Effects of a Theory- and Evidence-Based, Motivational Interviewing–Oriented Artificial Intelligence Digital Assistant on Vaccine Attitudes: A Randomized Controlled Trial
Abstract BackgroundAttitude-targeted interventions are important approaches for promoting vaccination. Educational approaches alone cannot effectively cultivate positive vaccine attitudes. Artificial intelligence (AI)–driven chatbots and motivational interviewing (MI) techniqu...
Saved in:
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
JMIR Publications
2025-08-01
|
| Series: | Journal of Medical Internet Research |
| Online Access: | https://www.jmir.org/2025/1/e72637 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849331670847586304 |
|---|---|
| author | Yan Li Mengqi Li Janelle Yorke Daniel Bressington Joyce Chung Yao-Jie Xie Lin Yang Mengting He Tsz-Ching Sun Angela Y M Leung |
| author_facet | Yan Li Mengqi Li Janelle Yorke Daniel Bressington Joyce Chung Yao-Jie Xie Lin Yang Mengting He Tsz-Ching Sun Angela Y M Leung |
| author_sort | Yan Li |
| collection | DOAJ |
| description |
Abstract
BackgroundAttitude-targeted interventions are important approaches for promoting vaccination. Educational approaches alone cannot effectively cultivate positive vaccine attitudes. Artificial intelligence (AI)–driven chatbots and motivational interviewing (MI) techniques show high promise in improving vaccine attitudes and facilitating readiness for vaccination.
ObjectiveThis study aimed to evaluate the effectiveness of a theory and evidence-based, MI-oriented AI digital assistant in improving COVID-19 vaccine attitudes among adults in Hong Kong.
MethodsThis 2 parallel-armed randomized controlled trial was conducted from October 2022 to June 2024. Hong Kong adults (N=177) who were vaccine-hesitant were randomly assigned into 2 study groups. The intervention group (n=91) interacted with the AI digital assistant over 5 weeks, including receiving a web-based education program comprising 5 educational modules and communicating with an AI-driven chatbot equipped with MI techniques. The control group (n=86) received WhatsApp (Meta) messages directing them to government websites for COVID-19 vaccine information and knowledge, with the same dosage as the intervention group. Primary outcomes included vaccine hesitancy. Secondary outcomes included vaccine readiness, confidence, trust in government, and health literacy. Outcomes were measured at baseline, postintervention, 3-month, and 6-month follow-up. Focus group interviews were conducted postintervention. Intervention effects were analyzed using the generalized estimating equation model. Interview data were content analyzed.
ResultsDecreases in vaccine hesitancy were observed while no statistically significant time-by-group interaction effects were found. The intervention showed significant time-by-group interaction effects on vaccine readiness (PPPddP
ConclusionsThe intervention indicated promising yet significant effects on vaccine readiness while the effects on vaccine hesitancy require further confirmation. The qualitative findings; however, further consolidate the significant effects on participants’ attitudes toward vaccines. The findings provide novel evidence to encourage the adoption and refinement of a MI-oriented AI digital assistant in vaccine promotion. |
| format | Article |
| id | doaj-art-3e260bc48f5546cdaeb9d95785ec5b2e |
| institution | Kabale University |
| issn | 1438-8871 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | JMIR Publications |
| record_format | Article |
| series | Journal of Medical Internet Research |
| spelling | doaj-art-3e260bc48f5546cdaeb9d95785ec5b2e2025-08-20T03:46:27ZengJMIR PublicationsJournal of Medical Internet Research1438-88712025-08-0127e72637e7263710.2196/72637Effects of a Theory- and Evidence-Based, Motivational Interviewing–Oriented Artificial Intelligence Digital Assistant on Vaccine Attitudes: A Randomized Controlled TrialYan Lihttp://orcid.org/0000-0002-5311-9190Mengqi Lihttp://orcid.org/0000-0002-9952-3690Janelle Yorkehttp://orcid.org/0000-0002-1344-5944Daniel Bressingtonhttp://orcid.org/0000-0003-0951-2208Joyce Chunghttp://orcid.org/0000-0001-5378-8274Yao-Jie Xiehttp://orcid.org/0000-0001-9289-4985Lin Yanghttp://orcid.org/0000-0002-5964-3233Mengting Hehttp://orcid.org/0009-0007-2987-9070Tsz-Ching Sunhttp://orcid.org/0009-0008-6801-0025Angela Y M Leunghttp://orcid.org/0000-0002-9836-1925 Abstract BackgroundAttitude-targeted interventions are important approaches for promoting vaccination. Educational approaches alone cannot effectively cultivate positive vaccine attitudes. Artificial intelligence (AI)–driven chatbots and motivational interviewing (MI) techniques show high promise in improving vaccine attitudes and facilitating readiness for vaccination. ObjectiveThis study aimed to evaluate the effectiveness of a theory and evidence-based, MI-oriented AI digital assistant in improving