title: Acceptability and feasibility of a virtual counselor (VICKY) to collect family health histories.
abstract: OBJECTIVE
  To overcome literacy-related barriers in the collection of electronic family health histories, we developed an animated Virtual Counselor for Knowing your Family History, or VICKY. This study examined the acceptability and accuracy of using VICKY to collect family histories from underserved patients as compared with My Family Health Portrait (MFHP).
  
  
  METHODS
  Participants were recruited from a patient registry at a safety net hospital and randomized to use either VICKY or MFHP. Accuracy was determined by comparing tool-collected histories with those obtained by a genetic counselor.
  
  
  RESULTS
  A total of 70 participants completed this study. Participants rated VICKY as easy to use (91%) and easy to follow (92%), would recommend VICKY to others (83%), and were highly satisfied (77%). VICKY identified 86% of first-degree relatives and 42% of second-degree relatives; combined accuracy was 55%. As compared with MFHP, VICKY identified a greater number of health conditions overall (49% with VICKY vs. 31% with MFHP; incidence rate ratio (IRR): 1.59; 95% confidence interval (95% CI): 1.13-2.25; P = 0.008), in particular, hypertension (47 vs. 15%; IRR: 3.18; 95% CI: 1.66-6.10; P = 0.001) and type 2 diabetes (54 vs. 22%; IRR: 2.47; 95% CI: 1.33-4.60; P = 0.004).
  
  
  CONCLUSIONS
  These results demonstrate that technological support for documenting family history risks can be highly accepted, feasible, and effective.
authors.affiliation: Department of Community Health Sciences, Boston University School of Public Health, Boston, Massachusetts, USA.
authors.forename: Catharine
authors.identifier: http://orcid.org/0000-0001-8584-2781
authors.initials: C
authors.lastname: Wang
authors.affiliation: Northeastern University College of Computer and Information Science, Boston, Massachusetts, USA.
authors.forename: Timothy
authors.identifier: http://orcid.org/0000-0002-2676-9788
authors.initials: T
authors.lastname: Bickmore
authors.affiliation: Department of Bioethics & Humanities, University of Washington School of Medicine, Seattle, Washington, USA.
authors.forename: Deborah J
authors.initials: DJ
authors.lastname: Bowen
authors.affiliation: Department of Community Health Sciences, Boston University School of Public Health, Boston, Massachusetts, USA.
authors.forename: Tricia
authors.initials: T
authors.lastname: Norkunas
authors.affiliation: Master of Science Program in Genetic Counseling, Boston University School of Medicine, Boston, Massachusetts, USA.
authors.forename: MaryAnn
authors.initials: M
authors.lastname: Campion
authors.affiliation: Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts, USA.
authors.forename: Howard
authors.initials: H
authors.lastname: Cabral
authors.affiliation: Data Coordinating Center, Boston University School of Public Health, Boston, Massachusetts, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Winter
authors.affiliation: General Internal Medicine, Boston University School of Medicine, Boston, Massachusetts, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Paasche-Orlow
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005192:Family Health; D005260:Female; D005817:Genetic Counseling; D006801:Humans; D008297:Male; D008487:Medical History Taking; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D012042:Registries; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires; D014584:User-Computer Interface; D055815:Young Adult