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RESEARCH ARTICLE
Contents Vol 21(4)

The impact of Chatbot-Assisted Self Assessment (CASA) on intentions for sexual health screening in people from minoritised ethnic groups at risk of sexually transmitted infections

Tom Nadarzynski https://orcid.org/0000-0001-7010-5308 A # * , Nicky Knights A # , Deborah Husbands A , Cynthia A. Graham B , Carrie D. Llewellyn C , Tom Buchanan A , Ian Montgomery D , Nuha Khlafa A , Jana Tichackova A , Riliwan Odeyemi A , Samantha Johnson A , Neomi Jesuthas A , Syeda Tahia https://orcid.org/0009-0002-9656-905X A and Damien Ridge https://orcid.org/0000-0001-9245-5958 A
+ Author Affiliations
- Author Affiliations

A School of Social Sciences, University of Westminster, London, UK.

B Kinsey Institute, Indiana University, Bloomington, IN, USA.

C Brighton and Sussex Medical School, University of Sussex, Brighton, UK.

D Positive East, London, UK.

* Correspondence to: T.Nadarzynski@westminster.ac.uk
# These authors contributed equally to this paper

Handling Editor: Dan Wu

Sexual Health 21, SH24058 https://doi.org/10.1071/SH24058
Submitted: 18 March 2024  Accepted: 28 June 2024  Published: 25 July 2024

© 2024 The Author(s) (or their employer(s)). Published by CSIRO Publishing

Abstract

Background

Sexually transmitted infections (STIs) present a significant global public health issue, with disparities in STI rates often observed across ethnic groups. The study investigates the impact of Chatbot-Assisted Self Assessment (CASA) on the intentions for sexual health screening within minoritised ethnic groups (MEGs) at risk of STIs as well as the subsequent use of a chatbot for booking STI screening.

Methods

A simulation within-subject design was utilised to evaluate the effect of CASA on intentions for STI/HIV screening, concern about STIs, and attitudes towards STI screening. Screening intentions served as the dependent variable, while demographic and behavioural factors related to STI/HIV risk were the independent variables. ANCOVA tests were conducted to measure the impact of CASA on these perceptions.

Results

Involving 548 participants (54% women, 66% black, average age = 30 years), the study found that CASA positively influenced screening intentions t(547) = −10.3, P < 0.001], concerns about STIs t(544) = −4.96, P < 0.001, and attitudes towards sexual health screening [t(543) = −4.36, P < 0.001. Positive attitudes towards CASA were observed (mean, 13.30; s.d., 6.73; range, −17 to 21). About 72% of users who booked STI screening appointments via chatbot were from MEGs.

Conclusion

CASA increased motivations for STI screening intentions among ethnically diverse communities. The intervention’s non-judgemental nature and the chatbot’s ability to emulate sexual history-taking were critical in fostering an environment conducive to behavioural intention change. The study’s high acceptability indicates the potential for broader application in digital health interventions. However, the limitation of not tracking actual post-intervention behaviour warrants further investigation into CASA’s real-world efficacy.

Keywords: AI, artificial intelligence, behaviour change, chatbot, natural language processing, risk assessment, self-assessment, sexual health, sexually transmitted disease, sexually transmitted infections, virtual assistant.

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