Evaluating Chatbots for Diabetes Education

On June 24,  2022, JMIR Diabetes published a study by Stellenbosch University and Aviro Health that evaluated the implementation of a digital health intervention for diabetics to better manage their condition. This implementation, the GREAT4Diabetes WhatsApp chatbot, used WhatsApp messaging to educate and empower people with type 2 diabetes during the COVID-19 pandemic in Cape Town, South Africa.


Although Aviro Health has traditionally focused on improving health outcomes by providing digital platforms that compliment HIV self-testing, the pandemic quickly pushed us out of our comfort zone. The Aviro Pocket Clinic was built with dynamic back-end architecture to allow for easy customisation, and this allowed us to quickly transform our HIVST flow on WhatsApp into a diabetes flow, which provided patients with diabetes education and counselling in the safety of their own home.

“All the sessions was applicable to me, I gain more information at large on how to look and care about myself. I was negative about my diabetes, after going through with you all these sessions, I am positive about it and would like you to continue the excellent work, thanks a lot. Regards.” [Male, 52 years]

The newly minted diabetes intervention provided users with 16 voice messages and graphics, which focused on the self-management of type 2 diabetes during the pandemic, and it was evaluated to determine whether this type of intervention could be scaled-up. From May–October 2021, over 8,000 people connected with the intervention, 4,577 (56%) proceeded to listen to the messages, and 575 (13%) completed the entire intervention. More than 90% of the users who listened to each message found them useful, 71% said they changed their self-management and 88% were more confident with their management. Healthcare workers also saw benefits for  patients and recommended that the service continue, while all stakeholders also agreed that there was the potential to go to scale.

Sustainability, however, depends on a variety of factors, and additional research is required to further explore user experience and determine whether this type of intervention can create proven health outcomes. Aviro is already in the design phase of another digitally-assisted diabetes project in South Africa, which will allow us to refine the user experience and should lay the groundwork for the Aviro Pocket Clinic to capture the data required to show proven health outcomes in the future.

To understand more about how the REAT4DIABETES chatbot complemented traditional healthcare and supported patients with comprehensive education, read the full publication here: GREAT4Diabetes WhatsApp Chatbot

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