COVID-19 vaccine attitudes among adults in Hong Kong. MethodsThis 2 parallel-armed randomized controlled trial was conducted from October 2022 to June 2024. Hong Kong adults (N=177) who were vaccine-hesitant were randomly assigned into 2 study groups. The intervention group (n=91) interacted with the AI digital assistant over 5 weeks, including receiving a web-based education program comprising 5 educational modules and communicating with an AI-driven chatbot equipped with MI techniques. The control group (n=86) received WhatsApp (Meta) messages directing them to government websites for COVID-19 vaccine information and knowledge, with the same dosage as the intervention group. Primary outcomes included vaccine hesitancy. Secondary outcomes included vaccine readiness, confidence, trust in government, and health literacy. Outcomes were measured at baseline, postintervention, 3-month, and 6-month follow-up. Focus group interviews were conducted postintervention. Intervention effects were analyzed using the generalized estimating equation model. Interview data were content analyzed. ResultsDecreases in vaccine hesitancy were observed while no statistically significant time-by-group interaction effects were found. The intervention showed significant time-by-group interaction effects on vaccine readiness (PPPddP ConclusionsThe intervention indicated promising yet significant effects on vaccine readiness while the effects on vaccine hesitancy require further confirmation. The qualitative findings; however, further consolidate the significant effects on participants’ attitudes toward vaccines. The findings provide novel evidence to encourage the adoption and refinement of a MI-oriented AI digital assistant in vaccine promotion.https://www.jmir.org/2025/1/e72637 |
| spellingShingle | Yan Li Mengqi Li Janelle Yorke Daniel Bressington Joyce Chung Yao-Jie Xie Lin Yang Mengting He Tsz-Ching Sun Angela Y M Leung Effects of a Theory- and Evidence-Based, Motivational Interviewing–Oriented Artificial Intelligence Digital Assistant on Vaccine Attitudes: A Randomized Controlled Trial Journal of Medical Internet Research |
| title | Effects of a Theory- and Evidence-Based, Motivational Interviewing–Oriented Artificial Intelligence Digital Assistant on Vaccine Attitudes: A Randomized Controlled Trial |
| title_full | Effects of a Theory- and Evidence-Based, Motivational Interviewing–Oriented Artificial Intelligence Digital Assistant on Vaccine Attitudes: A Randomized Controlled Trial |
| title_fullStr | Effects of a Theory- and Evidence-Based, Motivational Interviewing–Oriented Artificial Intelligence Digital Assistant on Vaccine Attitudes: A Randomized Controlled Trial |
| title_full_unstemmed | Effects of a Theory- and Evidence-Based, Motivational Interviewing–Oriented Artificial Intelligence Digital Assistant on Vaccine Attitudes: A Randomized Controlled Trial |
| title_short | Effects of a Theory- and Evidence-Based, Motivational Interviewing–Oriented Artificial Intelligence Digital Assistant on Vaccine Attitudes: A Randomized Controlled Trial |
| title_sort | effects of a theory and evidence based motivational interviewing oriented artificial intelligence digital assistant on vaccine attitudes a randomized controlled trial |
| url | https://www.jmir.org/2025/1/e72637 |
| work_keys_str_mv | AT yanli effectsofatheoryandevidencebasedmotivationalinterviewingorientedartificialintelligencedigitalassistantonvaccineattitudesarandomizedcontrolledtrial AT mengqili effectsofatheoryandevidencebasedmotivationalinterviewingorientedartificialintelligencedigitalassistantonvaccineattitudesarandomizedcontrolledtrial AT janelleyorke effectsofatheoryandevidencebasedmotivationalinterviewingorientedartificialintelligencedigitalassistantonvaccineattitudesarandomizedcontrolledtrial AT danielbressington effectsofatheoryandevidencebasedmotivationalinterviewingorientedartificialintelligencedigitalassistantonvaccineattitudesarandomizedcontrolledtrial AT joycechung effectsofatheoryandevidencebasedmotivationalinterviewingorientedartificialintelligencedigitalassistantonvaccineattitudesarandomizedcontrolledtrial AT yaojiexie effectsofatheoryandevidencebasedmotivationalinterviewingorientedartificialintelligencedigitalassistantonvaccineattitudesarandomizedcontrolledtrial AT linyang effectsofatheoryandevidencebasedmotivationalinterviewingorientedartificialintelligencedigitalassistantonvaccineattitudesarandomizedcontrolledtrial AT mengtinghe effectsofatheoryandevidencebasedmotivationalinterviewingorientedartificialintelligencedigitalassistantonvaccineattitudesarandomizedcontrolledtrial AT tszchingsun effectsofatheoryandevidencebasedmotivationalinterviewingorientedartificialintelligencedigitalassistantonvaccineattitudesarandomizedcontrolledtrial AT angelaymleung effectsofatheoryandevidencebasedmotivationalinterviewingorientedartificialintelligencedigitalassistantonvaccineattitudesarandomizedcontrolledtrial |