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BACKGROUND: Stark disparities exist in maternal and child outcomes and there is a need to provide timely and accurate health information. OBJECTIVE: In this pilot study, we assessed the feasibility and acceptability of a health chatbot for new mothers of color. METHODS: Rosie, a question-and-answer chatbot, was developed as a mobile app and is available to answer questions about pregnancy, parenting, and child development. From January 9, 2023, to February 9, 2023, participants were recruited using social media posts and through engagement with community organizations. Inclusion criteria included being aged ≥14 years, being a woman of color, and either being currently pregnant or having given birth within the past 6 months. Participants were randomly assigned to the Rosie treatment group (15/29, 52% received the Rosie app) or control group (14/29, 48% received a children's book each month) for 3 months. Those assigned to the treatment group could ask Rosie questions and receive an immediate response generated from Rosie's knowledgebase. Upon detection of a possible health emergency, Rosie sends emergency resources and relevant hotline information. In addition, a study staff member, who is a clinical social worker, reaches out to the participant within 24 hours to follow up. Preintervention and postintervention tests were completed to qualitatively and quantitatively evaluate Rosie and describe changes across key health outcomes, including postpartum depression and the frequency of emergency room visits. These measurements were used to inform the clinical trial's sample size calculations. RESULTS: Of 41 individuals who were screened and eligible, 31 (76%) enrolled and 29 (71%) were retained in the study. More than 87% (13/15) of Rosie treatment group members reported using Rosie daily (5/15, 33%) or weekly (8/15, 53%) across the 3-month study period. Most users reported that Rosie was easy to use (14/15, 93%) and provided responses quickly (13/15, 87%). The remaining issues identified included crashing of the app (8/15, 53%), and users were not satisfied with some of Rosie's answers (12/15, 80%). Mothers in both the Rosie treatment group and control group experienced a decline in depression scores from pretest to posttest periods, but the decline was statistically significant only among treatment group mothers (P=.008). In addition, a low proportion of treatment group infants had emergency room visits (1/11, 9%) compared with control group members (3/13, 23%). Nonetheless, no between-group differences reached statistical significance at P<.05. CONCLUSIONS: Rosie was found to be an acceptable, feasible, and appropriate intervention for ethnic and racial minority pregnant women and mothers of infants owing to the chatbot's ability to provide a personalized, flexible tool to increase the timeliness and accessibility of high-quality health information to individuals during a period of elevated health risks for the mother and child. TRIAL REGISTRATION: ClinicalTrials.gov NCT06053515; https://clinicaltrials.gov/study/NCT06053515.
RESUMEN
The overturning of Roe v Wade reinvigorated the national debate on abortion. We used Twitter data to examine temporal, geographical and sentiment patterns in the public's reaction. Using the Twitter API for Academic Research, a random sample of publicly available tweets was collected from 1 May-15 July in 2021 and 2022. Tweets were filtered based on keywords relating to Roe v Wade and abortion (227,161 tweets in 2021 and 504,803 tweets in 2022). These tweets were tagged for sentiment, tracked by state, and indexed over time. Time plots reveal low levels of conversations on these topics until the leaked Supreme Court opinion in early May 2022. Unlike pro-choice tweets which declined, pro-life conversations continued with renewed interest throughout May and increased again following the official overturning of Roe v Wade. Conversations were less prevalent in some these states had abortion trigger laws (Wyoming, North Dakota, South Dakota, Texas, Louisiana, and Mississippi). Collapsing across topic categories, 2022 tweets were more negative and less neutral and positive compared to 2021 tweets. In network analysis, tweets mentioning woman/women, supreme court, and abortion spread faster and reached to more Twitter users than those mentioning Roe Wade and Scotus. Twitter data can provide real-time insights into the experiences and perceptions of people across the United States, which can be used to inform healthcare policies and decision-making.