Chatbot-based Intervention for Education and Access to at-home COVID-19 Testing in the SCALE-UP II Trial: a Descriptive Log Analysis Study (Preprint)

<sec> <title>BACKGROUND</title> Promoting at-home tests (e.g., for COVID-19) using chatbots may be a novel and scalable way to improve uptake across diverse populations. </sec> <sec> <title>OBJECTIVE</title> The objective of this study was to assess patients’ navigational patterns (i.e., sequence of interactions) when using a chatbot designed to provide education on COVID-19 testing and to order free at-home COVID-19 test kits. </sec> <sec> <title>METHODS</title> The study was a secondary analysis of the SCALE-UP II trial, which compared different digital health strategies (i.e., chatbots versus simple text messages) to deliver free at-home COVID-19 test kits to minority populations in Utah. We analyzed chatbot usage logs to understand user behavior. </sec> <sec> <title>RESULTS</title> Of 1,051 patients randomized to the chatbot intervention, 309 (29%) launched the chatbot and 196 (63%) interacted with it. Among those who interacted, 170 (87%) completed a test kit order. One patient (0.3%) accessed the chatbot educational content. </sec> <sec> <title>CONCLUSIONS</title> Ordering of COVID-19 test kits among patients who interacted with the chatbot was high. Patients placed orders without reviewing educational content. Chatbot design should minimize the number of steps for patients to achieve a goal. </sec>