Impact of an artificial intelligence automated chatbot-driven educational-counselling intervention on childbearing attitudes and motivations among childless married women: study protocol for a parallel randomised controlled trial

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INTRODUCTION: Understanding population dynamics is essential for achieving the Sustainable Development Goals. Global population growth has slowed, and Iran has experienced a marked fertility decline. Given the decline in fertility rates and shifts in women's attitudes and motivations regarding childbearing, this study aims to explore whether an artificial intelligence (AI)-based chatbot can improve attitudes and increase positive motivation towards childbearing among married women of reproductive age. METHODS AND ANALYSIS: This parallel randomised controlled trial will be conducted on 80 childless married women who need fertility counselling according to national guidelines. Participants will be randomly allocated using permuted-block randomisation (four blocks) to either an intervention or control arm. The intervention consists of a systematic educational and counselling programme delivered via an AI-powered chatbot across 4 weekly sessions. The control arm will receive standard in-person childbearing counselling per national guidelines. Primary outcomes are attitudes and motivation towards fertility and childbearing, measured by validated questionnaires at baseline and 1-month postintervention. Analysis will use analysis of covariance (ANCOVA) with group as a fixed factor and baseline scores as covariates; effect size will be reported as mean difference with 95% CIs. ETHICS AND DISSEMINATION: The Ethics Committee of Babol University of Medical Sciences (IR.MUBABOL.HRI.REC.1404.172). The study findings will be disseminated through publication in peer-reviewed journals and presentation at scientific conferences. TRIAL REGISTRATION NUMBER: IRCT20221109056451N7.

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