Use of a chatbot to engage parents of preterm and term infants on parental stress, parental sleep and infant feeding: a feasibility study (Preprint)

BACKGROUND Parents commonly experience anxiety, worry and psychological distress in caring for newborn infants, particularly those born preterm. Web-based therapist services may offer greater accessibility and timely psychological support for parents, but are nevertheless labor-intensive due to their interactive nature. Chatbots that simulate human-like conversations show promise for such interactive applications. OBJECTIVE To explore the usability and feasibility of chatbot technology for gathering real-life conversation data on stress, sleep and infant feeding from parents with newborn infants and to investigate differences between experiences of parents with preterm and term infants. METHODS Parents aged ≥21 years with infants aged ≤6 months were enrolled from November 2018 to March 2019. Three chatbot scripts (stress, sleep, feeding) were developed to capture conversations with parents via their mobile devices. Parents completed a chatbot usability questionnaire upon study completion. Responses to closed-ended questions and manually-coded open-ended responses were summarized descriptively. Open-ended responses were analyzed using the Latent Dirichlet Allocation (LDA) method to uncover semantic topics. RESULTS Of 45 enrolled participants (20 preterm; 25 term), 26 completed the study. Parents rated the chatbot as "easy" to use (mean ± SD: 4.08±0.74; 1 [Very difficult] - 5 [Very easy]) and were "satisfied" (mean ± SD: 3.81±0.90; 1 [Very dissatisfied] - 5 [Very satisfied]). Of 45 enrolled parents, those with preterm infants reported emotional stress more frequently than parents of term infants (33 vs. 24 occasions). Parents generally reported satisfactory sleep quality. The preterm group reported feeding problems more frequently than the term group (8 vs. 2 occasions). In stress domain conversations, topics linked to "discomfort" and "tiredness" were more prevalent in preterm group conversations, whereas the topic of "positive feelings" occurred more frequently in term group conversations. Interestingly, feeding-related topics dominated the content of sleep domain conversations, suggesting that frequent or irregular feeding may affect parents' ability to get adequate sleep or rest. CONCLUSIONS The chatbot was successfully utilized to collect real-time conversation data on stress, sleep and infant feeding from a group of 45 parents. In their chatbot conversations, term group parents frequently expressed positive emotions, whereas preterm group parents frequently expressed physical discomfort and tiredness, as well as emotional stress. Overall, parents who completed the study gave positive feedback on their user experience with the chatbot as a tool to express their thoughts and concerns. CLINICALTRIAL ClinicalTrials.gov NCT03630679.