Use of Health Care Chatbots Among Young People in China During the Omicron Wave of COVID-19: Evaluation of the User Experience of and Satisfaction With the Technology
Authors: Shan Yi , Ji Meng , Xie Wenxiu , Zhang Xiaomin , Qian Xiaobo , Li Rongying , Hao Tianyong 
Published: May 2022

Background
Long before the outbreak of COVID-19, chatbots had been playing an increasingly crucial role and gaining growing popularity in health care. In the current omicron waves of this pandemic when the most resilient health care systems at the time are increasingly being overburdened, these conversational agents (CA) are being resorted to as preferred alternatives for health care information. For many people, especially adolescents and the middle-aged, mobile phones are the most favored source of information. As a result of this, it is more important than ever to investigate the user experience of and satisfaction with chatbots on mobile phones.

Objective
The objective of this study was twofold: (1) Informed by Deneche and Warren’s evaluation framework, Zhu et al’s measures of variables, and the theory of consumption values (TCV), we designed a new assessment model for evaluating the user experience of and satisfaction with chatbots on mobile phones, and (2) we aimed to validate the newly developed model and use it to gain an understanding of the user experience of and satisfaction with popular health care chatbots that are available for use by young people aged 17-35 years in southeast China in self-diagnosis and for acquiring information about COVID-19 and virus variants that are currently spreading.

Methods
First, to assess user experience and satisfaction, we established an assessment model based on relevant literature and TCV. Second, the chatbots were prescreened and selected for investigation. Subsequently, 413 informants were recruited from Nantong University, China. This was followed by a questionnaire survey soliciting the participants’ experience of and satisfaction with the selected health care chatbots via wenjuanxing, an online questionnaire survey platform. Finally, quantitative and qualitative analyses were conducted to find the informants’ perception.

Results
The data collected were highly reliable (Cronbach α=.986) and valid: communalities=0.632-0.823, Kaiser-Meyer-Olkin (KMO)=0.980, and percentage of cumulative variance (rotated)=75.257% (P<.001). The findings of this study suggest a considerable positive impact of functional, epistemic, emotional, social, and conditional values on the participants’ overall user experience and satisfaction and a positive correlation between these values and user experience and satisfaction (Pearson correlation P<.001). The functional values (mean 1.762, SD 0.630) and epistemic values (mean 1.834, SD 0.654) of the selected chatbots were relatively more important contributors to the students’ positive experience and overall satisfaction than the emotional values (mean 1.993, SD 0.683), conditional values (mean 1.995, SD 0.718), and social values (mean 1.998, SD 0.696). All the participants (n=413, 100%) had a positive experience and were thus satisfied with the selected health care chatbots. The 5 grade categories of participants showed different degrees of user experience and satisfaction: Seniors (mean 1.853, SD 0.108) were the most receptive to health care chatbots for COVID-19 self-diagnosis and information, and second-year graduate candidates (mean 2.069, SD 0.133) were the least receptive; freshmen (mean 1.883, SD 0.114) and juniors (mean 1.925, SD 0.087) felt slightly more positive than sophomores (mean 1.989, SD 0.092) and first-year graduate candidates (mean 1.992, SD 0.116) when engaged in conversations with the chatbots. In addition, female informants (mean 1.931, SD 0.098) showed a relatively more receptive attitude toward the selected chatbots than male respondents (mean 1.999, SD 0.051).

Conclusions
This study investigated the use of health care chatbots among young people (aged 17-35 years) in China, focusing on their user experience and satisfaction examined through an assessment framework. The findings show that the 5 domains in the new assessment model all have a positive impact on the participants’ user experience and satisfaction. In this paper, we examined the usability of health care chatbots as well as actual chatbots used for other purposes, enriching the literature on the subject. This study also provides practical implication for designers and developers as well as for governments of all countries, especially in the critical period of the omicron waves of COVID-19 and other future public health crises.