Tailored, Just-in-Time Education and Resources for Birthing Individuals and Newborn Caregivers After Hospital Discharge: Developing a Chatbot Experience [ID: 1376023

Abstract

INTRODUCTION: The District of Columbia has some of the highest rates of maternal mortality in the United States, which disproportionally affects Black birthing individuals. Chatbots are a particularly promising platform as they can offer tailored, just-in-time information to birthing individuals and newborn caregivers through active outreach. METHODS: We developed an interactive chatbot experience to focus on warning signs (physical and mental health), education, and reconnecting with health care teams in the 42 days after discharge. We solicited input from expert stakeholders with expertise in obstetrics, pediatrics, social work, psychiatry, mHealth, and health equity to develop content for a clinical setting where patients mostly utilize public insurance. Feedback was also solicited from end users through virtual and in-person testing and feedback sessions. The chatbot experience was launched on August 30, 2022, whereby all birthing individuals at a large, urban hospital in Washington, DC, began to receive messaging 24 hours after discharge. The IRB protocol was approved by MedStar Health Research Institute. RESULTS: In the first 60 days, 418 messages were sent out, and 230 individuals engaged with the chatbot. 66% of users engaged through SMS, while 34% engaged through email. Nine users (not all of whom engaged) were recruited to provide in-depth feedback. Positive feedback included ease of navigation, enthusiasm for resources, and checkup reminders. Users suggested additional content on barriers to care and community-based resources. CONCLUSION: Digital platforms may be an additional channel to offer birthing individuals information about warning signs and connect them to care where needed. Next steps include testing effect on health disparities.