title: Reducing Preconception Risks Among African American Women with Conversational Agent Technology.
abstract: BACKGROUND
  Systems and tools are needed to identify and mitigate preconception health (PCH) risks, particularly for African American (AA) women, given persistent health disparities. We developed and tested "Gabby," an online preconception conversational agent system.
  
  
  METHODS
  One hundred nongravid AA women 18-34 years of age were screened for over 100 PCH risks and randomized to the Gabby or control group. The Gabby group interacted with the system for up to six months; the control group received a letter indicating their health risks with a recommendation to talk with their clinician. The numbers, proportions, and types of risks were compared between groups.
  
  
  RESULTS
  There were 23.7 (SD 5.9) risks identified per participant. Eighty-five percent (77 of 91) provided 6 month follow up data. The Gabby group had greater reductions in the number (8.3 vs. 5.5 risks, P < .05) and the proportion (27.8% vs 20.5%, P < 0.01) of risks compared to controls. The Gabby group averaged 63.7 minutes of interaction time. Seventy-eight percent reported that it "was easy to talk to Gabby" and 64% used information from Gabby to improve their health.
  
  
  CONCLUSIONS
  Gabby was significantly associated with preconception risk reduction. More research is needed to determine if Gabby can benefit higher risk populations and if risk reduction is clinically significant.
authors.affiliation: From the Department of Family Medicine, Boston University School of Medicine/Boston Medical Center, Boston, MA (BJ, MH, ES, SM, PG, FA, BP, KD); the College of Computer and Information Science, Northeastern University, Boston, MA (TB); Department of Occupational Therapy, Sargent College of Health and Rehabilitation Sciences, Boston University, Boston, MA (LY-N); and the Veteran's Administration, Boston Healthcare System, Jamaica Plain, MA (DS). brian.jack@bmc.org.
authors.forename: Brian
authors.initials: B
authors.lastname: Jack
authors.affiliation: From the Department of Family Medicine, Boston University School of Medicine/Boston Medical Center, Boston, MA (BJ, MH, ES, SM, PG, FA, BP, KD); the College of Computer and Information Science, Northeastern University, Boston, MA (TB); Department of Occupational Therapy, Sargent College of Health and Rehabilitation Sciences, Boston University, Boston, MA (LY-N); and the Veteran's Administration, Boston Healthcare System, Jamaica Plain, MA (DS).
authors.forename: Timothy
authors.initials: T
authors.lastname: Bickmore
authors.affiliation: From the Department of Family Medicine, Boston University School of Medicine/Boston Medical Center, Boston, MA (BJ, MH, ES, SM, PG, FA, BP, KD); the College of Computer and Information Science, Northeastern University, Boston, MA (TB); Department of Occupational Therapy, Sargent College of Health and Rehabilitation Sciences, Boston University, Boston, MA (LY-N); and the Veteran's Administration, Boston Healthcare System, Jamaica Plain, MA (DS).
authors.forename: Megan
authors.initials: M
authors.lastname: Hempstead
authors.affiliation: From the Department of Family Medicine, Boston University School of Medicine/Boston Medical Center, Boston, MA (BJ, MH, ES, SM, PG, FA, BP, KD); the College of Computer and Information Science, Northeastern University, Boston, MA (TB); Department of Occupational Therapy, Sargent College of Health and Rehabilitation Sciences, Boston University, Boston, MA (LY-N); and the Veteran's Administration, Boston Healthcare System, Jamaica Plain, MA (DS).
authors.forename: Leanne
authors.initials: L
authors.lastname: Yinusa-Nyahkoon
authors.affiliation: From the Department of Family Medicine, Boston University School of Medicine/Boston Medical Center, Boston, MA (BJ, MH, ES, SM, PG, FA, BP, KD); the College of Computer and Information Science, Northeastern University, Boston, MA (TB); Department of Occupational Therapy, Sargent College of Health and Rehabilitation Sciences, Boston University, Boston, MA (LY-N); and the Veteran's Administration, Boston Healthcare System, Jamaica Plain, MA (DS).
