ASPO Abstracts
Positioning virtual clinicians as a tool to reduce colorectal cancer disparities in rural communities: The impact of identity on evaluations of virtual clinician appearance
Category: Cancer Health Disparities
Conference Year: 2022
Abstract Body:
PURPOSE: Rural patients experience significant disparities in colorectal cancer (CRC) screening. Virtual clinicians (VCs) are uniquely situated to reduce screening disparities, yet how rural identity (RUID) (i.e., how patients identify with rural communities) influences patient experiences with VCs is unknown. To explore the association between RUID and patient evaluations of VC appearance, we piloted a telehealth intervention for delivering CRC prevention messaging. METHODS: White and Black adults (N = 2079) who were non-adherent with screening guidelines and between 50-73 years old tested the Meet ALEX (-Agent Leveraging Empathy for eXams) VC intervention. VCs were developed through collaboration with health communication experts, computer scientists, and a diverse group of rural participants. Participants were randomized to one of eight conditions: VC race (Black, White), VC gender (male, female), and intervention type (static, interactive). RUID was assessed using a four-item measure. Perceptions of VC appearance were also measured. Logistic regression models examined participant evaluations of the VCs. RESULTS: Overall, participants with stronger RUID (β = 0.11, p = .02), specifically place identity (β = 0.09, p = .05), similarity (β = 0.13, p = .01), and self-concept (β = 0.11, p = .03), rated the VC as more attractive regardless of VC race or gender. A sense of belonging to a rural community influenced ratings of VC attractiveness for Black participants (β = .20, p = .02). In addition, Black participants who received screening messages from a Black VC and reported higher self-concept (aligned more strongly with rural communities) rated the VC as more attractive (β = 0.58, p = .01). CONCLUSIONS: Understanding rural patients' perceptions of VCs for delivering medical care and screening interventions is imperative for reaching and reducing rural cancer disparities. Our findings suggest that adults who strongly identify with rural communities have different perceptions of VCs for delivering screening interventions than those for whom RUID is less important. Investing resources to maximize VC appearance in telehealth interventions is critical to reducing CRC screening disparities in rural communities, particularly when targeting rural Black patients.
Keywords: Cancer screening disparities, rural health, virtual human technology, precision health communication