Feasibility of Virtual Agent Cervical Cancer Education for Hispanic Farmworkers

针对西班牙裔农场工人虚拟代理宫颈癌教育的可行性

• 批准号: 8722742
• 负责人: Laura Elizabeth Barnes
• 金额: $ 1.8万
• 依托单位: SAN DIEGO STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-09-20 至 2015-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8722742
• 关键词: Abnormal coordination; Address; Adherence; Agriculture; American College of Obstetricians and Gynecologists; Behavioral; Belief; Cancer Patient; Caring; Cervical Cancer Education; Cervical Cancer Screening; Clinic; Clinical; Communication; Communities; Community Health; Computers; Data; Data Collection; Development; Education; Educational Technology; Ensure; Evaluation; Feedback; Florida; Funding; Future; General Population; Guidelines; Health; Health Personnel; Health Services Accessibility; Health education; Healthcare; Hispanics; Human Papillomavirus; Incidence; Intention; Intervention; Interview; Knowledge; Language; Latina; Learning; Life; Malignant Neoplasms; Malignant neoplasm of cervix uteri; Medical; Methods; Mexican Americans; Multimedia; Outcome; Pap smear; Participant; Patient Care; Patient Education; Patients; Persuasive Communication; Phase; Population; Preparation; Process; Public Health; Randomized; Randomized Controlled Trials; Reporting; Research; Research Project Grants; Rural; Self Efficacy; Series; Services; Shame; System; Techniques; Technology; Testing; Time; United States; Visual; Woman; Work; cancer health disparity; design; empowered; experience; farm worker; follow-up; interactive multimedia; literacy; member; mortality; prevent; programs; response; satisfaction; social cognitive theory; touchscreen; usability; virtual

DESCRIPTION (provided by applicant): Latinas experience higher cervical cancer (CC) incidence and mortality when compared to the general population in the United States. Many Latinas lack access to health care and experience literacy, communication, and knowledge barriers that prevent them from obtaining CC screening. Patient navigator (PN) and other similar interventions have been implemented to increase CC screening rates; however, few have focused directly on the needs of Latinas. Interactive technological interventions, like embodied conversational agents (ECA), are currently used in other populations, settings, and for other health topics, but no known initiative has used culturally and literacy appropriate technology to deliver Spanish-language CC education as part of a PN intervention. This study aims to create and conduct a preliminary evaluation of a Spanish-language Virtual Patient Educator (VPE) multimedia application to augment a PN intervention for increasing CC screening rates among Latinas in a rural agricultural community. Using the Social Cognitive Theory, the proposed project will be conducted in 2 phases. In Phase 1, the research team will engage community members to develop a low literacy Spanish-language interactive multimedia application consisting of an ECA. Using theoretical principles and drawing from our formative research, the project team will design the VPE through systematic and technical processes. Ongoing feedback (usability testing) from members of the intended audience will be carried out to ensure that patients (users) can perform intended system tasks efficiently, effectively, and satisfactoril. Once usability testing is complete, a series of learner verification interviews will be conducted t assess initial suitability of the VPE. Since the VPE will be the first known Spanish-language ECA used to augment a PN intervention, it is important to see whether patients accept the VPE and whether it is feasible to conduct a study of patient navigation augmented by the VPE. In Phase 2, a preliminary evaluation of 2 methods of patient navigation delivery (with and without VPE) will be conducted with 60 participants who are not up to date with recommended CC screening according to American College of Gynecologists and Obstetricians' guidelines. Cluster randomization will be used to randomize patients to 1 of 2 PN intervention conditions: (1) PN; or (2) PN plus VPE (PN+VPE) using date of clinic as unit of randomization. The preliminary evaluation will examine the feasibility of recruitment, randomization, data collection, and acceptability of VPE application. Exploratory data will also be collected regarding the potential impact of PN+VPE on behavioral capacity and self-efficacy for obtaining CC screening, Pap test adherence, and satisfaction with care. The proposed project will advance our research towards the development of interactive technology interventions to disseminate health education to disparate populations.

描述（由申请人提供）：与美国普通人群相比，拉丁裔的宫颈癌 (CC) 发病率和死亡率更高。许多拉丁裔美国人缺乏医疗保健服务，并且在读写能力、沟通和知识方面存在障碍，这些障碍阻碍了他们获得 CC 筛查。已实施患者导航 (PN) 和其他类似干预措施，以提高 CC 筛查率；然而，很少有人直接关注拉丁裔的需求。交互式技术干预措施，如具身对话代理 (ECA)，目前已用于其他人群、环境和其他健康主题，但没有已知的举措使用适合文化和读写能力的技术来提供西班牙语 CC 教育，作为 PN 的一部分干涉。本研究旨在创建西班牙语虚拟患者教育者 (VPE) 多媒体应用程序并进行初步评估，以增强 PN 干预措施，提高农村农业社区拉丁裔的 CC 筛查率。利用社会认知理论，拟议的项目将分两个阶段进行。在第一阶段，研究团队将让社区成员参与开发一个由 ECA 组成的低识字率西班牙语交互式多媒体应用程序。项目团队将利用理论原理和我们的形成性研究成果，通过系统和技术流程设计 VPE。将进行来自目标受众成员的持续反馈（可用性测试），以确保患者（用户）能够高效、有效且令人满意地执行预期的系统任务。可用性测试完成后，将进行一系列学习者验证访谈，以评估 VPE 的初始适用性。由于 VPE 将是第一个已知的用于增强 PN 干预的西班牙语 ECA，因此了解患者是否接受 VPE 以及开展由 VPE 增强的患者导航研究是否可行非常重要。在第 2 阶段，将对 2 种患者导航分娩方法（有和没有 VPE）进行初步评估，其中 60 名参与者未及时了解美国妇产科医师学会指南推荐的 CC 筛查。将使用整群随机化将患者随机分配至 2 种 PN 干预条件中的一种：(1) PN； (2) PN 加 VPE (PN+VPE)，使用临床日期作为随机化单位。初步评估将审查招募、随机化、数据收集、 VPE 申请的可接受性。还将收集关于 PN+VPE 对行为能力和自我效能的潜在影响的探索性数据，以获得 CC 筛查、巴氏试验依从性和护理满意度。拟议的项目将推进我们的研究，开发交互式技术干预措施，以向不同人群传播健康教育。