A Not So Chatty “Chatbot”: Co-designing to support First-Time Parents in South Africa and Portugal
Authors: 
Leina Meoli, 
Francisco Nunes, Beatriz Félix, Joana Couto da Silva, Xolani Ntinga, 
Melissa DensmoreAuthors Info & Claims
Leina Meoli, Francisco Nunes, Beatriz Félix, Joana Couto da Silva, Xolani Ntinga, Melissa DensmoreAuthors Info & ClaimsArticle No.: 30, Pages 1 - 8
Abstract
Innovations in chatbot technology have greatly accelerated in recent years, yet challenges persist in implementing them effectively for healthcare in diverse socio-economic contexts, especially in the global south. We engaged in two sets of co-design workshops that gave insight into the preferences of parents regarding chatbot design modalities but also uncovered constraints for our design including working with low-resource languages and limited internet connectivity. Though we set out for a chatbot to support first-time parents, our co-design in Portugal and South Africa resulted in the development of a "not-so-chatty" chatbot. Our intervention, ParentCoach App, is a question-and-answer informational resource presented in a chat-like user interface with search and menus for content exploration. We discuss the challenges of designing and implementing chatbots across different geographic and socio-economic contexts, presenting our resulting intervention and the preliminary findings from a two-week feasibility pilot with first-time parents in the two countries.
References
[1]
Alaa Ali Abd-Alrazaq, Asma Rababeh, Mohannad Alajlani, Bridgette M. Bewick, and Mowafa Househ. 2020. Effectiveness and Safety of Using Chatbots to Improve Mental Health: Systematic Review and Meta-Analysis. Journal of medical Internet research 22, 7 (2020), e16021–e16021. https://doi.org/10.2196/16021
[2]
Eleni Adamopoulou and Lefteris Moussiades. 2020. An Overview of Chatbot Technology. In Artificial Intelligence Applications and Innovations(IFIP Advances in Information and Communication Technology), Ilias Maglogiannis, Lazaros Iliadis, and Elias Pimenidis (Eds.). Springer International Publishing, Cham, 373–383. https://doi.org/10.1007/978-3-030-49186-4_31
[3]
Jessica Bartlett, Lina Guzman, and Maria Ramos-Olazagasti. 2018. Parenting Knowledge among First-time Parents of Young Children: A Research-to-Practice Brief. https://cms.childtrends.org/wp-content/uploads/2018/07/ParentingKnowledge_ChildTrends_July2018.pdf
[4]
Heather Breiner, Morgan Ford, and Vivian L. Gadsden (Eds.). 2016. Parenting Matters: Supporting Parents of Children Ages 0-8. National Academies Press (US), Washington (DC). http://www.ncbi.nlm.nih.gov/books/NBK402024/
[5]
David Byrne. 2022. A worked example of Braun and Clarke’s approach to reflexive thematic analysis. Quality & Quantity 56, 3 (June 2022), 1391–1412. https://doi.org/10.1007/s11135-021-01182-y
[6]
Xinyuan Chang. 2023. The Analysis of Open Source Search Engines. Highlights in Science, Engineering and Technology 32 (Feb. 2023), 32–42. https://doi.org/10.54097/hset.v32i.4933
[7]
Toshka Coleman, Sarina Till, Jaydon Farao, Londiwe Shandu, Nonkululeko Khuzwayo, Livhuwani Muthelo, Masenyani Mbombi, Mamare Bopape, Alastair van Heerden, Tebogo Mothiba, Shane Norris, Nervo Verdezoto, and Melissa Densmore. 2023. Reconsidering Priorities for Digital Maternal and Child Health: Community-centered Perspectives from South Africa. Proc. ACM Hum.-Comput. Interact. 7, CSCW2, Article 290 (oct 2023), 31 pages. https://doi.org/10.1145/3610081
[8]
Guido A Entenberg, Sophie Mizrahi, Hilary Walker, Shirin Aghakhani, Karin Mostovoy, Nicole Carre, Zendrea Marshall, Gilly Dosovitsky, Daniellee Benfica, Alexandra Rousseau, 2023. AI-based chatbot micro-intervention for parents: Meaningful engagement, learning, and efficacy. Frontiers in Psychiatry 14 (2023), 1080770.
