title: Tailored interactive multimedia computer programs to reduce health disparities: opportunities and challenges.
abstract: OBJECTIVE
  To review the theory and research evidence suggesting that tailored interactive multimedia computer programs (IMCPs) aimed at optimizing patient health behaviors could lessen socio-demographic health disparities.
  
  
  METHODS
  Selective critical review of research regarding IMCPs tailored to psychological mediators of behavior and their effects on health behavior and outcomes among socio-demographically disadvantaged patients.
  
  
  RESULTS
  Tailored IMCPs can address patient factors (e.g. language barriers, low self-efficacy) and buffer provider (e.g. cognitive bias) and health system (e.g. office visit time constraints) factors that contribute to poor provider-patient communication and, thereby, suboptimal health behaviors. Research indicates disadvantaged individuals' interactions with providers are disproportionately affected by such factors, and that their behaviors respond favorably to tailored information, thus suggesting tailored IMCPs could mitigate disparities. However, no randomized controlled trials (RCTs) have examined this question. The optimal design and deployment of tailored IMCPs for disadvantaged patients also requires further study.
  
  
  CONCLUSIONS
  Preliminary research suggests tailored IMCPs have the potential to reduce health disparities. RCTs designed expressly to examine this issue are warranted.
  
  
  CONCLUSIONS
  Many socio-demographic health disparities exist, and there is a dearth of proven disparity-reducing interventions. Thus, if tailored IMCPs were shown to lessen disparities, the public health implications would be considerable.
authors.affiliation: Department of Family and Community Medicine, University of California Davis School of Medicine, Sacramento, CA, USA. afjerant@ucdavis.edu
authors.forename: Anthony
authors.initials: A
authors.lastname: Jerant
authors.forename: Nancy
authors.initials: N
authors.lastname: Sohler
authors.forename: Kevin
authors.initials: K
authors.lastname: Fiscella
authors.forename: Becca
authors.initials: B
authors.lastname: Franks
authors.forename: Peter
authors.initials: P
authors.lastname: Franks
mesh_terms: D006266:Health Education / Q000379:methods*; D054625:Healthcare Disparities; D006801:Humans; D019212:Multimedia; D010353:Patient Education as Topic; D012984:Software; D035862:Vulnerable Populations