ASPO Abstracts
Rural Adults Reactions to Colorectal Cancer Risk and Screening Information delivered by Race and Gender Concordant Virtual Health Assistants
Category: Behavioral Science & Health Communication
Conference Year: 2020
Abstract Body:
Exploring user responses to cancer screening interventions delivered by virtual health
assistants (VHAs) can provide important insights into culturally-relevant implementation of
digital interventions. The purpose of this study is to compare the perceptions of a VHA-
delivered colorectal cancer (CRC) screening intervention and screening intentions of
patient populations with diverse experiences within healthcare systems.
Methods: Twenty-five focus groups were conducted with Black (n=78) and White (n=38)
adults between 50-73 years old. Participants tested a CRC intervention, delivered by
VHAs matched to user’s race and gender, promoting a non-invasive home stool
screening test (FIT). Moderated discussions were recorded, transcribed, and analyzed
using a constant comparison method and thematic analysis.
Results: Overall, cues relevant to trustworthiness and expertise were important with
authority, friendliness, and medical expertise cited as essential VHA characteristics.
Participants expressed variations in intentions to engage in a number of CRC prevention
behaviors after viewing the intervention including, (1) information seeking (wanting to talk
to doctor about screening or learn more about risk), (2) information sharing (wanting to
share the app with friends and family), and (3) pursuing screening (FIT or colonoscopy).
For example, all groups expressed interest in sharing content; however, Black adults
wanted to share content with networks “at a younger age”. Participants were familiar with
non-invasive home screening from commercials; however, few recalled learning about
these options from their primary care provider. When screening intentions favored FIT it
was largely due to perceived elimination of hassles associated with colonoscopy prep.
Other participants expressed preferences for colonoscopy due to lingering concerns over
FIT accuracy or lack of clarity regarding benefits of FIT over colonoscopy.
Conclusion: A patient-centered approach to understanding how users engage with digital
health content can facilitate equity in CRC prevention efforts. Results from this study
identify important considerations for VHA interventions seeking to engage
demographically diverse patient populations in health behaviors broadly, and CRC
screening specifically
Keywords: cancer screening disparities, digital inervention, virtual human technology, colorectal cancer prevention