Utility of a virtual counselor (VICKY) to collect family health histories among vulnerable patient populations: A randomized controlled trial
Catharine Wang, Michael K Paasche-Orlow, Deborah J Bowen, Howard Cabral, Michael R Winter, Tricia Norkunas Cunningham, Michelle Trevino-Talbot, Diana M Toledo, Dharma E Cortes, MaryAnn Campion, Timothy Bickmore, Catharine Wang, Michael K Paasche-Orlow, Deborah J Bowen, Howard Cabral, Michael R Winter, Tricia Norkunas Cunningham, Michelle Trevino-Talbot, Diana M Toledo, Dharma E Cortes, MaryAnn Campion, Timothy Bickmore
Abstract
Objectives: This study is a randomized controlled trial comparing the efficacy of a virtual counselor (VICKY) to the My Family Health Portrait (MFHP) tool for collecting family health history (FHx).
Methods: A total of 279 participants were recruited from a large safety-net hospital and block randomized by health literacy to use one of the digital FHx tools, followed by a genetic counselor interview. A final sample of 273 participants were included for analyses of primary study aims pertaining to tool concordance, which assessed agreement between tool and genetic counselor.
Results: Tool completion differed significantly between tools (VICKY = 97%, MFHP = 51%; p < .0001). Concordance between tool and genetic counselor was significantly greater for participants randomized to VICKY compared to MFHP for ascertaining first- and second-degree relatives (ps<.0001), and most health conditions examined. There was significant interaction by health literacy, with greater differences in concordance observed between tools among those with limited literacy.
Conclusions: A virtual counselor overcomes many of the literacy-related barriers to using traditional digital tools and highlights an approach that may be important to consider when collecting health histories from vulnerable populations.
Practice implications: The usability of digital health history tools will have important implications for the quality of the data collected and its downstream clinical utility.
Trial registration: ClinicalTrials.gov NCT02344433.
Keywords: Ehealth; Family health history; Health disparities; Health literacy; Virtual counselor; Vulnerable populations.
Conflict of interest statement
Declaration of competing interest The authors report no declarations of interest.
Copyright © 2021 Elsevier B.V. All rights reserved.
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Source: PubMed