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Using a Chatbot as an Alternative Approach for In-Person Toothbrushing Training During the COVID-19 Pandemic: Comparative Study

BACKGROUND: It is recommended that caregivers receive oral health education and in-person training to improve toothbrushing for young children. To strengthen oral health education before COVID-19, the 21-Day FunDee chatbot with in-person toothbrushing training for caregivers was used. During the pan...

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Autores principales: Pithpornchaiyakul, Samerchit, Naorungroj, Supawadee, Pupong, Kittiwara, Hunsrisakhun, Jaranya
Formato: Online Artículo Texto
Lenguaje:English
Publicado: JMIR Publications 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9591704/
https://www.ncbi.nlm.nih.gov/pubmed/36179147
http://dx.doi.org/10.2196/39218
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author Pithpornchaiyakul, Samerchit
Naorungroj, Supawadee
Pupong, Kittiwara
Hunsrisakhun, Jaranya
author_facet Pithpornchaiyakul, Samerchit
Naorungroj, Supawadee
Pupong, Kittiwara
Hunsrisakhun, Jaranya
author_sort Pithpornchaiyakul, Samerchit
collection PubMed
description BACKGROUND: It is recommended that caregivers receive oral health education and in-person training to improve toothbrushing for young children. To strengthen oral health education before COVID-19, the 21-Day FunDee chatbot with in-person toothbrushing training for caregivers was used. During the pandemic, practical experience was difficult to implement. Therefore, the 30-Day FunDee chatbot was created to extend the coverage of chatbots from 21 days to 30 days by incorporating more videos on toothbrushing demonstrations and dialogue. This was a secondary data comparison of 2 chatbots in similar rural areas of Pattani province: Maikan district (Study I) and Maelan district (Study II). OBJECTIVE: This study aimed to evaluate the effectiveness and usability of 2 chatbots, 21-Day FunDee (Study I) and 30-Day FunDee (Study II), based on the protection motivation theory (PMT). This study explored the feasibility of using the 30-Day FunDee chatbot to increase toothbrushing behaviors for caregivers in oral hygiene care for children aged 6 months to 36 months without in-person training during the COVID-19 pandemic. METHODS: A pre-post design was used in both studies. The effectiveness was evaluated among caregivers in terms of oral hygiene practices, knowledge, and oral health care perceptions based on PMT. In Study I, participants received in-person training and a 21-day chatbot course during October 2018 to February 2019. In Study II, participants received only daily chatbot programming for 30 days during December 2021 to February 2022. Data were gathered at baseline of each study and at 30 days and 60 days after the start of Study I and Study II, respectively. After completing their interventions, the chatbot's usability was assessed using open-ended questions. Study I evaluated the plaque score, whereas Study II included an in-depth interview. The 2 studies were compared to determine the feasibility of using the 30-Day FunDee chatbot as an alternative to in-person training. RESULTS: There were 71 pairs of participants: 37 in Study I and 34 in Study II. Both chatbots significantly improved overall knowledge (Study I: P<.001; Study II: P=.001), overall oral health care perceptions based on PMT (Study I: P<.001; Study II: P<.001), and toothbrushing for children by caregivers (Study I: P=.02; Study II: P=.04). Only Study I had statistically significant differences in toothbrushing at least twice a day (P=.002) and perceived vulnerability (P=.003). The highest overall chatbot satisfaction was 9.2 (SD 0.9) in Study I and 8.6 (SD 1.2) in Study II. In Study I, plaque levels differed significantly (P<.001). CONCLUSIONS: This was the first study using a chatbot in oral health education. We established the effectiveness and usability of 2 chatbot programs for promoting oral hygiene care of young children by caregivers. The 30-Day FunDee chatbot showed the possibility of improving toothbrushing skills without requiring in-person training. TRIAL REGISTRATION: Thai Clinical Trials Registry TCTR20191223005; http://www.thaiclinicaltrials.org/show/TCTR20191223005 and TCTR20210927004; https://www.thaiclinicaltrials.org/show/TCTR20210927004
