{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T12:08:24Z","timestamp":1791893304643,"version":"4.3.4"},"reference-count":73,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Hum Factors"],"abstract":"\n Background<\/jats:title>\n Health outcomes are significantly influenced by unmet social needs. Although screening for social needs has become common in health care settings, there is often poor linkage to resources after needs are identified. The structural barriers (eg, staffing, time, and space) to helping address social needs could be overcome by a technology-based solution.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n This study aims to present the design and evaluation of a chatbot, DAPHNE (Dialog-Based Assistant Platform for Healthcare and Needs Ecosystem), which screens for social needs and links patients and families to resources.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n This research used a three-stage study approach: (1) an end-user survey to understand unmet needs and perception toward chatbots, (2) iterative design with interdisciplinary stakeholder groups, and (3) a feasibility and usability assessment. In study 1, a web-based survey was conducted with low-income US resident households (n=201). Following that, in study 2, web-based sessions were held with an interdisciplinary group of stakeholders (n=10) using thematic and content analysis to inform the chatbot\u2019s design and development. Finally, in study 3, the assessment on feasibility and usability was completed via a mix of a web-based survey and focus group interviews following scenario-based usability testing with community health workers (family advocates; n=4) and social workers (n=9). We reported descriptive statistics and chi-square test results for the household survey. Content analysis and thematic analysis were used to analyze qualitative data. Usability score was descriptively reported.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Among the survey participants, employed and younger individuals reported a higher likelihood of using a chatbot to address social needs, in contrast to the oldest age group. Regarding designing the chatbot, the stakeholders emphasized the importance of provider-technology collaboration, inclusive conversational design, and user education. The participants found that the chatbot\u2019s capabilities met expectations and that the chatbot was easy to use (System Usability Scale score=72\/100). However, there were common concerns about the accuracy of suggested resources, electronic health record integration, and trust with a chatbot.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Chatbots can provide personalized feedback for families to identify and meet social needs. Our study highlights the importance of user-centered iterative design and development of chatbots for social needs. Future research should examine the efficacy, cost-effectiveness, and scalability of chatbot interventions to address social needs.<\/jats:p>\n <\/jats:sec>","DOI":"10.2196\/57114","type":"journal-article","created":{"date-parts":[[2024,5,24]],"date-time":"2024-05-24T11:49:42Z","timestamp":1716551382000},"page":"e57114","source":"Crossref","is-referenced-by-count":30,"title":["Chatbot for Social Need Screening and Resource Sharing With Vulnerable Families: Iterative Design and Evaluation Study"],"prefix":"10.2196","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8798-9605","authenticated-orcid":false,"given":"Emre","family":"Sezgin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8328-5317","authenticated-orcid":false,"given":"A Baki","family":"Kocaballi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0122-8296","authenticated-orcid":false,"given":"Millie","family":"Dolce","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6786-8128","authenticated-orcid":false,"given":"Micah","family":"Skeens","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7827-1466","authenticated-orcid":false,"given":"Lisa","family":"Militello","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3265-9902","authenticated-orcid":false,"given":"Yungui","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6586-1918","authenticated-orcid":false,"given":"Jack","family":"Stevens","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5491-3997","authenticated-orcid":false,"given":"Alex R","family":"Kemper","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2024,7,19]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2015.08.024"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1353\/hpu.2020.0048"},{"key":"ref3","year":"2019","journal-title":"Integrating Social Care Into the Delivery of Health Care: Moving Upstream to Improve the Nation's Health"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1097\/pq9.0000000000000512"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1016\/j.acap.2022.05.002"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1097\/JAC.0000000000000221"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2015-3301"},{"key":"ref8","unstructured":"BilliouxAVerlanderKAnthonySAlleyDStandardized screening for health-related social needs in clinical settings: the accountable health communities screening toolNational Academy of Medicine Perspectives20172024-06-21https:\/\/nam.edu\/standardized-screening-for-health-related-social-needs-in-clinical-settings-the-accountable-health-communities-\u200bscreening-tool\/"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1542\/hpeds.2019-0286"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.2196\/11613"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1007\/s10639-021-10862-z"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1016\/j.chb.2020.106627"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1093\/jamia\/ocac014"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.3758\/s13428-020-01475-4"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.2196\/15823"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.2196\/25933"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.2196\/24045"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2016.0400"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.2196\/38525"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.2196\/12856"},{"key":"ref21","first-page":"552","volume":"2019","author":"Kocielnik, R","year":"2019","journal-title":"AMIA