AI-Enhanced Conversational Agents for Personalized Asthma Support in People With Asthma: Factors for Engagement, Value, and Efficacy in a Cross-Sectional Survey Study.

Background: Asthma-related deaths in the United Kingdom are the highest in Europe, and only 30% of patients access basic care. There is a need for alternative approaches to reaching people with asthma to provide health education, self-management support, and better bridges to care. Objective: This study aimed to examine patients' interest in using a chatbot for asthma and to identify factors that influence engagement. Automated conversational agents (specifically, mobile chatbots) present opportunities for providing alternative and individually tailored access to health education, self-management support, and risk self-assessment. But would patients engage with a chatbot, and what factors influence engagement? Methods: We present results from a patient survey (N=1257) developed by a team of asthma clinicians, patients, and technology developers, conducted to identify optimal factors for efficacy, value, and engagement with an asthma chatbot. Results: Results indicate that most adults with asthma (53%) are interested in using a chatbot. The patients most likely to do so are those who believe their asthma is more serious and are less confident in their self-management. Results also indicate enthusiasm for 24/7 access, personalization, and for WhatsApp (Meta) as the preferred access method (compared to app, voice assistant, SMS text messaging, or website). Conclusions: Obstacles to uptake include security and privacy concerns and skepticism of technological capabilities. We present detailed findings and consolidate these into 7 recommendations for developers to optimize the efficacy of chatbot-based health support.