PT  - JOURNAL ARTICLE
AU  - El Ayadi, Alison M
AU  - Singh, Pushpendra
AU  - Duggal, Mona
AU  - Kumar, Vijay
AU  - Kaur, Jasmeet
AU  - Sharma, Preetika
AU  - Vosburg, Kathryn Bradford
AU  - Diamond-Smith, Nadia G
TI  - Feasibility and acceptability of Saheli, a WhatsApp Chatbot, on COVID-19 vaccination among pregnant and breastfeeding women in rural North India
AID  - 10.1136/bmjinnov-2022-001012
DP  - 2023 Oct 01
TA  - BMJ Innovations
PG  - 195--206
VI  - 9
IP  - 4
4099  - http://innovations.bmj.com/content/9/4/195.short
4100  - http://innovations.bmj.com/content/9/4/195.full
SO  - BMJ Innov2023 Oct 01; 9
AB  - Introduction Pregnant and breastfeeding women are priority targets for COVID-19 vaccination due to adverse maternal and fetal consequences of perinatal COVID-19 infection and the opportunity for protecting infants through maternal antibodies. Saheli (‘female friend’) is a WhatsApp-deployed chatbot providing evidence-based guidance on COVID-19 for pregnant and breastfeeding women.Objectives To understand the feasibility and acceptability of Saheli and its impact on COVID-19 vaccination.Methods We pilot-tested Saheli among pregnant and breastfeeding participants of pre-existing WhatsApp educational groups led by a community-based non-governmental organisation in Haryana, India from January to March 2022 using a pre/post design.Results 829 unique participants completed precommunity surveys or postcommunity surveys; 238 completed both. 829 individuals used Saheli, including 88% postintervention survey participants. Users reported Saheli was easy to engage with (79%), easy to understand (91%), quick (83%) and met their information needs (97%). 89% indicated it improved their COVID-19 knowledge a lot, 72% recommended it to others and 88% shared chatbot-derived information with others. Most participants received ≥1 COVID-19 vaccine (86% vs 88%, preintervention to postintervention); full vaccination was 55% and 61%, respectively. Vaccination over time increased marginally for ≥1 dose (OR 1.15, 95% CI 0.99 to 1.36) and significantly for 2 doses (OR 1.21, 95% CI 1.09 to 1.34), and increases were significant among pregnant (≥1 dose) and breastfeeding participants (2 doses). Vaccine hesitancy was low. Chatbot use was high, yet individual chatbot engagement did not alter COVID-19 vaccination.Conclusion Chatbots are a promising health education strategy due to high acceptability and deployment potential. Interpreting community chatbot impact must acknowledge the co-occurring constellation of multilevel interventions, community and pandemic factors.Data are available on reasonable request. The data that support the findings of the study are available from the authors on reasonable request.