Online Program

Feasibility of using virtual counselors to collect family health histories from underserved populations

Monday, November 4, 2013 : 8:30 a.m. - 8:45 a.m.

Catharine Wang, PhD, MSc, Boston University School of Public Health, Boston, MA
Timothy Bickmore, PhD, College of Computer and Information Science, Northeastern University, Boston, MA
Deborah Bowen, PhD, Community Health Sciences, Boston University School of Public Health, Boston, MA
MaryAnn Campion, MS, CGC, Genetic Counseling, Boston University School of Medicine, Boston, MA
Tricia Norkunas, MA, MPH, Boston University School of Public Health, Boston, MA
Carol Larson, BS, Department of Community Health Sciences, Boston University School of Public Health, Boston, MA
Michael K. Paasche-Orlow, MD, MA, MPH, General Internal Medicine, Boston University Medical Campus, Boston, MA
Family health history is an important predictor of disease risk yet is underutilized in clinical practice. Although computerized tools are currently available to help patients collect family history, they are often too complex for underserved patient populations who might lack the literacy or computer experience necessary to use effectively. To address these barriers, we developed a virtual counselor (beta prototype) to collect and record information from patients about their family health history for a select set of common, chronic conditions. Participants ‘answer' the counselor's questions by choosing among touch screen button responses. Interviews were conducted with 20 participants recruited from a patient research registry. Approximately, 85% were female, 65% had a high school degree or less, 50% were African American, and 65% had household income < 25K. Participants rated the virtual counselor as easy to use (90%), understood the questions being asked (95%), liked the tool (80%), rated tool quality as very good or excellent (69%), and were highly satisfied with the tool (75%). Compared to family histories obtained by a genetic counselor, the virtual counselor identified 73% of first and second degree relatives and 54% of the health conditions assessed within the tool. This study demonstrates the acceptability and feasibility of using virtual counselors to collect family health history in an electronic format, and overcomes previously identified barriers among underserved populations. Future efforts will focus on refining the virtual counselor to improve collection of more complex family trees (e.g., half siblings, twins, nieces/nephews) and accommodate additional diseases and languages.

Learning Areas:

Communication and informatics
Diversity and culture

Learning Objectives:
Describe the development of a virtual counselor prototype to collect family health history. Demonstrate the feasibility of the tool for use among underserved patient populations. Discuss future efforts to refine the virtual counselor to accommodate more complex pedigrees.

Keyword(s): Genetics, Underserved Populations

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified because I have a PhD in health behavior and health education and have been conducting research in public health genomics for over 15 years, with several federally funded grants in the area.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.