The gamification and development of a chatbot to promote oral self-care by adopting behavior change wheel for Taiwanese children.

Background: Oral health is closely related to general health and quality of life. School-aged children are at a critical stage for developing their self-care ability in oral health. Digital interventions can encourage and facilitate oral self-care in children.

Objective: This study aims to present the development of an educational chatbot for school-aged children to address their oral self-care and evaluate its usability.

Methods: The development and evaluation of the chatbot for oral self-care consisted of four stages: target behavior analysis, intervention design, system development, and the chatbot evaluation. The target behavior analysis identified barriers to children's engagement in oral self-care based on dentists' clinical observations; hence, the requirements for achieving the desired behavior were categorized according to the capability-opportunity-motivation behavior model. Interventional functions were created following the behavior change wheel. A menu-driven chatbot was created and evaluated for usability as well as likeability.

Results: The barriers and requirements for achieving good behavior in school-aged children's oral self-care were identified by the dental professionals. Intervention strategy incorporated specific functions enriched with gamification features to support school-aged children in developing their abilities for engaging in oral self-care. The intervention functions consist of capability establishment, motivation enhancement, and opportunity creation, which were designed to support children in their oral self-care practices. The designed chatbot was piloted with a convenient sample of 30 school-aged children and their accompanying parents at the pediatric dental clinic. The results indicated good usability, with a mean usability score of 79.91, and high likeability with a mean score of 4.32 out of 5 for the designed chatbot.

Conclusions: The educational chatbot incorporated a combination of clinical dentistry practice and guidelines, aiming to promote oral self-care behavior in school-aged children. The designed chatbot achieved high scores for its usability and user likability.