title: Toward a trustworthy voice: increasing the effectiveness of automated outreach calls to promote colorectal cancer screening among African Americans.
abstract: BACKGROUND
  Colorectal cancer screening rates are lower among African-American members of Kaiser Permanente Colorado (KPCO) than among members of other races and ethnicities. This study evaluated use of a linguistically congruent voice in interactive voice response outreach calls about colorectal cancer screening as a strategy to increase call completion and response.
  
  
  METHODS
  After an initial discussion group to assess cultural acceptability of the project, 6 focus groups were conducted with 33 KPCO African-American members. Participants heard and discussed recordings of 5 female voices reading the same segment of the standard-practice colorectal cancer message using interactive voice response. The linguistic palette included the voices of a white woman, a lightly accented Latina, and 3 African-American women.
  
  
  RESULTS
  Participants strongly preferred the African-American voices, particularly two voices. Participants considered these voices the most trustworthy and reported that they would be the most effective at increasing motivation to complete an automated call. Participants supported the use of African-American voices when designing outgoing automated calls for African Americans because the sense of familiarity engendered trust among listeners. Participants also indicated that effective automated messages should provide immediate clarity of purpose; explain why the issue is relevant to African Americans; avoid sounding scripted; emphasize that the call is for the listener's benefit only; sound personable, warm, and positive; and not create fear among listeners.
  
  
  CONCLUSIONS
  Establishing linguistic congruence between African Americans and the voices used in automated calls designed to reach them may increase the effectiveness of outreach efforts.
authors.affiliation: Assistant Professor in the Department of Community and Behavioral Health at the University of Colorado, Anschutz Medical Campus in Aurora. karen.albright@ucdenver.edu.
authors.forename: Karen
authors.initials: K
authors.lastname: Albright
authors.affiliation: Physician Lead at the Kaiser Permanente Colorado African American Center of Excellence in Denver. terri.richardson@kp.org.
authors.forename: Terri
authors.initials: T
authors.lastname: Richardson
authors.affiliation: The former Medical Director of Clinical Prevention Services in the Department of Population Care and Prevention Services at Kaiser Permanente Colorado in Denver. karinkempe@comcast.net.
authors.forename: Karin L
authors.initials: KL
authors.lastname: Kempe
authors.affiliation: Project Manager in the Department of Population and Prevention Services at Kaiser Permanente Colorado in Denver. kristin.b.wallace@kp.org.
authors.forename: Kristin
authors.initials: K
authors.lastname: Wallace
mesh_terms: D001741:Black or African American; D000368:Aged; D001331:Automation; D003120:Colorado; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000208:ethnology; D003142:Communication; D054521:Cultural Competency; D055088:Early Detection of Cancer; D005260:Female; D017144:Focus Groups; D006293:Health Promotion / Q000379:methods*; D006630:Hispanic or Latino; D006801:Humans; D007802:Language; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000208:ethnology*; D010700:Phonetics; D013689:Telephone; D035502:Trust; D014831:Voice; D044465:White People