Annu Symp Proc"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2020.4143"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1038\/s41746-023-00856-1"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.1145\/3469595.3469599"},{"issue":"1","key":"ref25","doi-asserted-by":"crossref","first-page":"188","DOI":"10.2307\/1129606","volume":"51","author":"Garbarino, J","year":"1980","journal-title":"Child Dev"},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2015.0645"},{"key":"ref27","doi-asserted-by":"publisher","DOI":"10.1056\/CAT.22.0366"},{"key":"ref28","unstructured":"Use Memoji on your iPhone or iPad ProApple Inc2023-05-04https:\/\/support.apple.com\/en-us\/HT208986"},{"key":"ref29","unstructured":"Prolific homepageProlific2024-06-21https:\/\/www.prolific.com\/"},{"issue":"3","key":"ref30","first-page":"39","volume":"13","author":"Drain, A","year":"2019","journal-title":"Int J Design"},{"key":"ref31","doi-asserted-by":"publisher","DOI":"10.2196\/humanfactors.8621"},{"key":"ref32","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2009.02.002"},{"key":"ref33","doi-asserted-by":"publisher","DOI":"10.2307\/249008"},{"key":"ref34","doi-asserted-by":"publisher","DOI":"10.1080\/10447318.2017.1418805"},{"key":"ref35","author":"Krippendorff, K","year":"1980","journal-title":"Content Analysis: An Introduction to Its Methodology"},{"key":"ref36","doi-asserted-by":"publisher","DOI":"10.1191\/1478088706qp063oa"},{"key":"ref37","unstructured":"SauroJMeasuring usability: from the SUS to the UMUX-liteMeasuringU201710112023-05-08https:\/\/measuringu.com\/umux-lite\/"},{"key":"ref38","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-319-20886-2_20"},{"key":"ref39","doi-asserted-by":"publisher","DOI":"10.1109\/mic.2020.3037151"},{"key":"ref40","doi-asserted-by":"publisher","DOI":"10.2196\/27850"},{"key":"ref41","doi-asserted-by":"publisher","DOI":"10.1038\/s41746-021-00413-8"},{"key":"ref42","doi-asserted-by":"publisher","DOI":"10.1007\/s41134-020-00147-9"},{"key":"ref43","doi-asserted-by":"publisher","DOI":"10.1016\/j.acap.2019.01.008"},{"key":"ref44","doi-asserted-by":"publisher","DOI":"10.2196\/17158"},{"key":"ref45","first-page":"1354","volume":"2020","author":"You, Y","year":"2021","journal-title":"AMIA Annu Symp Proc"},{"key":"ref46","doi-asserted-by":"publisher","DOI":"10.2196\/15360"},{"key":"ref47","doi-asserted-by":"publisher","DOI":"10.2196\/22845"},{"key":"ref48","doi-asserted-by":"publisher","DOI":"10.1145\/3290607.3312887"},{"key":"ref49","doi-asserted-by":"publisher","DOI":"10.1186\/s13104-021-05720-7"},{"key":"ref50","doi-asserted-by":"publisher","DOI":"10.1007\/s10639-021-10542-y"},{"key":"ref51","doi-asserted-by":"publisher","DOI":"10.1016\/j.health.2022.100072"},{"key":"ref52","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2022.887492"},{"key":"ref53","doi-asserted-by":"publisher","DOI":"10.2196\/18240"},{"key":"ref54","doi-asserted-by":"publisher","DOI":"10.1016\/j.future.2022.05.014"},{"key":"ref55","doi-asserted-by":"publisher","DOI":"10.1177\/20552076231186520"},{"key":"ref56","doi-asserted-by":"publisher","DOI":"10.1056\/CAT.22.0373"},{"key":"ref57","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2023.115837"},{"key":"ref58","doi-asserted-by":"publisher","DOI":"10.1370\/afm.2275"},{"key":"ref59","doi-asserted-by":"publisher","DOI":"10.1111\/j.1475-6773.2010.01140.x"},{"key":"ref60","doi-asserted-by":"publisher","DOI":"10.1007\/s10916-016-0489-2"},{"key":"ref61","doi-asserted-by":"publisher","DOI":"10.24095\/hpcdp.41.3.03"},{"key":"ref62","doi-asserted-by":"publisher","DOI":"10.3389\/frobt.2021.618866"},{"key":"ref63","unstructured":"Affordable connectivity programFederal Communications Commission2024-04-16https:\/\/www.fcc.gov\/acp"},{"key":"ref64","doi-asserted-by":"publisher","DOI":"10.1186\/s13063-021-05453-9"},{"key":"ref65","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijhcs.2021.102630"},{"key":"ref66","doi-asserted-by":"publisher","DOI":"10.21203\/rs.3.rs-2566942\/v1"},{"key":"ref67","doi-asserted-by":"publisher","DOI":"10.2196\/20346"},{"key":"ref68","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.230163"},{"key":"ref69","unstructured":"SellersJNavigating sensitive topics: from food security to insurance coverageOncology Nursing News201908072023-05-07https:\/\/www.oncnursingnews.com\/view\/navigating-sensitive-topics-from-food-security-to-insurance-coverage"},{"key":"ref70","doi-asserted-by":"publisher","DOI":"10.1056\/CAT.19.1037"},{"key":"ref71","unstructured":"Screening for social needs: guiding care teams to engage patientsAmerican Hospital Association2023-05-07https:\/\/www.aha.org\/toolkitsmethodology\/2019-06-05-screening-social-needs-guiding-care-teams-engage-patients"},{"key":"ref72","doi-asserted-by":"publisher","DOI":"10.2196\/18301"},{"key":"ref73","doi-asserted-by":"publisher","DOI":"10.2196\/41583"}],"container-title":["JMIR Human Factors"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/humanfactors.jmir.org\/2024\/1\/e57114","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T17:47:02Z","timestamp":1782841622000},"score":1,"resource":{"primary":{"URL":"https:\/\/humanfactors.jmir.org\/2024\/1\/e57114"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7,19]]},"references-count":73,"URL":"https:\/\/doi.org\/10.2196\/57114","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-3749148\/v1","asserted-by":"object"},{"id-type":"doi","id":"10.2196\/preprints.57114","asserted-by":"object"}]},"ISSN":["2292-9495"],"issn-type":[{"value":"2292-9495","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,7,19]]}}}