Conversational AI technology improves sexual and reproductive health education, study finds

Young women around the world face problems such as unwanted pregnancy and sexually transmitted infections. The 1.8 billion youth and young adults (ages 15-24) of both sexes worldwide account for 42% of new HIV infections.

Providing sexual and reproductive health education to young women is a priority in Sub-Saharan Africa, where 80% of the world’s young people with HIV live. Lesotho, a poor mountainous country in southern Africa, has the second highest HIV prevalence in the world at nearly 23% of the population. The country is challenged by a very low number of health care personnel and a terrain that makes face-to-face interactions difficult.

In a study published in BMC Global and Public Healthresearchers from Boston University Chobanian & Avedisian School of Medicine, collaborating with Northeastern University, University of Massachusetts Chan Medical School, University of Oklahoma and South Africa’s Sefako Makgatho Health Sciences University, used conversational AI technology to successfully disseminate information about sexual and reproductive health. .

“Our results support the use of e-health solutions to address the challenges of providing high-quality, evidence-based health education to young women in low-income countries where this education is much needed,” said study leader and first author Elizabeth Nkabane Nkholongo, Ph.D., and the executive director of the Lesotho Boston Health Alliance (LeBoHA), a partnership between the medical school of BU and the Lesotho Ministry of Health.

“In Lesotho, this could even lead to e-health ‘leap-frogging’ face-to-face health education,” added Nkholongo.

People are familiar with the technology known as chatbots, but AI-empowered embodied conversational agents (ECA) continue to interact with the user using software technology that creates a screen persona that can mimic interactions with real people. by speaking in the target’s natural language. audience with familiar gestures and other body expressions.

In the Lesotho study, researchers adapted an ECA model known as “Gabby” that has been successfully used to disseminate information about sexual and reproductive health among African American women in the US The Lesotho model used the hairstyle , complexion, facial expressions and mannerisms that distinguish young people. Lesotho women and developed the persona of Nthabi, a professional nurse midwife.

In this case, the choice of ECA technology was made possible by the rapid diffusion in Lesotho of mobile technologies such as smart phones and tablets. Researchers have developed an Nthabi app that can be downloaded to mobile devices without relying on the country’s spotty Wi-Fi coverage.

To study Nthabi’s effectiveness, researchers recruited 172 young women with an average age of 22.5 years to use the app. They measured participant knowledge before and after their discussions with Nthabi about family planning, folic acid use (a B vitamin important in preventing brain and spinal cord birth defects) and healthy eating. The number of correct answers before and after the test was compared.

“The young women enrolled in this study showed a significant increase in knowledge about family planning methods and preconception use of folic acid after contact with Nthabi,” the report concluded. For example, the overall percentage of correct answers to questions on folic acid use increased from 45.3% in Nthabi’s pre-use testing and 71.6% in post-use testing.

According to the researchers, Nthabi can help overcome the obstacles inherent in traditional face-to-face education, especially in places like Lesotho with fewer health care workers and difficult geographic challenges, but also to combat stigma surrounding the discussion of sexual reproductive health issues. .

“The potential of using Nthabi as a population health education tool is a game-changer as the world works toward achieving Universal Health Coverage,” said LeBoHA President Brian Jack, MD, and BU professor of family medicine.