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

J Pediatr Nurs. 2019 Nov-Dec:49:85-91. doi: 10.1016/j.pedn.2019.09.004. Epub 2019 Oct 20.


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.

Keywords: Healthcare transition; Pilot study; Quality improvement; Text messaging.

MeSH terms

  • Adolescent
  • Adult
  • Cell Phone / statistics & numerical data
  • Chronic Disease / rehabilitation
  • Disability Evaluation*
  • Disabled Children / rehabilitation*
  • Feasibility Studies
  • Female
  • Hospitals, Pediatric
  • Hospitals, University
  • Humans
  • Male
  • Mentoring / methods
  • Patient Education as Topic / methods*
  • Program Development
  • Program Evaluation
  • Quality Improvement
  • Text Messaging / instrumentation*
  • Transition to Adult Care / organization & administration*
  • Vermont
  • Young Adult