Getting Ready for Adult Healthcare: Designing a Chatbot to Coach Adolescents with Special Health Needs Through the Transitions of Care

Objective: The AAP, AFP, and ACP have authored statements and recommendations to clinicians about the importance of the transition from pediatric to adult care. The Got Transition program provides a framework and resources based on AAP, AFP and ACP recommendations to promote skill attainment in self-care. Engaging adolescents along the transition journey has proven challenging. Use of smartphones, text messaging, and social media are prevalent among teenagers, offering a unique opportunity to engage teenagers in their preferred channel to provide tools and resources to help them successfully transition to adult focused care. Methods: A multidisciplinary team of clinicians, quality improvement facilitators, and human-centered designers at the University of Vermont (UVM) Children's Hospital designed tools for teens with chronic conditions that support the Got Transition recommendations. Using a co-creative design process, we created a novel tool to increase engagement among teenagers. We conducted a pilot study of 13 teenagers with a chronic medical condition using a text messaging platform (chatbot) with scripted interactions to increase engagement and deliver educational content according to Got Transition. Results: Mean engagement was 97% during the study period. Qualitative feedback from study participants suggests our chatbot should be extended and shows promise to help teenagers attain self-care skills on the transition journey. Conclusions: A scripted text messaging platform is feasible and appears to be well-received by patients and caregivers. Furthermore, our approach emphasizes the need to engage teenagers through multiple platforms to effectively serve as coaches during the transition to adult care. (c) 2019 Elsevier Inc. All rights reserved.