Mobile health2011 slide skingfinal

21
Employing ‘Virtual Advisors’ to Promote Physical Activity in Underserved Communities: Results from the COMPASS Study Abby King, Tim Bickmore, Ines Campero, Leslie Pruitt, Langxuan Yin Stanford University School of Medicine Northeastern University NIH R21CA127511 © Stanford University

description

 

Transcript of Mobile health2011 slide skingfinal

Page 1: Mobile health2011 slide skingfinal

Employing ‘Virtual Advisors’ to Promote Physical

Activity in Underserved Communities: Results from

the COMPASS Study

Abby King, Tim Bickmore, Ines Campero, Leslie Pruitt,

Langxuan Yin

Stanford University School of MedicineNortheastern University

NIH R21CA127511

© Stanford University

Page 2: Mobile health2011 slide skingfinal

BACKGROUND

• While electronically delivered ‘e-Health’

interventions have proliferated . . .

• Few have targeted specific needs/preferences of

older adults as well socioeconomically

disadvantaged & ethnic minority populations

© Stanford University

Page 3: Mobile health2011 slide skingfinal

COMPASS Study -

OBJECTIVES

• Evaluate 4-month impacts on Walking of a ‘Virtual Advisor’, tailored in visual and auditory dimensions to inactive, low income Latino older adults

• Experiment preceded by a year of formative research to culturally adapt intervention, study procedures

• All study components occurred at a neighborhood senior center

Page 4: Mobile health2011 slide skingfinal

Stanford Health Aging Studies Technology Team

Tim Bickmore, Northeastern University

Page 5: Mobile health2011 slide skingfinal

COMPASS

PARTICIPANTS

• Low-income, ethnic minority older adults living in San Jose, CA (n = 40)

(93% Latino; 72% women; ~50% with < high school education)

• Ages 55 yrs & older (mean = 68 + 8 yrs)

• Inactive (< 60 mins MVPA/wk), able to walk unaided

(mean BMI = 30)

Page 6: Mobile health2011 slide skingfinal

COMPASS

PHYSICAL ACTIVITY PROGRAM

• Based on successful 2-mo ECA PA program aimed at older African Americans in Boston (Bickmore et al., 2005)

• ECA (Embodied Conversational Agent):

- Animated computer character simulating face-to-face counseling using speech, facial cues & other nonverbal behaviors

- Interact with ECA through touching one of several conversation-based responses shown on computer screen (encouraged weekly interaction or whenever at Center)

Page 7: Mobile health2011 slide skingfinal

(Culturally adapted, bi-lingual)© Stanford University

Carmen

Page 8: Mobile health2011 slide skingfinal
Page 9: Mobile health2011 slide skingfinal

COMPASS

PHYSICAL ACTIVITY PROGRAM - continued

• ‘Carmen’ incorporated evidence-based cognitive & behavioral strategies

• Some Personal information also programmed for each individual (e.g., favorite hobbies, family member names)

• Program accessed using a PIN; housed on dedicated computer located at Senior Center

Page 10: Mobile health2011 slide skingfinal

COMPASS

PHYSICAL ACTIVITY PROGRAM - continued

• Downloadable Omron pedometer used to capture daily/weekly steps

• ‘Carmen’ used pedometer info to provide tailored feedback, advice

Page 11: Mobile health2011 slide skingfinal

COMPASS

CONTROL PROGRAM

• Adapted version of general health education workshops used in previous PA research

• Monthly Age-relevant topics (no PA)

Page 12: Mobile health2011 slide skingfinal

COMPASS

RESULTS

Intervention participants:

• Logged into program mean of 1.6 sessions/week

(range = .35 – 2.3)

• Mean of 27 total sessions across 4 months (range = 6 – 40)

• Mean length of Virtual Advisor sessions = 7 minutes

• 55% interacted with Virtual Advisor in Spanish

Page 13: Mobile health2011 slide skingfinal

COMPASS - RESULTS 4-mos Change in Minutes of Walking/Wk [CHAMPS]

(N = 39)

** p < .0008

Rep

orte

d C

hang

e in

Min

s/W

k

0

50

100

150

200

250

300

© Stanford University

Page 14: Mobile health2011 slide skingfinal

4-month Change in Daily Steps (Omron Pedometer)

Intervention Participants (n = 20)

* Slope analysis: p = .002; Spearman rho with CHAMPS walking items = .47 (p=.04)

Week 1 Week 16

Mea

n D

aily

Ste

ps

0

3000

4000

5000

6000

7000

8000

COMPASS Study

*

Page 15: Mobile health2011 slide skingfinal

Bas

elin

e-ad

just

ed m

ean

* p < .03 vs. Control

0

1.0

1.5

2.0

2.5

3.0

3.5

4.0

4.5

SubstitutingAlternatives

RewardingOneself

CommittingOneself

* **

*

Control

RemindingOneself

COMPASS

4-month Motivational Processes of Change

*

UnderstandingRisks

Page 16: Mobile health2011 slide skingfinal

AFTER the 4-month Study Period . . .

• ‘Carmen’ remained in Senior Center for additional 20 weeks (in response to participant requests)

• All but 1 intervention participant accessed ‘Carmen’

during this post-study period

• Participants accessed ‘Carmen’ mean of 14 additional times (range of <1 to 4.5 times/week)

Page 17: Mobile health2011 slide skingfinal

At 4-month Post-test, Intervention participants indicated that . . .

• ‘Carmen’ cared about them (average rating = 6.2 out of 7)

• Felt close to ‘Carmen’ (average = 6 out of 7)

• Trusted ‘Carmen’ (average = 6 out of 7)

• Felt that length of talks with ‘Carmen’ was “just about

right”

• Were interested in continuing to work with ‘Carmen’

Page 18: Mobile health2011 slide skingfinal

Conclusions

• Intervention participants reported ~30 minute/day increase in usual walking activity relative to modest changes in controls by 4 months

• Daily pedometer steps in last intervention month (~6800) generally commensurate with National Recs. in this age group

Page 19: Mobile health2011 slide skingfinal

Conclusions - continued

• Program was safe (no significant PA injuries)

• Program found to be easy to use/engaging for

this less educated, low computer-literate sample

• 95% of intervention participants accessed the Virtual

Advisor after the study ended

Page 20: Mobile health2011 slide skingfinal

Next Steps

• Expand community venues & populations in which

to test ‘Carmen’, as well as lengthen time period

e.g., clinics, pharmacies, libraries, recreation centers

• Explore which subgroups may do better with Carmen

vs. other intervention sources & delivery channels

• Explore this technology further for other health

behaviors

Page 21: Mobile health2011 slide skingfinal

THANK YOU!THANK YOU!