Employing Virtual Advisors in Preventive Care for Underserved Communities: Results From the COMPASS Study

King, Abby C.; Bickmore, Timothy; Campero, Maria Ines; Pruitt, Leslie A.; Yin, James Langxuan

doi:10.1080/10810730.2013.798374

Cited by 106 publications

(148 citation statements)

References 50 publications

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“…8, 9, 10 Conversational agents are a logical option to deliver PCH information as they can reach a large audience while providing high user acceptability through culturally-appropriate content and information appropriate to those with low health literacy. 11, 12 AA women may benefit from conversational agents due to disparities in health literacy levels as according to the 2006 report by the U.S. Department of Education, 58 percent of AA adults possess Below Basic or Basic health literacy, compared to 28 percent of white adults. 13 There is also evidence that clinicians are more verbally-dominant and less patient-centered with AA patients, 14 and that these systems can overcome clinician time constraints 15 and assist in delivering recommended preventive care.…”

Section: Introductionmentioning

confidence: 99%

Reducing Preconception Risks Among African American Women with Conversational Agent Technology

Jack

Bickmore

Hempstead

et al. 2015

The Journal of the American Board of Family Medicine

143

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BACKGROUND Preconception care (PCC) should be provided for all women capable of becoming pregnant to identify and treat existing risk factors for adverse perinatal outcomes for both the woman and her future baby. Additional tools are needed for providers and the public to screen for and address preconception health (PCH) risks, particularly for African American (AA) women given the national persistent health outcome and healthcare disparities. We developed and tested the “Gabby System,” featuring an online interactive conversational agent programmed to discuss women’s specific PCH risks and encourage behavioral change through evidence-based interventions. METHODS A 6-month randomized controlled trial of a purposeful, convenience sample of 100 non-gravid, primarily college-attending AA women 18–34 years of age was conducted. All participants were screened at enrollment for over 100 PCH risks and then randomized to the Gabby or control group. Controls were sent a letter listing identified PCH risks, suggesting they discuss these risks with a health care provider. The numbers, proportions, and types of risks identified and addressed were compared between groups. RESULTS Of the 100 women enrolled, 99 provided baseline data, 91 completed the online PCH risk assessment, and 80 completed the 6-month follow-up phone call. The mean participant age was 25.5 years and all had at least one PCH risk with a mean (sd) of 23.7 (5.9), range of 11 to 45 PCH risks. In 6 months the Gabby group had significantly greater reductions compared to controls in both the number of PCH risks (34% higher- 8.3 vs. 5.5, p<.05) and in the proportion of risks resolved (25% higher- 27.8% vs 20.5% p<0.01). Women in the Gabby group averaged 2.9 logins and 63.7 minutes of interaction time. The most common PCH risks triggered were nutrition, activity and infectious disease. The majority of women (78%) reported it “was easy to talk to Gabby” and that they had used information from Gabby to improve their health (64%). CONCLUSION Among a group of reproductive age African American women, use of the Gabby system was associated with a significant reduction in identified PCH risks. More research is needed to determine if Gabby can impact risk status among a larger, more socio-demographically diverse group of black women and if reducing the number of risks is clinically significant.

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Section: Introductionmentioning

confidence: 99%

Reducing Preconception Risks Among African American Women with Conversational Agent Technology

Jack

Bickmore

Hempstead

et al. 2015

The Journal of the American Board of Family Medicine

143

View full text Add to dashboard Cite

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“…24-27 Use of the relational agent system requires very minimal reading skills. We have previously shown that the interface can be designed in a manner that is usable for people with limited health literacy, limited reading capacity, and no prior computer experience, 19,22,28,29 which makes it a potentially useful platform to collecting detailed family history information in an electronic format.…”

Section: Introductionmentioning

confidence: 99%

Acceptability and feasibility of a virtual counselor (VICKY) to collect family health histories

Wang

Bickmore

Bowen

et al. 2015

Genetics in Medicine

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Purpose To overcome literacy-related barriers in the collection of electronic family health histories, we developed VICKY, an animated “virtual counselor”. This study examines the acceptability and accuracy of using VICKY to collect family histories, among underserved patients, compared to My Family Health Portrait (MFHP). Methods Participants were recruited from a patient registry at a safety net hospital and randomized to use either VICKY or MFHP. Accuracy was determined by comparing tool-collected histories to those obtained by a genetic counselor. Results A total of 70 participants completed this study. Participants rated VICKY easy to use (91%) and easy to follow (92%), would recommend VICKY to others (83%) and were highly satisfied (77%). VICKY identified 86% of first degree relatives, and 42% of second degree relatives; combined accuracy was 55%. Compared to MFHP, VICKY identified a greater number of health conditions overall (49% VICKY vs 31% MFHP, IRR: 1.59, 95% CI 1.13, 2.25, p=.008); in particular, hypertension (47% vs 15%; IRR = 3.18; 95% CI: 1.66, 6.10; p=.001) and type 2 diabetes (54% vs 22%; IRR = 2.47; 95% CI: 1.33, 4.60; p=.004). Conclusion These results demonstrate that technological support for documenting family history risks can be highly accepted, feasible, and effective.

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“…Primary task support features such as tailoring and monitoring are often present together with dialogue support features such as reminder, rewards and praise. An example of this is "user specific goal setting" present with "text based positive reinforcement" [49]. Applications that included self-monitoring feature generally included also a feedback mechanism that allowed the user to review their data [34].…”

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confidence: 99%

Persuasive Technology in Mobile Applications Promoting Physical Activity: a Systematic Review

et al. 2016

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Persuasive technology in mobile applications can be used to influence the behaviour of users. A framework known as the Persuasive Systems Design model has been developed for designing and evaluating systems that influence the attitudes or behaviours of users. This paper reviews the current state of mobile applications for health behavioural change with an emphasis on applications that promote physical activity. The inbuilt persuasive features of mobile applications were evaluated using the Persuasive Systems Design model. A database search was conducted to identify relevant articles. Articles were then reviewed using the Persuasive Systems Design model as a framework for analysis. Primary task support, dialogue support, and social support were found to be moderately represented in the selected articles. However, system credibility support was found to have only low levels of representation as a persuasive systems design feature in mobile applications for supporting physical activity. To ensure that available mobile technology resources are best used to improve the wellbeing of people, it is important that the design principles that influence the effectiveness of persuasive technology be understood. AbstractPersuasive technology in mobile applications can be used to influence the behaviour of users. A framework known as the Persuasive Systems Design model has been developed for designing and evaluating systems that influence the attitudes or behaviours of users. This paper reviews the current state of mobile applications for health behavioural change with an emphasis on applications that promote physical activity. The inbuilt persuasive features of mobile applications were evaluated using the Persuasive Systems Design model. A database search was conducted to identify relevant articles. Articles were then reviewed using the Persuasive Systems Design model as a framework for analysis. Primary task support, dialogue support, and social support were found to be moderately represented in the selected articles. However, system credibility support was found to have only low levels of representation as a persuasive systems design feature in mobile applications for supporting physical activity. To ensure that available mobile technology resources are best used to improve the wellbeing of people, it is important that the design principles that influence the effectiveness of persuasive technology be understood.

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Employing Virtual Advisors in Preventive Care for Underserved Communities: Results From the COMPASS Study

Cited by 106 publications

References 50 publications

Reducing Preconception Risks Among African American Women with Conversational Agent Technology

Reducing Preconception Risks Among African American Women with Conversational Agent Technology

Acceptability and feasibility of a virtual counselor (VICKY) to collect family health histories

Persuasive Technology in Mobile Applications Promoting Physical Activity: a Systematic Review

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