[9]
Joel E Fischer. 2023. Generative AI Considered Harmful. In Proceedings of the 5th International Conference on Conversational User Interfaces (, Eindhoven, Netherlands,) (CUI ’23). Association for Computing Machinery, New York, NY, USA, Article 7, 5 pages. https://doi.org/10.1145/3571884.3603756
[10]
Gabriel Lino Garcia, Pedro Henrique Paiola, Luis Henrique Morelli, Giovani Candido, Arnaldo Cândido Júnior, Danilo Samuel Jodas, Luis C. S. Afonso, Ivan Rizzo Guilherme, Bruno Elias Penteado, and João Paulo Papa. 2024. Introducing Bode: A Fine-Tuned Large Language Model for Portuguese Prompt-Based Task. arxiv:2401.02909 [cs.CL]
[11]
Jonathan Grudin and Richard Jacques. 2019. Chatbots, Humbots, and the Quest for Artificial General Intelligence. In Proceedings of the 2019 CHI Conference on Human Factors in Computing Systems(CHI ’19). Association for Computing Machinery, New York, NY, USA, 1–11. https://doi.org/10.1145/3290605.3300439
[12]
Lauren P. Hunter, Jacqueline D. Rychnovsky, and Susan M. Yount. 2009. A Selective Review of Maternal Sleep Characteristics in the Postpartum Period. Journal of Obstetric, Gynecologic & Neonatal Nursing 38, 1 (Jan. 2009), 60–68. https://doi.org/10.1111/j.1552-6909.2008.00309.x
[13]
Jamie Lachman, Paula Zinser, Seema Vyas, Inge Vallance, Francisco Calderon, Frances Gardner, Laurie Markle, David Stern, Chiara Facciolà, Hlengiwe Sacolo-Gwebu, Anne Schley, Kanyisile Brukwe, G. J. Melendez-Torres, Maria da Graca Ambrosio, Nompumelelo Danisa, and Kimberly Rimber. 2023. ParentText Optimisation Study - A factorial randomised controlled trial to optimise user engagement in a chatbot-led parenting intervention in South Africa: Study protocol for the ParentText Optimisation Trial. https://doi.org/10.17605/OSF.IO/WFXNE Publisher: OSF.
[14]
Stuart Mesham, Luc Hayward, Jared Shapiro, and Jan Buys. 2021. Low-Resource Language Modelling of South African Languages. http://arxiv.org/abs/2104.00772 arXiv:2104.00772 [cs].
[15]
Federico Milana, Enrico Costanza, and Joel E Fischer. 2023. Chatbots as Advisers: the Effects of Response Variability and Reply Suggestion Buttons. In Proceedings of the 5th International Conference on Conversational User Interfaces(CUI ’23). Association for Computing Machinery, New York, NY, USA, 1–10. https://doi.org/10.1145/3571884.3597132
[16]
Amit Mishra. 2019. Chatbot in isiXhosa for Remote Pre/post-Natal Care. preprint. engrXiv. https://doi.org/10.31224/osf.io/jm54z
[17]
Kevin Mugoye, Henry Okoyo, and Sylvester Mcoyowo. 2019. Smart-bot Technology: Conversational Agents Role in Maternal Healthcare Support. In 2019 IST-Africa Week Conference (IST-Africa) (Nairobi, Kenya). IEEE, New York, New York, 1–7. https://doi.org/10.23919/ISTAFRICA.2019.8764817
[18]
S. Nithuna and C.A. Laseena. 2020. Review on Implementation Techniques of Chatbot. In 2020 International Conference on Communication and Signal Processing (ICCSP) (Chennai, India). IEEE, New York, New York, 0157–0161. https://doi.org/10.1109/ICCSP48568.2020.9182168
[19]
Vanessa M. Patrick and Candice R. Hollenbeck. 2021. Designing for All: Consumer Response to Inclusive Design. Journal of Consumer Psychology 31, 2 (2021), 360–381. https://doi.org/10.1002/jcpy.1225 _eprint: https://onlinelibrary.wiley.com/doi/pdf/10.1002/jcpy.1225.
[20]
Amreesh Phokeer, Melissa Densmore, David Johnson, and Nick Feamster. 2016. A First Look at Mobile Internet Use in Township Communities in South Africa. In Proceedings of the 7th Annual Symposium on Computing for Development (Nairobi, Kenya) (ACM DEV ’16). Association for Computing Machinery, New York, NY, USA, Article 15, 10 pages. https://doi.org/10.1145/3001913.3001926
[21]
Amon Rapp, Lorenzo Curti, and Arianna Boldi. 2021. The human side of human-chatbot interaction: A systematic literature review of ten years of research on text-based chatbots. International Journal of Human-Computer Studies 151 (July 2021), 102630. https://doi.org/10.1016/j.ijhcs.2021.102630
[22]
Raquel Silveira, Cláudia Pernencar, Fábio de Sousa, Kamila Gomes, Deivith Oliveira, Inga Saboia, Cristiane Mourão, Odorico Monteiro, and Ivana Barreto. 2023. GISSA intelligent chatbot experience – How effective was the interaction between pregnant women and a chatbot during the COVID-19 pandemic?Procedia Computer Science 219 (2023), 1271–1278. https://doi.org/10.1016/j.procs.2023.01.411
[23]
Sarina Till, Jaydon Farao, Toshka Lauren Coleman, Londiwe Deborah Shandu, Nonkululeko Khuzwayo, Livhuwani Muthelo, Masenyani Oupa Mbombi, Mamare Bopane, Molebogeng Motlhatlhedi, Gugulethu Mabena, Alastair Van Heerden, Tebogo Maria Mothiba, Shane Norris, Nervo Verdezoto Dias, and Melissa Densmore. 2022. Community-based Co-design across Geographic Locations and Cultures: Methodological Lessons from Co-design Workshops in South Africa. In Proceedings of the Participatory Design Conference 2022 - Volume 1(PDC ’22). Association for Computing Machinery, New York, NY, USA, 120–132. https://doi.org/10.1145/3536169.3537786
[24]
Pulani Tlebere, Debra Jackson, Marian Loveday, Lyness Matizirofa, Nomafrench Mbombo, Tanya Doherty, Alyssa Wigton, Latasha Treger, and Mickey Chopra. 2007. Community-Based Situation Analysis of Maternal and Neonatal Care in South Africa to Explore Factors that Impact Utilization of Maternal Health Services. Journal of Midwifery & Women’s Health 52, 4 (July 2007), 342–350. https://doi.org/10.1016/j.jmwh.2007.03.016
[25]
Kentaro Toyama. 2011. Technology as amplifier in international development. In Proceedings of the 2011 iConference. ACM, Seattle Washington USA, 75–82. https://doi.org/10.1145/1940761.1940772
[26]
Victor Volovici, Nicholas L. Syn, Ari Ercole, Joseph J. Zhao, and Nan Liu. 2022. Steps to avoid overuse and misuse of machine learning in clinical research. Nature Medicine 28, 10 (Oct. 2022), 1996–1999. https://doi.org/10.1038/s41591-022-01961-6 Publisher: Nature Publishing Group.
