Design and Validation of a Chatbot-Based Cervical Cancer Screening Decision Aid for Women Experiencing Socioeconomic Disadvantage: User-Centered Approach Study

BackgroundCervical 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 Occi...

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Main Authors: Alice Le Bonniec, Catherine Sauvaget, Eric Lucas, Abdelhak Nassiri, Farida Selmouni
Format: Article
Language:English
Published: JMIR Publications 2025-07-01
Series:JMIR Cancer
Online Access:https://cancer.jmir.org/2025/1/e70251
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author Alice Le Bonniec
Catherine Sauvaget
Eric Lucas
Abdelhak Nassiri
Farida Selmouni
author_facet Alice Le Bonniec
Catherine Sauvaget
Eric Lucas
Abdelhak Nassiri
Farida Selmouni
author_sort Alice Le Bonniec
collection DOAJ
description BackgroundCervical 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). ObjectiveThis 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. MethodsThe 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. ResultsThe 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. ConclusionsThis 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
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spelling doaj-art-7446a49f460d43dbb84ea9de9b00c1692025-08-20T03:31:48ZengJMIR PublicationsJMIR Cancer2369-19992025-07-0111e7025110.2196/70251Design and Validation of a Chatbot-Based Cervical Cancer Screening Decision Aid for Women Experiencing Socioeconomic Disadvantage: User-Centered Approach StudyAlice Le Bonniechttps://orcid.org/0000-0001-9916-8038Catherine Sauvagethttps://orcid.org/0000-0002-8053-4963Eric Lucashttps://orcid.org/0000-0002-1252-1925Abdelhak Nassirihttps://orcid.org/0000-0003-4672-8622Farida Selmounihttps://orcid.org/0000-0002-2662-1126 BackgroundCervical 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). ObjectiveThis 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. MethodsThe 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. ResultsThe 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. ConclusionsThis 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)RR2-10.2196/39288https://cancer.jmir.org/2025/1/e70251
spellingShingle Alice Le Bonniec
Catherine Sauvaget
Eric Lucas
Abdelhak Nassiri
Farida Selmouni
Design and Validation of a Chatbot-Based Cervical Cancer Screening Decision Aid for Women Experiencing Socioeconomic Disadvantage: User-Centered Approach Study
JMIR Cancer
title Design and Validation of a Chatbot-Based Cervical Cancer Screening Decision Aid for Women Experiencing Socioeconomic Disadvantage: User-Centered Approach Study
title_full Design and Validation of a Chatbot-Based Cervical Cancer Screening Decision Aid for Women Experiencing Socioeconomic Disadvantage: User-Centered Approach Study
title_fullStr Design and Validation of a Chatbot-Based Cervical Cancer Screening Decision Aid for Women Experiencing Socioeconomic Disadvantage: User-Centered Approach Study
title_full_unstemmed Design and Validation of a Chatbot-Based Cervical Cancer Screening Decision Aid for Women Experiencing Socioeconomic Disadvantage: User-Centered Approach Study
title_short Design and Validation of a Chatbot-Based Cervical Cancer Screening Decision Aid for Women Experiencing Socioeconomic Disadvantage: User-Centered Approach Study
title_sort design and validation of a chatbot based cervical cancer screening decision aid for women experiencing socioeconomic disadvantage user centered approach study
url https://cancer.jmir.org/2025/1/e70251
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