Hostname: page-component-76fb5796d-x4r87 Total loading time: 0 Render date: 2024-04-26T07:31:08.749Z Has data issue: false hasContentIssue false
  • English
  • Français

Assessing the potential of a Virtual Patient Advocate to provide preconception care and health advice to women living in Australia

Published online by Cambridge University Press:  20 April 2020

Ruth Walker Open the ORCID record for Ruth Walker [Opens in a new window] ,
Sheila Drakeley ,
Clevanne Julce ,
Nireesha Sidduri ,
Timothy Bickmore ,
Helen Skouteris ,
Brian Jack  and
Jacqueline Boyle
Ruth Walker*
Affiliation:
Monash Centre for Health Research and Implementation, School of Public Health and Preventative Medicine, Monash University, Clayton, Victoria, Australia
Sheila Drakeley
Affiliation:
School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
Clevanne Julce
Affiliation:
School of Medicine, Boston University, Boston, Massachusetts, USA
Nireesha Sidduri
Affiliation:
School of Medicine, Boston University, Boston, Massachusetts, USA
Timothy Bickmore
Affiliation:
Khoury College of Computer Sciences, Northeastern University, Boston, Massachusetts, USA
Helen Skouteris
Affiliation:
Monash Centre for Health Research and Implementation, School of Public Health and Preventative Medicine, Monash University, Clayton, Victoria, Australia Warwick Business School, Warwick University, Warwick, UK
Brian Jack
Affiliation:
School of Medicine, Boston University, Boston, Massachusetts, USA
Jacqueline Boyle
Affiliation:
Monash Centre for Health Research and Implementation, School of Public Health and Preventative Medicine, Monash University, Clayton, Victoria, Australia
*
Address for correspondence: Ruth Walker, Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia. Email: ruth.walker@monash.edu
Get access Rights & Permissions [Opens in a new window]

Abstract

A preconception Virtual Patient Advocate (VPA) called “Gabby” supported African-American women to decrease their preconception health risks and may be a scalable resource to increase women’s access to preconception care. Aims were to assess the acceptability of a preconception VPA in women living in Australia and document the changes required to adapt Gabby to suit an Australian context. Taking a descriptive qualitative approach, nonpregnant female participants (n = 31), aged 18–45 years, living in metropolitan and regional Victoria, Australia interacted with Gabby. Focus groups (n = 7) that gathered participants’ perspectives of their experience with Gabby ran in July–August 2019 before being transcribed verbatim and thematically analyzed. Six interrelated themes and 12 subthemes were identified. Participants found VPAs to be an acceptable provider of health information with potential to increase women’s access preconception health advice. Gabby was considered to be trustworthy and was able to develop rapport with participants in a relatively short time. Context-specific, relevant, tailored and trustworthy information and advice were considered more important that Gabby’s physical appearance. Participants had strong opinions about potential technological advancements (e.g., reminders and rewards) and addressing navigation issues to increase Gabby’s acceptability. Participants envisaged that they would use Gabby for readily available and evidence-based information before seeking advice from a health professional if required. Overall, the concept VPAs to provide preconception advice and Gabby were acceptable to participants. Future development of VPAs, Gabby, and other online technology-based resources should consider women’s high expectations of the online health information they choose to interact with.

Keywords

Preconceptioneducationbehaviorsinformation technologyhealthcare
Type
Original Article
Information
Journal of Developmental Origins of Health and Disease , Volume 12 , Issue 2 , April 2021 , pp. 300 - 308
Check for updates
Copyright
© Cambridge University Press and the International Society for Developmental Origins of Health and Disease 2020

