Le Bonniec Alice, Sauvaget Catherine, Lucas Eric, Nassiri Abdelhak, Selmouni Farida
National Screening Service, Dublin, Ireland.
International Agency for Research on Cancer, Lyon, France.
JMIR Cancer. 2025 Jul 24;11:e70251. doi: 10.2196/70251.
Cervical cancer (CC) screening participation remains suboptimal among vulnerable populations in France. This study aimed to develop and evaluate AppDate-You, a chatbot-based decision aid, to support women from socioeconomically disadvantaged areas in the French Occitanie region to make informed decisions about CC screening, particularly human papillomavirus self-sampling (HPVss).
This study aimed to explore the needs, preferences, and barriers related to CC screening and to design and validate a user-centered, empathetic, and effective chatbot-based decision aid to empower women experiencing socioeconomic challenges in France to make informed choices about HPVss.
The chatbot was developed following a validated framework for developing decision aids. The process included qualitative research involving online and in-person interviews and focus groups with women and health care professionals, followed by alpha testing with both groups and beta testing with women only. Participants included women (both French and non-French speaking) aged between 30 and 65 years from socioeconomically disadvantaged areas of the Occitanie region and health care professionals (general practitioners, gynecologists, and midwives) working with these populations. AppDate-You was made accessible through WhatsApp and Facebook Messenger, offering text-based and voice-based interactions and multimedia content.
The exploratory phase identified key barriers to screening and digital tool preferences. Prototype testing revealed great satisfaction with the chatbot's performance, educational value, and content quality. Contrary to the expectations of health care professionals, women from diverse backgrounds, including women who were older and socioeconomically disadvantaged, were willing and able to use the tool. Users-even those with limited digital literacy-found AppDate-You innovative, user-friendly, and informative. In the beta testing phase, 80% (12/15) of the participants expressed interest in HPVss. Some limitations were identified, such as the chatbot's occasional repetitive responses and the need for clearer medical terminology.
This study demonstrates the potential for artificial intelligence chatbots to improve access to health education and increase cervical screening intention among underserved populations. The user-centered approach resulted in a tool that effectively meets the needs of the target population.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.2196/39288.
在法国，弱势群体中宫颈癌（CC）筛查的参与率仍不理想。本研究旨在开发并评估AppDate-You，这是一种基于聊天机器人的决策辅助工具，以支持法国奥克西塔尼地区社会经济弱势地区的女性就CC筛查，特别是人乳头瘤病毒自我采样（HPVss）做出明智决策。
本研究旨在探索与CC筛查相关的需求、偏好和障碍，并设计和验证一种以用户为中心、富有同理心且有效的基于聊天机器人的决策辅助工具，以使在法国面临社会经济挑战的女性能够就HPVss做出明智选择。
聊天机器人是按照经过验证的决策辅助工具开发框架开发的。该过程包括定性研究，涉及与女性和医疗保健专业人员进行的在线和面对面访谈以及焦点小组讨论，随后对两组进行alpha测试，仅对女性进行beta测试。参与者包括来自奥克西塔尼地区社会经济弱势地区的30至65岁女性（包括法语和非法语使用者）以及与这些人群合作的医疗保健专业人员（全科医生、妇科医生和助产士）。可通过WhatsApp和Facebook Messenger访问AppDate-You，提供基于文本和语音的交互以及多媒体内容。
探索阶段确定了筛查的关键障碍和数字工具偏好。原型测试显示对聊天机器人的性能、教育价值和内容质量非常满意。与医疗保健专业人员的预期相反，包括年龄较大和社会经济弱势的女性在内的不同背景的女性愿意并能够使用该工具。用户——即使是数字素养有限的用户——也认为AppDate-You具有创新性、用户友好且信息丰富。在beta测试阶段，80%（12/15）的参与者对HPVss表示感兴趣。发现了一些局限性，例如聊天机器人偶尔的重复回复以及需要更清晰的医学术语。
本研究证明了人工智能聊天机器人在改善弱势群体获得健康教育的机会以及提高宫颈癌筛查意愿方面的潜力。以用户为中心的方法产生了一种有效满足目标人群需求的工具。
国际注册报告标识符（IRRID）：RR2-10.2196/39288。
