Acceptability, Feasibility, and Preliminary Efficacy of a Theory-Based Relational Embodied Conversational Agent Mobile Phone Intervention to Promote HIV Medication Adherence in Young HIV-Positive African American MSM

2019 ◽  
Vol 31 (1) ◽  
pp. 17-37 ◽  
Author(s):  
Mark S. Dworkin ◽  
Sangyoon Lee ◽  
Apurba Chakraborty ◽  
Colleen Monahan ◽  
Lisa Hightow-Weidman ◽  
...  
Keyword(s):  
African American ◽  
Health Literacy ◽  
Pilot Study ◽  
Self Efficacy ◽  
African American Men ◽  
Personal Health ◽  
Conversational Agent ◽  
Embodied Conversational Agent ◽  
African American Msm

An embodied conversational agent can serve as a relational agent and provide information, motivation, and behavioral skills. To evaluate the feasibility, acceptability, and preliminary efficacy of My Personal Health Guide, a theory-based mobile-delivered embodied conversational agent intervention to improve adherence to antiretroviral therapy in young African American men who have sex with men, we conducted this prospective pilot study using a 3-month pre–post design. Outcome measures included adherence, acceptability, feasibility, pre versus post health literacy, and pre versus post self-efficacy. There were 43 participants. Pill count adherence > 80% improved from 62% at baseline to 88% at follow-up (p = .05). The acceptability of the app was high. Feasibility issues identified included loss of usage data from unplanned participant app deletion. Health literacy improved whereas self-efficacy was high at baseline and follow-up. This pilot study of My Personal Health Guide demonstrated acceptability and preliminary efficacy in improving adherence in this important population.

A Pilot Study of a Culturally Grounded Breastfeeding Intervention for Pregnant, Low-Income African American Women

2018 ◽  
Vol 34 (3) ◽  
pp. 478-484
Author(s):  
Rebecca Reno
Keyword(s):  
African American ◽  
Pilot Study ◽  
African American Women ◽  
Health Equity ◽  
Low Income ◽  
Self Efficacy ◽  
Short Form ◽  
Assessment Process ◽  
American Women ◽  
Significant Difference

Background: Increasing breastfeeding rates among low-income African American women may work toward the achievement of health equity. The dynamic breastfeeding assessment process (D-BAP) is a community-grounded, equity-focused intervention designed to increase prenatal breastfeeding self-efficacy. Research aim: The aims of the pilot study were (a) to determine the effect of the D-BAP on breastfeeding self-efficacy among pregnant, low-income African American women, (b) to examine the findings among women with no previous breastfeeding experience, and (c) to compare the findings between women with prior breastfeeding experience and those without it. Methods: A pre/post, paired-samples design was utilized. Convenience sampling was used to recruit pregnant, low-income African American women ( N = 25). Participants completed the Breastfeeding Self-Efficacy Scale–Short Form prior to and following the D-BAP. Results: The Wilcoxon signed rank test indicated that participation in the D-BAP had a statistically significant influence on breastfeeding self-efficacy ( z = −2.01, p = .04). Among a subsample of participants with no previous breastfeeding experience ( n = 12), completion of the D-BAP resulted in a statistically significant increase in breastfeeding self-efficacy ( z = −2.36, p = .02). There was no statistically significant difference between those with prior breastfeeding experience and those without it. Conclusion: Breastfeeding among low-income African American women is a health equity issue for which culturally responsive, effective breastfeeding interventions are needed. This research demonstrates an association between completion of the D-BAP and an increase in prenatal breastfeeding self-efficacy.

scholarly journals Multimodal Interaction: Correlates of Learners’ Metacognitive Skill Training Negotiation Experience

Information ◽  
2020 ◽  
Vol 11 (8) ◽  
pp. 381
Author(s):  
Dimitris Spiliotopoulos ◽  
Eleni Makri ◽  
Costas Vassilakis ◽  
Dionisis Margaris
Keyword(s):  
Goal Orientation ◽  
Self Efficacy ◽  
Readiness To Change ◽  
Conversational Agent ◽  
Learning Context ◽  
Civic Action ◽  
Problem Solving Skills ◽  
Metacognitive Training ◽  
Embodied Conversational Agent ◽  
Positive Direct

Metacognitive training reflects knowledge, consideration and control over decision-making and task performance evident in any social and learning context. Interest in understanding the best account of effective (win-win) negotiation emerges in different social and cultural interactions worldwide. The research presented in this paper explores an extended study of metacognitive training system during negotiation using an embodied conversational agent. It elaborates on the findings from the usability evaluation employing 40 adult learners pre- and postinteraction with the system, reporting on the usability and metacognitive, individual- and community-level related attributes. Empirical evidence indicates (a) higher levels of self-efficacy, individual readiness to change and civic action after user-system experience, (b) significant and positive direct associations between self-efficacy, self-regulation, interpersonal and problem-solving skills, individual readiness to change, mastery goal orientation and civic action pre- and postinteraction and (c) gender differences in the perceptions of system usability performance according to country of origin. Theoretical and practical implications in tandem with future research avenues are discussed in light of embodied conversational agent metacognitive training in negotiation.