authors.forename: Ekaterina
authors.initials: E
authors.lastname: Sadikova
authors.affiliation: From the Department of Family Medicine, Boston University School of Medicine/Boston Medical Center, Boston, MA (BJ, MH, ES, SM, PG, FA, BP, KD); the College of Computer and Information Science, Northeastern University, Boston, MA (TB); Department of Occupational Therapy, Sargent College of Health and Rehabilitation Sciences, Boston University, Boston, MA (LY-N); and the Veteran's Administration, Boston Healthcare System, Jamaica Plain, MA (DS).
authors.forename: Suzanne
authors.initials: S
authors.lastname: Mitchell
authors.affiliation: From the Department of Family Medicine, Boston University School of Medicine/Boston Medical Center, Boston, MA (BJ, MH, ES, SM, PG, FA, BP, KD); the College of Computer and Information Science, Northeastern University, Boston, MA (TB); Department of Occupational Therapy, Sargent College of Health and Rehabilitation Sciences, Boston University, Boston, MA (LY-N); and the Veteran's Administration, Boston Healthcare System, Jamaica Plain, MA (DS).
authors.forename: Paula
authors.initials: P
authors.lastname: Gardiner
authors.affiliation: From the Department of Family Medicine, Boston University School of Medicine/Boston Medical Center, Boston, MA (BJ, MH, ES, SM, PG, FA, BP, KD); the College of Computer and Information Science, Northeastern University, Boston, MA (TB); Department of Occupational Therapy, Sargent College of Health and Rehabilitation Sciences, Boston University, Boston, MA (LY-N); and the Veteran's Administration, Boston Healthcare System, Jamaica Plain, MA (DS).
authors.forename: Fatima
authors.initials: F
authors.lastname: Adigun
authors.affiliation: From the Department of Family Medicine, Boston University School of Medicine/Boston Medical Center, Boston, MA (BJ, MH, ES, SM, PG, FA, BP, KD); the College of Computer and Information Science, Northeastern University, Boston, MA (TB); Department of Occupational Therapy, Sargent College of Health and Rehabilitation Sciences, Boston University, Boston, MA (LY-N); and the Veteran's Administration, Boston Healthcare System, Jamaica Plain, MA (DS).
authors.forename: Brian
authors.initials: B
authors.lastname: Penti
authors.affiliation: From the Department of Family Medicine, Boston University School of Medicine/Boston Medical Center, Boston, MA (BJ, MH, ES, SM, PG, FA, BP, KD); the College of Computer and Information Science, Northeastern University, Boston, MA (TB); Department of Occupational Therapy, Sargent College of Health and Rehabilitation Sciences, Boston University, Boston, MA (LY-N); and the Veteran's Administration, Boston Healthcare System, Jamaica Plain, MA (DS).
authors.forename: Daniel
authors.initials: D
authors.lastname: Schulman
authors.affiliation: From the Department of Family Medicine, Boston University School of Medicine/Boston Medical Center, Boston, MA (BJ, MH, ES, SM, PG, FA, BP, KD); the College of Computer and Information Science, Northeastern University, Boston, MA (TB); Department of Occupational Therapy, Sargent College of Health and Rehabilitation Sciences, Boston University, Boston, MA (LY-N); and the Veteran's Administration, Boston Healthcare System, Jamaica Plain, MA (DS).
authors.forename: Karla
authors.initials: K
authors.lastname: Damus
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American; D005260:Female; D005500:Follow-Up Studies; D006293:Health Promotion / Q000379:methods*; D054624:Health Status Disparities; D006801:Humans; D020407:Internet; D008491:Medical Informatics Applications; D062405:Motivational Interviewing; D010043:Outcome and Process Assessment, Health Care; D010358:Patient Participation; D016742:Preconception Care / Q000379:methods*; D011369:Professional-Patient Relations; D018570:Risk Assessment / Q000379:methods; D040242:Risk Reduction Behavior; D014481:United States; D055815:Young Adult
keywords: Health Care Disparities; Health Information Technology; Health Promotion; Preconception Care; Reproductive Health