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Background: There is an urgent need to innovate methods of health education, which can often be resource- and time-intensive. Microinterventions have shown promise as a platform for rapid, tailored resource dissemination yet have been underexplored as a method of standardized health or dietary education; social media chatbots display unique potential as a modality for accessible, efficient, and affordable educational microinterventions., Objective: This study aims to provide public health professionals with practical recommendations on the use of social media chatbots for health education by (1) documenting the development of a novel social media chatbot intervention aimed at improving dietary attitudes and self-efficacy among South Asian American young adults and (2) describing the applied experiences of implementing the chatbot, along with user experience and engagement data., Methods: In 2023, the "Roti" chatbot was developed on Facebook and Instagram to administer a 4-lesson tailored dietary health curriculum, informed by formative research and the Theory of Planned Behavior, to 18- to 29-year-old South Asian American participants (recruited through social media from across the United States). Each lesson (10-15 minutes) consisted of 40-50 prescripted interactive texts with the chatbot (including multiple-choice and open-response questions). A preintervention survey determined which lesson(s) were suggested to participants based on their unique needs, followed by a postintervention survey informed by the Theory of Planned Behavior to assess changes in attitudes, self-efficacy, and user experiences (User Experience Questionnaire). This study uses a cross-sectional design to examine postintervention user experiences, engagement, challenges encountered, and solutions developed during the chatbot implementation., Results: Data from 168 participants of the intervention (n=92, 54.8% Facebook; n=76, 45.2% Instagram) were analyzed (mean age 24.5, SD 3.1 years; n=129, 76.8% female). Participants completed an average of 2.6 lessons (13.9 minutes per lesson) and answered an average of 75% of questions asked by the chatbot. Most reported a positive chatbot experience (User Experience Questionnaire: 1.34; 81/116, 69.8% positive), with pragmatic quality (ease of use) being higher than hedonic quality (how interesting it felt; 88/116, 75.9% vs 64/116, 55.2% positive evaluation); younger participants reported greater hedonic quality (P=.04). On a scale out of 10 (highest agreement), participants reported that the chatbot was relevant (8.53), that they learned something new (8.24), and that the chatbot was helpful (8.28). Qualitative data revealed an appreciation for the cheerful, interactive messaging of the chatbot and outlined areas of improvement for the length, timing, and scope of text content. Quick replies, checkpoints, online forums, and self-administered troubleshooting were some solutions developed to meet the challenges experienced., Conclusions: The implementation of a standardized, tailored health education curriculum through an interactive social media chatbot displayed strong feasibility. Lessons learned from challenges encountered and user input provide a tangible roadmap for future exploration of such chatbots for accessible, engaging health interventions., (©Shahmir H Ali, Fardin Rahman, Aakanksha Kuwar, Twesha Khanna, Anika Nayak, Priyanshi Sharma, Sarika Dasraj, Sian Auer, Rejowana Rouf, Tanvi Patel, Biswadeep Dhar. Originally published in JMIR Formative Research (https://formative.jmir.org), 09.12.2024.)

Foreign-born (first-generation) South Asians face a growing diet-related chronic disease burden. Little is known about whether the adult US-born (second-generation) children of South Asian immigrants can provide unique insights as changemakers in their parents' dietary behaviors. This study aims to assess how second-generation South Asians describe and influence the dietary behaviors of their parents. Between October and November 2020, 32 second-generation South Asians [mean age 22.4 (SD 2.9), 53% female] participated in online interviews centered around factors involved in their (and their parents) eating behaviors. Thematic analysis revealed three types of parental dietary drivers (socioecological factors that impact the dietary choices of parents): goal-oriented (i.e., parents' dietary intentionality), capacity-related (e.g., environmental barriers) and sociocultural (cultural familiarity, religion and traditions). Participants described three major mechanisms of influence: recommending new foods, cooking for parents, and bringing new foods home. These influences primarily occurred in the household and often involved participants leveraging their own nutritional knowledge and preferences to expand dietary diversity and healthier behaviors among their parents. Evidence suggests that second-generation South Asians may act as powerful agents of dietary change within their households and can provide novel insights to help address and overcome sociocultural, linguistic, and other structural barriers to better understanding and intervening in the health of the South Asian community., (© The Author(s) 2023. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

The dietary behaviors of Asian American (AA) young adults, who face a growing non-communicable disease burden, are impacted by complex socio-ecological forces. Family plays a crucial role in the lifestyle behaviors of AA young adults; however, little is known on the methods, contributors, and impact of familial dietary influence. This study aims to deconstruct the mechanisms of AA young adult familial dietary influence through a multi-perspective qualitative assessment. A five-phase method of dyadic analysis adapted from past research was employed to extract nuanced insights from dyadic interviews with AA young adults and family members, and ground findings in behavioral theory (the Social Cognitive Theory, SCT). 37 interviews were conducted: 18 young adults, comprising 10 different AA ethnic subgroups, and 19 family members (10 parents, 9 siblings). Participants described dietary influences that were both active (facilitating, shaping, and restricting) and passive (e.g., sharing foods or environment, mirroring food behaviors). Influences connected strongly with multiple SCT constructs (e.g., behavioral capacity, reinforcements for active influences, and expectations, observational learning for passive influences). Familial influence contributed to changes in the total amount, variety, and healthfulness of foods consumed. Intra-family dynamics were crucial; family members often leveraged each other's persuasiveness or food skills to collaboratively influence diet. AA family-based interventions should consider incorporating both passive and active forms of dietary influence within a family unit, involve multiple family members, and allow for individualization to the unique dynamics and dietary behaviors within each family unit.

This study explores a novel, mixed qualitative method to deconstruct the diet of second-generation South Asian Americans (SAAs). Online interviews of 32 second-generation SAAs were conducted usingintegrated free-listing and mind-mapping. Ranked free-lists were aggregated to identify salient drivers, while connections made within mind-maps were analyzed using social network analysis (SNA) methods. Overall, 34 distinct drivers and 247 unique connections were identified. Taste, family, and health had the highest adjusted rankings, while health displayed the strongest network centrality. Interventions aimed at second-generation SAA dietary behaviors may benefit from family-based or multi-level interventions, which consider the complex, unique dietary norms identified.