SAFE.AI: Developing and Testing an AI-based Hybrid Chatbot for Financial Empowerment in Rural Cancer Care
University of Utah
Summary
This is a randomized, two-arm, parallel-group pilot trial investigating a new chatbot tool designed to support cancer patients and caregivers, particularly those in rural communities. Approximately 60 participants will be randomized 1:1 to interact with either a hybrid chatbot or an AI-enabled chatbot. Participants will use their assigned chatbot to obtain clear and helpful information related to insurance, travel costs, and other financial aspects of cancer care.
Description
Costs of cancer care will approach $246 billion by 2030, making cancer one of the most expensive health conditions for individuals. Cancer-related financial hardships negatively impacts psychological wellbeing, health-related quality of life, medication adherence, and decisions to delay or forgo care. Rural cancer patients and families have a higher prevalence of financial hardships, incur greater travel-related expenses, face unique employment and income stressors, and have lower access to specialized cancer care services and providers-- including those that support financial needs. Few fina…
Eligibility
- Age range
- 18+ years
- Sex
- All
- Healthy volunteers
- No
Inclusion Criteria: * Adults (18 years and older) * Cancer patients or financially responsible caregivers of cancer patients who: * Reside in the Huntsman Cancer Institute's five-state catchment area (Utah, Idaho, Wyoming, Montana, and Nevada), * Are able to read and write in English, and * Live in a rural area, defined by endorsement of a residential ZIP code classified as non-metropolitan (RUCA codes 4-10) per the USDA Rural-Urban Commuting Area Codes. Exclusion Criteria: * Respondents who do not live within this 5-state region--The SAFE toolkit material was developed for the Huntsman Can…
Interventions
- OtherRule-Based Chatbot
The rule-based (scripted) SAFE.ai chatbot is a guided conversational tool built to provide structured, accurate, and consistent information to rural cancer patients and caregivers experiencing cancer-related financial toxicity. This chatbot is grounded in the Self-Advocacy for Financial Empowerment (SAFE) resource toolkit, which was co-developed with a community advisory board (CAB) composed of rural patients, caregivers, nurses, and financial navigation experts across HCI's five-state catchment area. All scripted responses reflect priorities identified during qualitative needs assessment sessions, ensuring that content is culturally aligned with rural patient experiences and real-world financial challenges. The chatbot follows a rule-based decision tree. Users progress through the conversation by selecting a response from a set of fixed options displayed on-screen. This ensures that all content is clinically vetted, safe, consistent, and aligned with evidence-based practices.
- OtherHybrid Chatbot
The hybrid SAFE.ai chatbot builds on the existing rule-based system by integrating a large language model (LLM) layer to support more flexible, open-ended, and conversational interactions. While the rule-based chatbot provides structured conversations through predefined content, the hybrid approach allows users to ask complex or personalized questions about financial toxicity. To ensure safety and accuracy, the hybrid chatbot is not allowed to generate responses from the open internet. By combining the consistency of rule-based logic with the adaptability of an LLM, the hybrid chatbot will enable users to ask follow-up questions, describe nuanced financial situations, request clarification in their own words, and receive more tailored guidance while still ensuring adherence to SAFE content.
Location
- Huntsman Cancer Institute/ University of UtahSalt Lake City, Utah