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Goossens, J, De Roose, M, Van Hecke, A, Goemaes, R, Verhaeghe, S, Beeckman, D. Barriers and facilitators to the provision of preconception care by healthcare providers: a systematic review. Int J Nurs Studies. 2018; 87, 113–130.10.1016/j.ijnurstu.2018.06.009CrossRefGoogle ScholarPubMed
Langley-Evans, S. Nutrition in early life and the programming of adult disease: a review. J Hum Nutr Diet. 2015; 28, 1–14.10.1111/jhn.12212CrossRefGoogle ScholarPubMed
Stephenson, J, Heslehurst, N, Hall, J, et al. Before the beginning: nutrition and lifestyle in the preconception period and its importance for future health. Lancet. 2018; 391(10132), 1830–1841.10.1016/S0140-6736(18)30311-8CrossRefGoogle ScholarPubMed
World Health Organization. Meeting to develop a global consensus on preconception care to reduce maternal and childhood mortality and morbidity: World Health Organization Headquarters, Geneva, 6–7 February 2012: meeting report. World Health Organization, 2013. https://apps.who.int/iris/handle/10665/78067.Google Scholar
El-Heis, S, Godfrey, K. Developmental origins of health and disease. Obstet Gynaecol Reprod Med. 2015; 25(8), 236–238.10.1016/j.ogrm.2015.05.005CrossRefGoogle Scholar
Lillycrop, KA, Burdge, GC. Maternal diet as a modifier of offspring epigenetics. J Dev Orig Health Dis. 2015; 6(2), 88–95.10.1017/S2040174415000124CrossRefGoogle ScholarPubMed
Godfrey, KM, Costello, PM, Lillycrop, KA. The developmental environment, epigenetic biomarkers and long-term health. J Dev Orig Health Dis. 2015; 6(5), 399–406.CrossRefGoogle ScholarPubMed
Wellings, K, Jones, KG, Mercer, CH, et al. The prevalence of unplanned pregnancy and associated factors in Britain: findings from the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3). Lancet. 2013; 382(9907), 1807–1816.10.1016/S0140-6736(13)62071-1CrossRefGoogle Scholar
Mazza, D, Chapman, A, Michie, S. Barriers to the implementation of preconception care guidelines as perceived by general practitioners: a qualitative study. BMC Health Service Res. 2013; 13(1), 36.CrossRefGoogle ScholarPubMed
Tuomainen, H, Cross-Bardell, L, Bhoday, M, Qureshi, N, Kai, J. Opportunities and challenges for enhancing preconception health in primary care: qualitative study with women from ethnically diverse communities. BMJ Open. 2013; 3(7), e002977.10.1136/bmjopen-2013-002977CrossRefGoogle ScholarPubMed
Petersen, EE, Davis, NL, Goodman, D, et al. Vital signs: pregnancy-related deaths, United States, 2011-2015, and strategies for prevention, 13 States, 2013-2017. Morbidity Mortality Weekly Report. 2019; 68(18), 423.Google ScholarPubMed
Centers for Disease Control (CDC). Infant Mortality [Internet]. Washington DC: US Department of Human Services; c 2019 [cited 2019 Nov 19]. Available from: https://www.cdc.gov/reproductivehealth/MaternalInfantHealth/InfantMortality.htm.Google Scholar
Gardiner, P, Hempstead, MB, Ring, L, et al. Reaching women through health information technology: the Gabby preconception care system. Am J Health Promot. 2013; 27(S3), eS11–eS20.10.4278/ajhp.1200113-QUAN-18CrossRefGoogle ScholarPubMed
Bickmore, TW, Pfeifer, LM, Byron, D, et al. Usability of conversational agents by patients with inadequate health literacy: evidence from two clinical trials. J Health Communication. 2010; 15(S2), 197–210.10.1080/10810730.2010.499991CrossRefGoogle ScholarPubMed
Jack, B, Bickmore, T, Hempstead, M, et al. Reducing preconception risks among African American women with conversational agent technology. J Am Board Fam Med. 2015; 28(4), 441–451.CrossRefGoogle ScholarPubMed
Bickmore, TW, Paasche-Orlow, MK. The role of information technology in health literacy research. J Health Communication. 2012; 17(S3), 23–29.CrossRefGoogle ScholarPubMed
Norcross, JC, Krebs, PM, Prochaska, JO. Stages of change. J Clin Psychol. 2011; 67(2), 143.10.1002/jclp.20758CrossRefGoogle ScholarPubMed
Liamputting, P. Research Methods in Health, 2010. Oxford University Press, UK.Google Scholar
Boyle, J, Xu, R, Gilbert, E, et al. Ask PCOS: identifying need to inform evidence-based app development for polycystic ovary syndrome. Semin Reprod Med. 2018; 36(1), 059–65.Google ScholarPubMed
Hee Jin, H, Kyung Lee, H, Jung Choo, H. Understanding usage intention in innovative mobile app service: comparison between millennial and mature consumers. Comput Human Behav. 2017; 73, 353–361.Google Scholar
Giambatista, RC, Hoover, JD, Tribble, L. Millennials, Learning, and development: managing complexity avoidance and narcissism. Psychol Manager J. 2017; 20(3), 176–193.CrossRefGoogle Scholar
Jo Delaney, L. Patient-centred care as an approach to improving health care in Australia. Collegian. 2018; 25(1), 119–123.CrossRefGoogle Scholar
Bickmore, T, Gruber, A, Picard, R. Establishing the computer–patient working alliance in automated health behavior change interventions. Patient Educ Counsel. 2005; 59(1), 21–30.CrossRefGoogle ScholarPubMed
Negin, J, Rozea, A, Cloyd, B, Martiniuk, ALC. Foreign-born health workers in Australia: an analysis of census data. Hum Resour Health. 2013; 11, 69.10.1186/1478-4491-11-69CrossRefGoogle ScholarPubMed
Australian Bureau of Statistics (ABS). Migration Australia [Internet]. Canberra: Australian Government c 2019 [cited 2019 Nov 19]. Available from: https://www.abs.gov.au/AUSSTATS/abs@.nsf/productsbyCatalogue/66CDB63F615CF0A2CA257C4400190026?OpenDocument.Google Scholar
Jack, BW, Atrash, H, Coonrod, DV, Moos, M-K, O’donnell, J, Johnson, K. The clinical content of preconception care: an overview and preparation of this supplement. Am J Obstet Gynecol. 2008; 199(6), S266–S79.10.1016/j.ajog.2008.07.067CrossRefGoogle ScholarPubMed
Aluttis, C, Bishaw, T, Frank, MW. The workforce for health in a globalized context–global shortages and international migration. Global Health Action. 2014; 7(1), 23611.CrossRefGoogle Scholar