Online Interactive System Helps Lower Women’s Health Risks Before Pregnancy, AHRQ-Funded Study Finds

African-American women who interacted with an online “conversational agent” to discuss health risks before becoming pregnant had significantly lower risks than women who didn’t use the system, according to results of a new AHRQ-funded study. The “Gabby System” was developed to help young (ages 18-34), college-attending African American women identify and learn about preconception health risks and get information about behavior change. Women who interacted with Gabby over a six-month period through biweekly emails with links to information had a higher proportion (28 percent vs. 21 percent) and a greater average number (8.3 vs. 5.5) of risks that were resolved compared with women who did not interact with Gabby. Interactions included a greeting from Gabby, a review of identified health risks, a discussion of risks selected by women and a review and update of their health to-do list. The most common content area requested by participants was nutrition and activity, followed by infectious disease, environmental issues and immunization and vaccines. The Gabby system holds promise for improving access to the primary and preventive care assessments that women need to prepare for pregnancy, study authors concluded. “Reducing Preconception Risks Among African American Women With Conversational Agent Technology” and abstract were published in the July/August issue of the Journal of the American Board of Family Medicine.

2015 Jul-Aug;28(4):441-51. doi: 10.3122/jabfm.2015.04.140327.

Reducing Preconception Risks Among African American Women with Conversational Agent Technology.

Jack B1, Bickmore T2, Hempstead M2, Yinusa-Nyahkoon L2, Sadikova E2, Mitchell S2, Gardiner P2, Adigun F2, Penti B2, Schulman D2, Damus K2.

Author information

Abstract

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.