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Abstract
This dissertation investigates how sexual and reproductive health (SRH) chatbots can be optimized to enhance health management among young adults. Utilizing a mixed-methods approach, this study integrates the Health Belief Model (HBM), Unified Theory of Acceptance and Use of Technology (UTAUT), and Computers as Social Actors (CASA) framework to identify motivational, functional, and interactional factors that predict behavioral intentions to use SRH chatbots to manage SRH. The quantitative study surveyed 1,200 U.S. participants and validated a robust theoretical model and revealed the relationships between key variables and chatbot use intentions. Subgroup analysis highlighted that LGBTQ+ individuals value anonymity, empathy, and judgment-free communication, reinforcing the importance of inclusivity in chatbot design. The qualitative study involved co-creation workshops and an open-ended survey to explore user perceptions of empathetic and non-empathetic message designs. Findings revealed that empathetic messaging fosters emotional safety and trust, while concise, factual language enhances credibility. The study demonstrated that tailoring chatbot messaging and user interface features enhances engagement, user satisfaction, and self-disclosure. Ultimately, this dissertation contributed to the growing body of human-machine communication (HMC) and health communication research by proposing an integrated theoretical framework and offering practical recommendations for ethical, culturally sensitive, and user-centered chatbot design.