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Reducing Preconception Risks Among African American Women with Conversational Agent Technology
Brian Jack1, Timothy Bickmore2, Megan Hempstead2
1From the Department of Family Medicine, Boston University School of Medicine/Boston Medical Center, Boston, MA (BJ, MH, ES, SM, PG, FA, BP, KD); the College of Computer and Information Science, Northeastern University, Boston, MA (TB); Department of Occupational Therapy, Sargent College of Health and Rehabilitation Sciences, Boston University, Boston, MA (LY-N); and the Veteran's Administration, Boston Healthcare System, Jamaica Plain, MA (DS). brian.jack@bmc.org.
Background:
Systems and tools are needed to identify and mitigate preconception health (PCH) risks, particularly for African American (AA) women, given persistent health disparities. We developed and tested "Gabby," an online preconception conversational agent system.
Methods:
One hundred nongravid AA women 18-34 years of age were screened for over 100 PCH risks and randomized to the Gabby or control group. The Gabby group interacted with the system for up to six months; the control group received a letter indicating their health risks with a recommendation to talk with their clinician. The numbers, proportions, and types of risks were compared between groups.
Results:
There were 23.7 (SD 5.9) risks identified per participant. Eighty-five percent (77 of 91) provided 6 month follow up data. The Gabby group had greater reductions in the number (8.3 vs. 5.5 risks, P < .05) and the proportion (27.8% vs 20.5%, P < 0.01) of risks compared to controls. The Gabby group averaged 63.7 minutes of interaction time. Seventy-eight percent reported that it "was easy to talk to Gabby" and 64% used information from Gabby to improve their health.
Conclusion:
Gabby was significantly associated with preconception risk reduction. More research is needed to determine if Gabby can benefit higher risk populations and if risk reduction is clinically significant.
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