Research Appraisalqualitative

Coconstructing CHAMP, an Artificial Intelligence Chatbot for Pediatric Infectious Symptoms Management: Protocol for a Multiphase Participatory Study

JMIR research protocolsLin, Jia, Jaiswal, Nikhil, Ma, Yuanchao et al.26 May 2026DOI

Clinical Snapshot

80CEBM
Evidence: Moderatequalitative

PICO Framework

P — PopulationYouth aged 14-17 years and parents/caregivers of children aged 0-17 years presenting with acute pediatric infectious symptoms
I — InterventionParticipatory co-construction of CHAMP chatbot through multiphase mixed-methods approach including focus groups, workshops, and collaborative ethnography
C — ComparatorNot applicable - protocol study without comparison group
O — OutcomesDevelopment of functioning CHAMP prototype, assessment of informational needs, usability and acceptability measures, equity and accessibility evaluation

Bottom Line

This protocol describes a methodologically sound participatory approach to developing a pediatric health chatbot for infectious symptom management. The multiphase co-construction methodology with families as co-researchers represents best practice in health technology development. While the protocol demonstrates strong ethical oversight and equity considerations, key methodological details around recruitment, sampling, and analysis require further specification. The research addresses a genuine clinical need - pediatric ED overcrowding due to low-acuity infectious presentations. For Australian clinicians, this approach could inform similar digital health initiatives, though adaptation to local clinical guidelines and regulatory frameworks would be essential. The emphasis on equity and multilingual accessibility is particularly relevant for diverse healthcare settings. Success will ultimately depend on clinical validation and real-world implementation effectiveness.

Evidence: Moderate

Key Findings

  • P Value: Not applicable - protocol study

  • Effect Size: Not applicable - protocol study

  • Primary Outcome: Development of functioning CHAMP chatbot prototype through participatory co-construction

  • Nnt Or Sensitivity: Not applicable - protocol study, though aims to reduce preventable ED visits

  • Confidence Interval: Not applicable - protocol study

Clinical Application

High feasibility given digital health adoption trends, though dependent on successful user engagement and clinical validation Highly relevant to Australian healthcare - similar pediatric ED pressures exist, aligns with digital health initiatives, though would require adaptation to Australian clinical guidelines and TGA digital therapeutics framework Families with children 0-17 years experiencing acute infectious symptoms in community settings

Abstract

BACKGROUND: Acute infectious symptoms are a leading cause of pediatric emergency department visits in Canada, many of which are low acuity and could be safely managed at home. Artificial intelligence (AI) chatbots offer a promising avenue for delivering accessible, evidence-based guidance to support families in managing these symptoms. OBJECTIVE: This study aims to adapt and coconstruct CHAMP (CHatbot to Assist the Management of Pediatric patients), an AI chatbot to support patients and families with acute pediatric infectious symptoms. CHAMP aims to deliver timely, tailored, and validated health information to support safe at-home self-management and informed care-seeking. METHODS: This multiphase, mixed methods participatory study will be conducted at the Montreal Children's Hospital in Montreal, Quebec, Canada. A coconstruction committee comprised of youth, parents, caregivers, and partners will be engaged as coresearchers. Eligible participants will include (1) youth aged 14-17 years and (2) parents and caregivers of children aged 0-17 years. The study comprises 5 phases. Phase 1 involves a qualitative needs assessment using focus groups with 20 participants to explore their informational needs, preferences, and concerns regarding pediatric infections and the use of AI chatbots. Phase 2 focuses on coconstructing and validating CHAMP's knowledge database through 3-5 workshops. Coresearchers will review pediatric clinical guidelines, map care questions and decision-making processes, and shape CHAMP's conversational framework. Phase 3 consists of iterative prototyping and testing through 3-5 workshops. Coresearchers will engage in prototyping and scenario testing, alongside preliminary usability and acceptability assessments. Phase 4 examines equity and accessibility through focus groups with 20 participants at risk of digital exclusion, as well as multilingual evaluation of an automated large language model-based translation layer. Phase 5 uses collaborative ethnography to explore the process of participatory coconstruction and its impact on CHAMP's design. RESULTS: Funding was secured in 2024, and Research Ethics Board approval was obtained in December 2024. As of December 2025, the coconstruction committee is being assembled, and Phase 1 recruitment is underway. CONCLUSIONS: This study will produce a functioning CHAMP prototype grounded in participatory, equitable, and responsible pediatric AI development. Findings will inform usability testing and an implementation-effectiveness evaluation, contributing to best practices for pediatric-centered AI health tools. By providing timely, tailored, and validated health information on acute infections, CHAMP may support safe at-home self-management, reduce preventable emergency department visits, ensure at-risk children are directed to appropriate care, and improve patient and family health care experiences.

References

  1. 1.Lin, J., Jaiswal, N., Ma, Y., Lebouché, B., Villanueva, S., Achiche, S., Lessard, D., Engler, K., Berthelot, S., Buckeridge, D., Celi, L. A., Gagnon, I., Gravel, J., Plotnick, L. H., Poenaru, D., Pomey, M.-P., Vang, Z. M., & Osmanlliu, E. (2026). Coconstructing CHAMP, an artificial intelligence chatbot for pediatric infectious symptoms management: Protocol for a multiphase participatory study. *JMIR Research Protocols*, Article 89852. https://doi.org/10.2196/89852
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