Feasibility of Virtual Agent Cervical Cancer Education for Hispanic Farmworkers

描述(由申请者提供)：与美国普通人群相比，拉丁裔经历了更高的宫颈癌(CC)发病率和死亡率。许多拉丁裔人缺乏获得医疗保健的机会，缺乏识字、沟通和知识障碍，这些障碍阻碍了他们获得CC筛查。实施了患者导航器(PN)和其他类似的干预措施，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，如具体化对话代理(ECA)，目前在其他人口、环境和其他健康主题中使用，但尚无已知的倡议使用文化和识字适当的技术来提供西班牙语CC教育，作为PN干预的一部分。这项研究旨在创建并进行西班牙语虚拟患者教育器(VPE)多媒体应用程序的初步评估，以加强PN干预，以提高农村农业社区拉丁裔人的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，研究小组将动员社区成员开发一个由非洲经委会组成的低识字率西班牙语交互式多媒体应用程序。运用理论原理，借鉴我们的形成性研究，项目组将通过系统和技术过程来设计VPE。将执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、有效和令人满意地执行预期的系统任务。一旦可用性测试完成，将进行一系列学习者验证面谈，以评估VPE的初步适宜性。由于VPE将是已知的第一个用于加强PN干预的西班牙语ECA，因此重要的是要了解患者是否接受VPE，以及进行VPE增强的患者导航研究是否可行。在第二阶段，将对两种患者导航分娩方法(使用和不使用VPE)进行初步评估，其中有60名参与者没有根据美国妇产科医生学会的指南进行推荐的CC筛查。采用整群随机化方法将患者随机分为两种PN干预条件：(1)PN；或(2)PN+VPE(PN+VPE)，以临床日期为随机单位。初步评价将审查招募、随机化、数据收集、 以及VPE应用的可接受性。还将收集有关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。拟议的项目将推动我们的研究，朝着开发互动技术干预措施的方向发展，以向不同的人群传播健康教育。

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.