“WhatsApp me!” Conversational Interfaces as Digital Tools for Global Health – A Perspective on Design and Data in Portuguese-Speaking Countries Open Access
Bolina Kersanach, Maria (Spring 2024)
Abstract
Background: COVID-19 accelerated the digital transformation in the health sector worldwide. The widespread use of technology can widen or narrow the health equity gap within populations, depending on how interface design and data collection decisions are made. This study explores how conversational interfaces are being used as digital tools in healthcare and public health.
Objective: This study's objectives were to document how public health and healthcare professionals use instant messaging in health-related initiatives. The utilization of WhatsApp in the eight Portuguese-speaking countries illustrates different use cases and the reasons, challenges, and concerns surrounding the application of this popular instant messaging mobile app in global health initiatives.
Methods: We ran a self-administered online survey with 20 close-ended questions through convenience sampling. The questionnaire was answered by public health or healthcare professionals using WhatsApp as a work tool on projects, healthcare facilities, startups, or research in Portuguese-speaking countries.
Results: 89 respondents completed the survey over one month. This was the first study mapping the use of instant messaging in global health throughout Portuguese-speaking countries. This is also the first research to document the mixture of personal and professional life as a significant concern public health and healthcare professionals have (48%), being even more prevalent with professionals in clinical roles (63% of clinicians indicated this as their top three concerns, compared with 39% of non-clinicians). Another highlighted concern was the privacy and safety of patient data (38.4%), a well-documented issue in the literature. 71% of respondents reported that their initiative collects patient data, and from those, 28% do not implement any action towards the safety and security of patient data. In our sample, the most frequent applications of WhatsApp were field coordination (39.3%), patient communication (34.5%), and telemedicine (31%). The main reasons for using it were real-time engagement with users (57%) and low-cost implementation (51.2%).
Conclusion: The study suggests instant messaging mobile applications, like WhatsApp, as viable digital tools for public health and healthcare initiatives. By leveraging its conversational design and familiarity among users, WhatsApp tends to be easily adopted and can work as an effective support tool, particularly when high levels of user engagement are necessary.
Table of Contents
Chapter 1: Literature Review 1
Digital Transformation in the Health Sector 1
The Optimistic and Pessimistic Lenses to Digital Health 2
The Design Perspective 一 Choosing Technology with Equity in Mind 4
Conversational Interfaces as a Strategy for Technology Adoption 6
The Data Perspective – Who is Being Represented in Healthcare Data? 8
Chapter 2: Manuscript 11
Background 11
Objectives 14
Methods 14
Results 15
Sample 15
Motivations and Concerns Around WhatsApp Use 17
Measures on Data Security and Privacy 20
Profile of WhatsApp Use 20
Discussion 21
Comparison With the Literature 22
Approaching Instant Messaging as a Work Tool 23
Software Ownership Challenges 25
Limitations and Future Work 26
Conclusion 26
Acknowledgments 27
References 28
Appendix 1: Survey (English Translation) 33
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