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

Abstract

Electronically delivered health promotion programs that are aimed primarily at educated, health-literate individuals have proliferated, raising concerns that such trends could exacerbate health disparities in the United States and elsewhere. The efficacy of a culturally and linguistically adapted virtual advisor that provides tailored physical activity advice and support was tested in low-income older adults. Forty inactive adults (92.5% Latino) 55 years of age and older were randomized to a 4-month virtual advisor walking intervention or a waitlist control. Four-month increases in reported minutes of walking/week were greater in the virtual advisor arm (mean increase = 253.5 ± 248.7 minutes/week) relative to the control (mean increase = 26.8 ± 67.0 minutes/week; p = .0008). Walking increases in the virtual advisor arm were substantiated via objectively measured daily steps (slope analysis p = .002). All but one intervention participant continued some interaction with the virtual advisor in the 20-week poststudy period (mean number of poststudy sessions = 14.0 ± 20.5). The results indicate that a virtual advisor delivering culturally and linguistically adapted physical activity advice led to meaningful 4-month increases in walking relative to control among underserved older adults. This interactive technology, which requires minimal language and computer literacy, may help reduce health disparities by ensuring that all groups benefit from e-health opportunities.

Reducing Preconception Risks Among African American Women with Conversational Agent Technology

“…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.…”

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

“…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.…”

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

“…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].…”