Using virtual counselors to overcome genetic literacy barriers: Project VICKY

使用虚拟咨询师克服遗传素养障碍：VICKY 项目

• 批准号: 9043159
• 负责人: Catharine Wang
• 金额: $ 75.16万
• 依托单位: BOSTON UNIVERSITY MEDICAL CAMPUS
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-05-16 至 2019-10-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9043159
• 关键词: Adult; Advocate; Age; Area; Behavioral; Boston; Caring; Centers for Disease Control and Prevention (U.S.); Chronic Disease; Collection; Computer Literacy; Computers; Counseling; Data; Diabetes Mellitus; Disease; Documentation; Education; Effectiveness; Electronic Health Record; Electronics; English Language; Ethnic Origin; Face; Familial disease; Family; Family health status; Family history of; Family member; Frequencies; Gender; General Population; Genetic; Genetic Predisposition to Disease; Genetic screening method; Genomics; Goals; Gold; Government Agencies; Health; Health Personnel; Health Promotion; Health Status; Health education; Healthcare; Heart Diseases; Human Genetics; Hypertension; Improve Access; Intervention; Knowledge; Language; Malignant Neoplasms; Medical; Medical History; Medical center; Online Systems; Patients; Population; Portraits; Preventive Intervention; Primary Health Care; Process; Professional counselor; Provider; Proxy; Race; Randomized; Randomized Controlled Trials; Readiness; Reading; Recording of previous events; Risk; Risk Assessment; Shapes; Stroke; Surgeon; System; Underserved Population; Validation; base; clinical practice; clinical risk; communication behavior; comparative efficacy; computerized; computerized tools; disorder prevention; disorder risk; genetic counselor; genomic tools; health literacy; higher education; illiteracy; improved; innovation; insight; interoperability; literacy; ninth grade; patient population; programs; prototype; tool; virtual

DESCRIPTION (provided by applicant): Rapid advances in human genetics have prompted concerns about the public's readiness to process and utilize the knowledge gained to make informed decisions about their health. To facilitate "genetic literacy," several government agencies including the Office of the Surgeon General and the Centers for Disease Control and Prevention (CDC) have advocated for the increased use of family health history assessment. The family health history, currently underutilized in primary care, offers an ideal proxy to assess genomic risk and is the simplest applied genomic tool available. Web-based family history tools are now publicly available to facilitate its collection, including My Family Health Portrait (MFHP) from the Office of the Surgeon General. Although family history tools like MFHP are developed for general public use, there is evidence to suggest that they may not be accessible to a large portion of the general population with limited health literacy, due to high reading grade demands and navigational challenges. An innovative approach previously demonstrated to overcome challenges with inadequate health literacy and computer literacy in health care settings is the use of Relational Agents (RAs), computer-animated characters that simulate conversations with patients. We have developed a prototype "virtual counselor" (VICKY: Virtual Counselor for Knowing Your Family History) to collect family health history information for common health conditions including heart disease, stroke, diabetes, hypertension and various cancers. In the proposed study, we plan to refine the virtual counselor and conduct a randomized controlled trial (RCT) to compare the efficacy of using VICKY to the existing MFHP tool for collecting family health history information among an underserved primary care patient population. The primary aims of the study are to 1) evaluate the efficacy of VICKY versus MFHP for collecting accurate family health histories and 2) determine whether accuracy varies as a function of health literacy. Secondary aims of the study will explore factors associated with the effective use of computerized family history tools and examine the impact of the tools on family and provider communication behaviors (e.g., sharing of family history information). This project will be the first to systematically obtain validation data on the efficacy of both VICKY and MFHP for collecting accurate family history data among an underserved patient population, in two languages (English and Spanish). We will determine whether a virtual counselor can overcome many of the existing barriers to using traditional web-based family history tools. This study is uniquely situated to provide insight on the most effective approaches to gathering electronic family history data from underserved populations such that they may be later integrated with electronic health record systems and broadly disseminated. Study findings will inform subsequent implementation efforts of these tools to maximize reach and effectiveness, with the goal of improving the systematic documentation and use of family history in primary care to identify those at greatest risk for chronic diseases who would benefit from preventive intervention efforts.

描述（由申请人提供）：人类遗传学的快速发展引起了人们对公众是否准备好处理和利用所获得的知识来做出有关其健康的知情决定的担忧。为了促进“基因素养”，包括外科医生办公室和疾病控制与预防中心（CDC）在内的几个政府机构提倡增加家庭健康史评估的使用。目前在初级保健中未充分利用的家族健康史提供了一个理想的评估指标