Feasibility of Virtual Agent Cervical Cancer Education for Hispanic Farmworkers

描述（由申请人提供）：与美国普通人群相比，拉丁裔宫颈癌（CC）的发病率和死亡率更高。许多拉丁美洲人缺乏获得医疗保健和经验的识字，沟通和知识障碍，阻止他们获得CC筛选。病人导航仪（PN）和其他类似的干预措施已经实施，以提高CC筛查率;然而，很少有人直接关注拉丁美洲人的需求。交互式技术干预，如嵌入式会话代理（ECA），目前用于其他人群，设置，并为其他健康主题，但没有已知的倡议已使用文化和识字适当的技术，提供西班牙语CC教育作为PN干预的一部分。本研究的目的是创建和进行初步评估的西班牙语虚拟患者教育（VPE）多媒体应用程序，以增加在农村农业社区的拉丁美洲人CC筛查率PN干预。根据社会认知理论，建议的项目将分两个阶段进行。在第一阶段，研究小组将参与社区成员开发一个低识字西班牙语交互式多媒体应用程序组成的ECA。利用理论原理和我们的形成性研究，项目团队将通过系统和技术流程设计VPE。将进行来自预期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、有效且安全地执行预期系统任务。一旦可用性测试完成，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，因此重要的是要了解患者是否接受VPE以及是否可以进行VPE增强患者导航的研究。在第2阶段，将对60名参与者进行2种患者导航输送方法（伴和不伴VPE）的初步评价，这些参与者尚未根据美国妇产科医师学会指南进行最新推荐的CC筛选。将使用整群随机化将患者随机分配至2种PN干预条件之一：（1）PN;或（2）PN + VPE（PN+VPE），使用门诊日期作为随机化单位。初步评估将检查招募、随机化、数据收集的可行性， 和VPE应用的可接受性。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，以发展互动技术干预措施，向不同人群传播健康教育。

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.