[27]
Jenny Waycott, Greg Wadley, Stefan Schutt, Arthur Stabolidis, and Reeva Lederman. 2015. The Challenge of Technology Research in Sensitive Settings: Case Studies in ’Sensitive HCI’. In Proceedings of the Annual Meeting of the Australian Special Interest Group for Computer Human Interaction(OzCHI ’15). Association for Computing Machinery, New York, NY, USA, 240–249. https://doi.org/10.1145/2838739.2838773
[28]
Rui Yang, Ting Fang Tan, Wei Lu, Arun James Thirunavukarasu, Daniel Shu Wei Ting, and Nan Liu. 2023. Large language models in health care: Development, applications, and challenges. Health Care Science 2, 4 (2023), 255–263. https://doi.org/10.1002/hcs2.61 _eprint: https://onlinelibrary.wiley.com/doi/pdf/10.1002/hcs2.61.
[29]
Andrew Zupon, Evan Crew, and Sandy Ritchie. 2021. Text normalization for low-resource languages of Africa.
Index Terms
- A Not So Chatty “Chatbot”: Co-designing to support First-Time Parents in South Africa and Portugal
Recommendations
Reconsidering Priorities for Digital Maternal and Child Health: Community-centered Perspectives from South Africa
CSCWEspecially in developing regions, parents are rarely given a direct voice in the design of digital maternal and child health (MCH) interventions. Instead, MCH needs and requirements are driven by organizations and health workers. In this research, we ...
Children with ADHD and their Care Ecosystem: Designing Beyond Symptoms
CHI '23: Proceedings of the 2023 CHI Conference on Human Factors in Computing SystemsDesigning for children with ADHD has been of increasing interest to the HCI community. However, current approaches do not adequately involve all relevant stakeholders, and primarily focus on addressing symptoms, following a medical model of disability ...
PDC Place Malaysia: Emerging Spaces for ICT4D and PD Communities
PDC '22: Proceedings of the Participatory Design Conference 2022 - Volume 2Participatory Design (PD) has a focus on enabling communities to take charge of shaping their own future and as such is a relevant approach for ICT4development (ICT4D), which has been strongly rooted in Sarawak, Malaysia. Therefore, we are organising a ...
Comments
Information & Contributors
Information
Published In
July 2024
616 pages
ISBN:9798400705113
DOI:10.1145/3640794
Copyright © 2024 Owner/Author.
Permission to make digital or hard copies of part or all of this work for personal or classroom use is granted without fee provided that copies are not made or distributed for profit or commercial advantage and that copies bear this notice and the full citation on the first page. Copyrights for third-party components of this work must be honored. For all other uses, contact the Owner/Author.
Sponsors
Publisher
Association for Computing Machinery
New York, NY, United States
Publication History
Published: 08 July 2024
Check for updates
Badges
Honorable Mention Short Paper
Author Tags
Qualifiers
- Work in progress
- Research
- Refereed limited
Funding Sources
- Aga Khan Development Network
- Fundação para a Ciência e Tecnologia
Conference
CUI '24
Sponsor:
Acceptance Rates
Overall Acceptance Rate 34 of 100 submissions, 34%
Contributors
Other Metrics
Bibliometrics & Citations
Bibliometrics
Article Metrics
- 0Total Citations
- 89Total Downloads
- Downloads (Last 12 months)89
- Downloads (Last 6 weeks)11
Reflects downloads up to 01 Nov 2024
Other Metrics
Citations
View Options
Get Access
Login options
Check if you have access through your login credentials or your institution to get full access on this article.
Sign inFull Access
View options
View or Download as a PDF file.
PDFeReader
View online with eReader.
eReaderHTML Format
View this article in HTML Format.
HTML Format