instant messaging support health education programs are designed for patients with chronic kidney disease (CKD) to evaluate their effectiveness. In addition, limited research exists on the usage of chat-based programs among patients with CKD, particularly those that integrate a chatbot aimed at enhancing the communication ability and disease-specific knowledge of patients.

Objective: The objective of this formative study is to gather the data necessary to develop an intervention program of chat-based instant messaging support health education for patients with CKD. Participants' user experiences will form the basis for program design improvements.

Methods: Data were collected from April to November 2020 using a structured questionnaire. A pre-post design was used, and a total of 60 patients consented to join the 3-month program. Among them, 55 successfully completed the study measurements. The System Usability Scale was used for participant evaluations of the usability of the chat-based program.

Results: Paired t tests revealed significant differences before and after intervention for communicative literacy (t₅₄=3.99; P<.001) and CKD-specific disease knowledge (t₅₄=7.54; P<.001). Within disease knowledge, significant differences were observed in the aspects of CKD basic knowledge (t₅₄=3.46; P=.001), lifestyle (t₅₄=3.83; P=.001), dietary intake (t₅₄=5.51; P<.001), and medication (t₅₄=4.17; P=.001). However, no significant difference was found in the aspect of disease prevention. Subgroup analysis revealed that while the findings among male participants were similar to those of the main sample, this was not the case among female participants.

Conclusions: The findings reveal that a chat-based instant messaging support health education program may be effective for middle-aged and older patients with CKD. The use of a chat-based program with multiple promoting approaches is promising, and users' evaluation is satisfactory.

Trial registration: ClinicalTrials.gov NCT05665517; https://clinicaltrials.gov/study/NCT05665517.

Keywords: chatbot; chronic kidney disease; health education; push notification; users’ evaluation.

©Nai-Jung Chen, Chiu-Mieh Huang, Ching-Chih Fan, Li-Ting Lu, Fen-He Lin, Jung-Yu Liao, Jong-Long Guo. Originally published in JMIR Formative Research (https://formative.jmir.org), 19.09.2023.

Associated data

ClinicalTrials.gov/NCT05665517