Background Artificial intelligence–driven chatbots are increasingly being used in health care, but few chat-based instant messaging support health education programs are designed for patients with chronic kidney disease (CKD) to evaluate their effectiveness. In addition, limited research exists on the usage of chat-based programs among patients with CKD, particularly those that integrate a chatbot aimed at enhancing the communication ability and disease-specific knowledge of patients. Objective The objective of this formative study is to gather the data necessary to develop an intervention program of chat-based instant messaging support health education for patients with CKD. Participants’ user experiences will form the basis for program design improvements. Methods Data were collected from April to November 2020 using a structured questionnaire. A pre-post design was used, and a total of 60 patients consented to join the 3-month program. Among them, 55 successfully completed the study measurements. The System Usability Scale was used for participant evaluations of the usability of the chat-based program. Results Paired t tests revealed significant differences before and after intervention for communicative literacy (t54=3.99; P<.001) and CKD-specific disease knowledge (t54=7.54; P<.001). Within disease knowledge, significant differences were observed in the aspects of CKD basic knowledge (t54=3.46; P=.001), lifestyle (t54=3.83; P=.001), dietary intake (t54=5.51; P<.001), and medication (t54=4.17; P=.001). However, no significant difference was found in the aspect of disease prevention. Subgroup analysis revealed that while the findings among male participants were similar to those of the main sample, this was not the case among female participants. Conclusions The findings reveal that a chat-based instant messaging support health education program may be effective for middle-aged and older patients with CKD. The use of a chat-based program with multiple promoting approaches is promising, and users’ evaluation is satisfactory. Trial Registration ClinicalTrials.gov NCT05665517; https://clinicaltrials.gov/study/NCT05665517

BACKGROUND Artificial intelligence-driven chatbots are increasingly being used in health care, but few chat-based instant messaging support health education programs are designed for patients with chronic kidney disease (CKD) and evaluate its effectiveness and gender differences. Furthermore, there is little research documenting how CKD patients use the chat-based program that combining a chatbot with push notifications and feedback awards for improving patients’ communicative literacy and disease-specific knowledge. OBJECTIVE To assess the effectiveness and identify gender differences using a chat-based instant messaging support health education program among patients with chronic kidney disease and the usability of the program for CKD patients was also assessed. METHODS A pre-and post-study design was employed, and 60 patients were invited to join a three-month program for chronic kidney disease health education; 55 successfully completed the intervention. Data were collected from April to November 2020 using a structured questionnaire. Paired t-tests and generalized equation estimation were used to examine the intervention effectiveness and users’ evaluation. System Usability Scale provide the patients’ evaluation regarding the usability of the chat-based program. RESULTS Paired t-tests revealed significant differences before and after intervention on communicative literacy (t=3.99, p<0.001) and CKD-specific disease knowledge (t=7.54, p<0.001). Within disease knowledge, CKD basic knowledge (t=3.46, p=0.001), lifestyle (t=3.83, p=0.001), dietary intake (t=5.51, p<0.001), and medication (t=4.17, p=0.001) were significant; prevention was not. The results of male participants were identical to those of all others; results of female participants were similar to those of all others, except for lifestyle. Participants’ evaluation improves with usage time, even approaching “excellent” on the System Usability Scale. CONCLUSIONS The findings reveal that a chat-based instant messaging support health education program may be effective for middle-aged and older patients with CKD, showing similar intervention effectiveness between male and female patients, except for disease knowledge regarding prevention. The use of a chat-based program with multiple promoting approaches targeting middle-aged and older patients with CKD is promising, and users’ evaluation is satisfactory. CLINICALTRIAL The study was posted on www.clinicaltrials.gov (NCT05665517) on 23/12/2022.