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spelling pubmed-95917042022-10-25 Using a Chatbot as an Alternative Approach for In-Person Toothbrushing Training During the COVID-19 Pandemic: Comparative Study Pithpornchaiyakul, Samerchit Naorungroj, Supawadee Pupong, Kittiwara Hunsrisakhun, Jaranya J Med Internet Res Original Paper BACKGROUND: It is recommended that caregivers receive oral health education and in-person training to improve toothbrushing for young children. To strengthen oral health education before COVID-19, the 21-Day FunDee chatbot with in-person toothbrushing training for caregivers was used. During the pandemic, practical experience was difficult to implement. Therefore, the 30-Day FunDee chatbot was created to extend the coverage of chatbots from 21 days to 30 days by incorporating more videos on toothbrushing demonstrations and dialogue. This was a secondary data comparison of 2 chatbots in similar rural areas of Pattani province: Maikan district (Study I) and Maelan district (Study II). OBJECTIVE: This study aimed to evaluate the effectiveness and usability of 2 chatbots, 21-Day FunDee (Study I) and 30-Day FunDee (Study II), based on the protection motivation theory (PMT). This study explored the feasibility of using the 30-Day FunDee chatbot to increase toothbrushing behaviors for caregivers in oral hygiene care for children aged 6 months to 36 months without in-person training during the COVID-19 pandemic. METHODS: A pre-post design was used in both studies. The effectiveness was evaluated among caregivers in terms of oral hygiene practices, knowledge, and oral health care perceptions based on PMT. In Study I, participants received in-person training and a 21-day chatbot course during October 2018 to February 2019. In Study II, participants received only daily chatbot programming for 30 days during December 2021 to February 2022. Data were gathered at baseline of each study and at 30 days and 60 days after the start of Study I and Study II, respectively. After completing their interventions, the chatbot's usability was assessed using open-ended questions. Study I evaluated the plaque score, whereas Study II included an in-depth interview. The 2 studies were compared to determine the feasibility of using the 30-Day FunDee chatbot as an alternative to in-person training. RESULTS: There were 71 pairs of participants: 37 in Study I and 34 in Study II. Both chatbots significantly improved overall knowledge (Study I: P<.001; Study II: P=.001), overall oral health care perceptions based on PMT (Study I: P<.001; Study II: P<.001), and toothbrushing for children by caregivers (Study I: P=.02; Study II: P=.04). Only Study I had statistically significant differences in toothbrushing at least twice a day (P=.002) and perceived vulnerability (P=.003). The highest overall chatbot satisfaction was 9.2 (SD 0.9) in Study I and 8.6 (SD 1.2) in Study II. In Study I, plaque levels differed significantly (P<.001). CONCLUSIONS: This was the first study using a chatbot in oral health education. We established the effectiveness and usability of 2 chatbot programs for promoting oral hygiene care of young children by caregivers. The 30-Day FunDee chatbot showed the possibility of improving toothbrushing skills without requiring in-person training. TRIAL REGISTRATION: Thai Clinical Trials Registry TCTR20191223005; http://www.thaiclinicaltrials.org/show/TCTR20191223005 and TCTR20210927004; https://www.thaiclinicaltrials.org/show/TCTR20210927004 JMIR Publications 2022-10-21 /pmc/articles/PMC9591704/ /pubmed/36179147 http://dx.doi.org/10.2196/39218 Text en ©Samerchit Pithpornchaiyakul, Supawadee Naorungroj, Kittiwara Pupong, Jaranya Hunsrisakhun. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 21.10.2022. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on https://www.jmir.org/, as well as this copyright and license information must be included.
spellingShingle Original Paper
Pithpornchaiyakul, Samerchit
Naorungroj, Supawadee
Pupong, Kittiwara
Hunsrisakhun, Jaranya
Using a Chatbot as an Alternative Approach for In-Person Toothbrushing Training During the COVID-19 Pandemic: Comparative Study
title Using a Chatbot as an Alternative Approach for In-Person Toothbrushing Training During the COVID-19 Pandemic: Comparative Study
title_full Using a Chatbot as an Alternative Approach for In-Person Toothbrushing Training During the COVID-19 Pandemic: Comparative Study
title_fullStr Using a Chatbot as an Alternative Approach for In-Person Toothbrushing Training During the COVID-19 Pandemic: Comparative Study
title_full_unstemmed Using a Chatbot as an Alternative Approach for In-Person Toothbrushing Training During the COVID-19 Pandemic: Comparative Study
title_short Using a Chatbot as an Alternative Approach for In-Person Toothbrushing Training During the COVID-19 Pandemic: Comparative Study
title_sort using a chatbot as an alternative approach for in-person toothbrushing training during the covid-19 pandemic: comparative study
topic Original Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9591704/
https://www.ncbi.nlm.nih.gov/pubmed/36179147
http://dx.doi.org/10.2196/39218
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