{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T06:15:31Z","timestamp":1788156931772,"version":"build-2803163510"},"reference-count":24,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T00:00:00Z","timestamp":1788134400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Human papillomavirus (HPV) vaccination and regular cervical screening are fundamental pillars of the World Health Organization (WHO) strategy to eliminate cervical cancer. While conventional one-way digital notifications moderately support preventive uptake, the specific behavioral impact of two-way, interactive patient-facing digital assistants-such as conversational artificial intelligence (AI) and gamified health applications-warrants rigorous, isolated synthesis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To systematically assess whether patient-facing interactive digital assistants are associated with improved initiation and completion of HPV vaccination and cervical cancer screening, strictly distinguishing between formative usability evidence and clinical effectiveness.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Following PRISMA 2020 guidelines and PROSPERO registration (CRD420261333651), six academic databases were systematically searched (January 1, 2016\u2013February 10, 2026). Eligible interventions were limited to interactive patient-facing digital tools. Data synthesis utilized a structured narrative approach, applying the Mixed Methods Appraisal Tool (MMAT 2018) for individual domain risk of bias and GRADE principles for evidence certainty.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The synthesis included 14 reports representing 13 independent studies. Formative evaluations indicated high usability and user acceptability. Within behavioral trials, conversational AI chatbots showed promising effects for short-term increases in HPV vaccine appointment booking (Moderate certainty). However, multi-dose series completion remained severely constrained by high attrition rates (Low certainty). For secondary prevention, theory-based apps were associated with enhanced short-term cytology uptake (Moderate certainty). A serious game correlated with a higher diagnostic rate of cervical precancer (CIN2+); however, profound uncontrolled confounding limits causal attribution.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Interactive patient-facing digital assistants may improve short-term appointment scheduling and screening participation. Nevertheless, the current literature is heavily constrained by self-selection, attrition, and the inability to isolate the effects of multicomponent interventions. Future pragmatic trials are essential to replicate these findings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic review registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link>https:\/\/www.crd.york.ac.uk\/PROSPERO\/view\/CRD420261333651<\/jats:ext-link>\n                      , CRD420261333651.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1851751","type":"journal-article","created":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T05:39:32Z","timestamp":1788154772000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Digital tools to enhance adherence to cervical cancer prevention practices: systematic review"],"prefix":"10.3389","volume":"14","author":[{"given":"Ayagyoz","family":"Umbetzhanova","sequence":"first","affiliation":[{"name":"Department of General Medical Practice with a Course in Evidence-based Medicine, Astana Medical University","place":["Astana, Kazakhstan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adina","family":"Kusniyeva","sequence":"additional","affiliation":[{"name":"Department of General Medical Practice with a Course in Evidence-based Medicine, Astana Medical University","place":["Astana, Kazakhstan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gulmira","family":"Derbissalina","sequence":"additional","affiliation":[{"name":"Department of General Medical Practice with a Course in Evidence-based Medicine, Astana Medical University","place":["Astana, Kazakhstan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Almabayeva","family":"Aigul","sequence":"additional","affiliation":[{"name":"Department of General Medical Practice with a Course in Evidence-based Medicine, Astana Medical University","place":["Astana, Kazakhstan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00c7igdem","family":"\u00c7aglayan","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Internal Medicine Sciences, Kocaeli University","place":["Izmit, T\u00fcrkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gulnur","family":"Tanbayeva","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Organization, Farabi University","place":["Almaty, Kazakhstan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vitaliy","family":"Koikov","sequence":"additional","affiliation":[{"name":"Ministry of Health of the Republic of Kazakhstan","place":["Astana, Kazakhstan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naila","family":"Toktarova","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Organization, Farabi University","place":["Almaty, Kazakhstan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhanagul","family":"Bekbergenova","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Organization, Farabi University","place":["Almaty, Kazakhstan"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,31]]},"reference":[{"key":"ref1","volume-title":"Global Strategy to Accelerate the Elimination of Cervical Cancer as a Public Health Problem","year":"2020"},{"key":"ref2","volume-title":"Human Papillomavirus and Cancer: Fact Sheet","year":"2024"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"575","DOI":"10.1016\/S0140-6736(20)30068-4","article-title":"Impact of HPV vaccination and cervical screening on cervical cancer elimination: a comparative modelling analysis in 78 low-income and lower-middle-income 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