A Conversational AI System to Enhance Knowledge About Vaccines and Promote Vaccination

Study Overview
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Brief Summary
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This study is designed to contribute to the growing body of evidence on the efficacy of digital health interventions. By rigorously evaluating the impact of the AI system on vaccine knowledge and acceptance, the study aims to inform future health communication strategies and policies. It stands as a potential model for integrating AI into public health initiatives, showcasing how technology can be harnessed to improve health outcomes on a large scale.

Official Title
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A Conversational AI System to Enhance Knowledge About Vaccines and Promote Vaccination: A Randomized Controlled Trial

Conditions
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Vaccination Hesitancy

Intervention / Treatment
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* Device: Conversational AI system
* Other: Printed educational Brochure


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria Individuals aged 18 or above Owning a smartphone/tablet capable of using the study app Willing to provide informed consent. Exclusion Criteria Individuals with ocular or hearing disorders that preclude the use of mobile phones or reading. Individuals with mental disorders that preclude the use of mobile phones or reading.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Triple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Conversational AI system<br> | Device: Conversational AI system<br>* The conversational AI system uses GPT-4 as the core LLM, and processes user queries with a sophisticated generation, decision, action, and safety framework to provide optimal feedback. The system has several key features. Firstly, it utilizes retrieval-augmented in-context learning to enhance responses generated by the LLM, sourcing information from trustworthy websites. Secondly, it includes Guardrail module that addresses potential harmful content in the LLM-generated responses by clarifying and validating the content before delivery. Furthermore, the AI system is equipped with Self-checking memory module that retains essential clinical characteristics across multi-turn dialogues, ensuring the continuity and consistency of its interactions with users. The educational content about vaccination was derived from the official website of World Health Organization (https://www.who.int/news-room/questions-and-answers/item/vaccines-and-immunization-what-is-vaccination).<br>|
| Active Comparator: Educational brochure<br> | Other: Printed educational Brochure<br>* A printed brochure whose content about vaccination was derived from the official website of World Health Organization (https://www.who.int/news-room/questions-and-answers/item/vaccines-and-immunization-what-is-vaccination).<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Acceptance of vaccines | Vaccine acceptance was evaluated based on responses to the question, 'Based on your actual situation, please choose the extent of your willingness to get vaccinated.' The response options were: Absolutely refuse, Refuse but uncertain about the future, Have not considered it yet, Accept but still considering, and Completely willing. Vaccine acceptance was considered if the participant selected 'Completely willing. | Day 14 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Hesitancy of vaccination | The Vaccine Hesitancy Scale was developed based on the 3Cs model (confidence, complacency, and convenience) by the SAGE Working Group on Vaccine Hesitancy, encompassing three aspects: confidence, complacency, and convenience. It utilizes a Likert 5-point scale (Strongly Disagree, Disagree, Neutral, Agree, Strongly Agree) for scoring. For the complacency dimension, aspect, scoring is reversed with Strongly Agree to Strongly Disagree rated as 5 to 1 points, respectively. In contrast, other items follow the standard scoring, where Strongly Agree to Strongly Disagree are scored from 1 to 5 points. Confidence is measured by perceived vaccine safety and efficacy. Complacency is assessed through perceived necessity of the vaccine and the severity of the preventable diseases. Convenience is evaluated by the perceived ease of transportation and appointment scheduling. | Day 14 |