{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T08:31:35Z","timestamp":1789720295123,"version":"4.0.1"},"reference-count":44,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2023,11,15]],"date-time":"2023-11-15T00:00:00Z","timestamp":1700006400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Provost\u2019s Pilot Clinical Research"},{"DOI":"10.13039\/100008513","name":"Thomas Jefferson University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008513","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Sidney Kimmel Cancer Center"},{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["5P30CA056036"],"award-info":[{"award-number":["5P30CA056036"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,1,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Challenges in ensuring adherence to colposcopy and follow-up recommendations, particularly within underserved communities, hinder the delivery of appropriate care. Informed by our established evidence-based program, we sought to assess the feasibility and acceptability of a novel cognitive-affective intervention delivered through a Chatbot interface, aimed to enhance colposcopy adherence within an urban inner-city population. We developed the evidence-based intervention, CervixChat, to address comprehension of colposcopy\u2019s purpose, human papillomavirus (HPV) understanding, cancer-related fatalistic beliefs, procedural concerns, and disease progression, offered in both English and Spanish. Females aged 21\u201365, with colposcopy appointments at an urban OBGYN clinic, were invited to participate. Enrolled patients experienced real-time counseling messages tailored via a Chatbot-driven barriers assessment, dispatched via text one week before their scheduled colposcopy. Cognitive-affective measures were assessed at baseline and through a 1-month follow-up. Participants also engaged in a brief post-intervention satisfaction survey and interview to capture their acceptance and feedback on the intervention. The primary endpoints encompassed study adherence (CervixChat response rate and follow-up survey rate) and self-evaluated intervention acceptability, with predefined feasibility benchmarks of at least 70% adherence and 80% satisfaction. Among 48 eligible women scheduled for colposcopies, 27 (56.3%) agreed, consented, and completed baseline assessments. Participants had an average age of 34 years, with 14 (52%) identifying as non-Hispanic White. Of these, 21 (77.8%) engaged with the CervixChat intervention via mobile phones. Impressively, 26 participants (96.3%) attended their diagnostic colposcopy within the specified timeframe. Moreover, 22 (81.5%) completed the follow-up survey and a brief interview. Barriers assessment revealed notable encodings in the Affect and Values\/Goals domains, highlighting concerns and understanding around HPV, as well as its impact on body image and sexual matters. Persistent and relatively high intrusive thoughts and lowered risk perceptions regarding cervical cancer were reported over time, unaffected by the intervention. Post-intervention evaluations documented high satisfaction and perceived usefulness, with recommendations for incorporating additional practical and educational content. Our findings underscore the robust satisfaction and practicality of the CervixChat intervention among a diverse underserved population. Moving forward, our next step involves evaluating the intervention\u2019s efficacy through a Sequential Multiple Assignment Randomized Trial (SMART) design. Enhanced by personalized health coaching, we aim to further bolster women\u2019s risk perception, address intrusive thoughts, and streamline resources to effectively improve colposcopy screening attendance.<\/jats:p>","DOI":"10.1093\/tbm\/ibad064","type":"journal-article","created":{"date-parts":[[2023,10,4]],"date-time":"2023-10-04T16:19:33Z","timestamp":1696436373000},"page":"1-12","source":"Crossref","is-referenced-by-count":9,"title":["Chatbot-interfaced and cognitive-affective barrier-driven messages to improve colposcopy adherence after abnormal Pap test results in underserved urban women: A feasibility pilot study"],"prefix":"10.1093","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4133-1178","authenticated-orcid":false,"given":"Kuang-Yi","family":"Wen","sequence":"first","affiliation":[{"name":"Department of Medical Oncology, Thomas Jefferson University , 834 Chestnut Street, Philadelphia, PA 19107 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra","family":"Dayaratna","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology, Sidney Kimmel Medical College, Thomas Jefferson University , 833 Chestnut Street, Philadelphia, PA 19107 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Slamon","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Thomas Jefferson University , 834 Chestnut Street, Philadelphia, PA 19107 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clara","family":"Granda-Cameron","sequence":"additional","affiliation":[{"name":"Department of Graduate Program, College of Nursing, Thomas Jefferson University , 901 Walnut Street, Suite 703, Philadelphia, PA 19107 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erin K","family":"Tagai","sequence":"additional","affiliation":[{"name":"Department of Cancer Prevention and Control, Fox Chase Cancer Center\/Temple University Health System , 333 Cottman Avenue, Philadelphia, PA 19111 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Racquel E","family":"Kohler","sequence":"additional","affiliation":[{"name":"Cancer Health Equity Center, Rutgers Cancer Institute of New Jersey , 120 Albany St, New Brunswick, NJ 08901 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shawna V","family":"Hudson","sequence":"additional","affiliation":[{"name":"Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School , 303 George St, New Brunswick, NJ 08901 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzanne M","family":"Miller","sequence":"additional","affiliation":[{"name":"Department of Cancer Prevention and Control, Fox Chase Cancer Center\/Temple University Health System , 333 Cottman Avenue, Philadelphia, PA 19111 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,11,15]]},"reference":[{"key":"2024011113293579000_CIT0001","doi-asserted-by":"crossref","first-page":"675","DOI":"10.1093\/jnci\/dji115","article-title":"Cervical cancer in women with comprehensive health care access: attributable factors in the screening process","volume":"97","author":"Leyden","year":"2005","journal-title":"J Natl Cancer Inst"},{"key":"2024011113293579000_CIT0002","doi-asserted-by":"crossref","first-page":"1044","DOI":"10.1002\/cncr.30507","article-title":"Hysterectomy-corrected cervical cancer mortality rates reveal a larger racial disparity in the United States","volume":"123","author":"Beavis","year":"2017","journal-title":"Cancer"},{"key":"2024011113293579000_CIT0003","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1016\/S0140-6736(18)32470-X","article-title":"Cervical 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