Abstract
Objectives: 1. Develop a chatbot platform for healthcare applications and assess its usability 2. Compare the effectiveness of in-person toothbrushing training by caregivers with the modified 21-Day FunDee chatbot (Gr.1) and the 21-Day Fundee plus (Gr.2) chatbot alone, on caries prevalence, plaque, and oral hygiene care practices by caregivers in children aged 6 months to 3.5 years. Methods: In phase 1, after the Wowbot platform was integrated with the Botnoi Platform, 6 chatbot developers performed 6 tasks that pertained to the functions of the Wowbot platform. Researchers observed their behaviors and assessed their performance by Think aloud method. The SUMI (The Software Usability Measurement Inventory) questionnaire and in-depth interviews was used to assess the platform’s usability. In phase 2, 315 participants from Kong-Ra district in Phatthalung province and Mai-Kaen district in Pattani province were randomly assigned to Gr.1 (n=159) and Gr.2 (n=156). The comparisons between the two groups were conducted using dental examination records, oral healthcare questionnaires, perception of oral healthcare based on protection-motivation theory (PMT) at 3 and 6 months and satisfaction with the chatbot usage at 3 months. The statistical significance level was set at p-value<0.05. Results: The developed Wowbot platform’s functions included broadcast, export data, API (Application Programming Interface): image frame, and parameter comparisons. The average SUMI score was 4.03±1.12. From observation, most chatbot developers completed the assigned tasks and the most challenging tasks were those involving API function. They suggested that all new functions be beneficial and that the user manual should be revised. Repeated measured ANOVA showed plaque scores decreased, while means of dmft, dmfs and oral healthcare knowledge scores increased significantly at 3 and 6 months. However, these outcomes were not statistically significant between Gr. 1 and 2. Oral health care perception was statistically significant between Gr.1 and 2, with no study groups and follow-up time interaction. At 3 and 6 months, each group showed significant improvement in percentages of toothbrushing by a caregiver or supervised by a caregiver, frequency of breastfeeding or nighttime bottle milk consumption, and frequency of bottle milk usage but there was no statistically significant difference between groups. At 6 months, frequency of falling asleep with a bottle of milk and percentages of fruit consumption significantly increased in Gr.1 than in Gr.2, while using fluoride toothpaste significantly increased in Gr. 2 than in Gr.1. Both groups were highly satisfied with the chatbot (4.0±0.5, 4.0±0.6, respectively.) Conclusion: At the end of the study, both groups led in overall improved oral health behaviors and reduced plaque levels, increased dental caries with no significant difference between groups. The Wowbot platform and chatbots exhibited good acceptability.
