ASPO Abstracts
Deploying virtual clinicians to reduce racial disparities in young-onset colorectal cancer: Experiences of Black adults with a culturally-tailored telehealth intervention
Category: Cancer Health Disparities
Conference Year: 2022
Abstract Body:
Purpose: When the USPTF updated colorectal cancer (CRC) screening guidelines in 2021, millions of adults aged 45-49 became screening eligible. Scalable communication strategies are needed to navigate this new cohort to screening. Questions remain if strategies should differ between younger and older groups. Delivering CRC prevention messages with virtual clinicians (VCs) may identify optimal age-specific strategies. Methods: A secondary analysis of Black adults' (N = 772) experiences with an interactive VC was conducted. Participants self-reported perceptions of usability, motivation to discuss screening, social presence (i.e., perceiving the VC as a real person), transportation (i.e., visualizing oneself in the virtual exam room), and VC appearance (e.g., natural gestures). Responses assessed on a 5-point Likert scale from adults aged 45-49 (newly screening eligible) were compared to those aged 50-73 using a Wilcoxon rank-sum test.Results: Younger adults rated the intervention as easier to use (Mdn= 3, M= 3.3, IQR= 3-3.5) vs. older adults (Mdn= 3, M= 3.1, IQR= 2.8-3.2), p < .001. After their virtual appointment, younger adults perceived less social presence (Mdn= 3, M= 3.3, IQR= 2-4.2) vs. older adults (Mdn= 3, M= 3, IQR= 2-4), p = .004, but felt more transported into the virtual setting (Mdn= 3, M= 2.6, IQR= 1-4) vs. older adults (Mdn= 2, M= 2.3, IQR= 1-3), p = .001. Further, younger adults were more motivated to discuss screening with family (Mdn= 4, M= 3.8, IQR= 3-5) compared to the older group (Mdn= 3, M= 3.4, IQR= 3-5), p = .003. Lastly, younger adults rated the VC as more similar in age (Mdn= 4, M= 3.6, IQR= 3-4) than did older adults (Mdn= 3, M= 2.8, IQR= 2-3), p = <.001, and more likeable in appearance (Mdn= 4.2, M= 4.1, IQR= 3.8-5) than older adults (Mdn= 4, M= 3.9, IQR= 3.2-4.8), p = .01. Conclusions: Young Black adults perceive VCs positively, engaging, and easy to use. Despite the VCs being perceived as less realistic by the younger cohort, transportation and motivations to discuss screening options were still high among this group. Findings indicate that VC-led interventions promoting CRC screening are appropriate for younger Black adults. Future studies should assess how age-related differences in patient experience impact screening behavior.
Keywords: Health disparities, colorectal cancer prevention, virtual human technology