Supplementary Material for: Views on a Chatbot for Cancer Family History Collection Among Leaders of Hispanic and Pacific Islander Communities in Utah

Introduction Individuals from historically marginalized communities have less access to genetic testing services. Incomplete family history information in electronic health records contributes to under-identification of those eligible for genetic testing of hereditary cancer genes. Digital health tools can aid in collecting family history information, but there is a lack of information about how to integrate these tools in ways that are effective for different communities. This study investigated experiences with family history collection as well as acceptability and approaches for cultural adaptation of a chatbot for family history collection. Methods Seven community engagement studios were conducted with community leaders (N=48) representing historically marginalized communities, specifically Hispanic and Pacific Islander. The studios were conducted by trained facilitators in English (n=4) or Spanish (n=3) with 5—8 participants per studio. Transcripts of recorded studios were analyzed using inductive thematic analysis. Results Two domains, each with underlying themes, were identified: (1) previous family history collection experience and (2) chatbot impressions and feedback. Community leaders saw value in using a chatbot for family history collection and also expressed the importance of addressing accessibility of the tool. They emphasized interpersonal interactions together with the use of digital health tools and the importance of trusting relationships with healthcare professionals regardless of chatbot integration. Conclusion Community leaders highlighted specific strengths and limitations of the chatbot. The importance of human connection with healthcare professionals to build trusting relationships was emphasized. Successful integration of this tool into historically marginalized communities will require ongoing conversations and investment in communities.