scholarly journals Associations of psychosocial factors with fruit and vegetable intake among African-Americans

2007 ◽  
Vol 10 (7) ◽  
pp. 701-711 ◽  
Author(s):  
Joanne L Watters ◽  
Jessie A Satia ◽  
Joseph A Galanko
Keyword(s):  
African American ◽  
African Americans ◽  
Psychosocial Factors ◽  
Self Efficacy ◽  
Vegetable Intake ◽  
African American Men ◽  
Predisposing Factors ◽  
Fruit And Vegetable Intake ◽  
Fruit And Vegetable ◽  
Enabling Factors

AbstractObjectiveTo examine associations of various psychosocial factors with fruit and vegetable intake in African-American adults.MethodsA cross-sectional survey of a population-based sample of 658 African-Americans, aged 18–70 years, in North Carolina. Information was collected on diet-related psychosocial (predisposing, reinforcing and enabling) factors based on the PRECEDE (Predisposing, Reinforcing, and Enabling Constructs in Educational Diagnosis and Evaluation) planning framework; demographic, lifestyle and behavioural characteristics, and fruit and vegetable intake.ResultsThe mean participant age was 43.9 years (standard deviation 11.6), 57% were female and 76% were overweight/obese. Participants expressed healthy beliefs regarding many of, but not all, the psychosocial factors. For example, although half of the respondents believed it is important to eat a diet high in fruits/vegetables, only 26% knew that ≥ 5 daily servings are recommended. The strongest associations of the psychosocial factors with fruit/vegetable intake were for predisposing factors (e.g. belief in the importance of a high fruit/vegetable diet and knowledge of fruit/vegetable recommendations) and one reinforcing factor (social support), with differences between the healthiest and least healthy responses of 0.5–1.0 servings per day. There was evidence of effect modification by gender in associations between psychosocial factors and fruit/vegetable consumption (e.g. self-efficacy was only significant in women), with higher intakes and generally healthier responses to the psychosocial variables in women than men.ConclusionsInterventions to increase fruit/vegetable intake in African-Americans may be more effective if they focus primarily on predisposing factors, such as knowledge, self-efficacy and attitudes, but not to the exclusion of reinforcing and enabling factors. The psychosocial factors that are targeted may also need to be somewhat different for African-American men and women.

Prostate Cancer in African American Men: Increasing Knowledge and Self-Efficacy

1995 ◽  
Vol 12 (3) ◽  
pp. 161-169 ◽  
Author(s):  
Susan Boehm ◽  
Patricia Coleman-Burns ◽  
Elizabeth A. Schlenk ◽  
Martha M. Funnell ◽  
Jeanne Parzuchowski ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
African American ◽  
Self Efficacy ◽  
African American Men ◽  
Increasing Knowledge

scholarly journals EVALUATING THE ENGAGING OLDER ADULT LEARNERS AS HEALTH RESEARCHERS PROJECT I

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S405-S405
Author(s):  
Kate Kondolf ◽  
Joyce Duckles ◽  
sandhya Seshadri ◽  
Phyllis Jackson ◽  
Craig Sellers ◽  
...  
Keyword(s):  
Health Literacy ◽  
Adult Learners ◽  
Older Adult ◽  
Self Efficacy ◽  
Repeated Measures ◽  
Subjective Health ◽  
King's College ◽  
Race And Health ◽  
Older Adult Learners

Abstract We discuss the evaluation of the Engaging Older Adult Learners as Health Researchers (ENGOAL), a program designed to educate older adults from underserved and underresourced communities about geriatric health and research methods, enabling them to become Research Partners. Quantitative and qualitative data were collected for evaluation from 21 participants aged 53-79. We used All Aspects of Health Literacy Scale (AAHLS, King’s College, London) and an adaptation of Stanford Patient Education Research Center Chronic Disease Self-Efficacy Scale to assess pre-post and follow-up changes, using repeated measures analyses. Results suggest notable increases in self-efficacy, but only small improvements in subjective health literacy. Themes identified through qualitative analysis of interviews with participants included: (1) Finding our Voices (2) Race and Health (3) Faith and Health (4) Communicating with Providers and (5) Sharing and Advocacy. Emerging community leadership of participants are further evidence of confidence gains in our participants.

scholarly journals Self-Rated Health and Health Care Access Associated With African American Men’s Health Self-Efficacy

2015 ◽  
Vol 11 (5) ◽  
pp. 1385-1387 ◽  
Author(s):  
Terry Thompson ◽  
Jamie A. Mitchell ◽  
Vicki Johnson-Lawrence ◽  
Daphne C. Watkins ◽  
Charles S. Modlin
Keyword(s):  
Health Care ◽  
African American ◽  
Health Insurance ◽  
Health Care Access ◽  
Self Efficacy ◽  
African American Men ◽  
Good Care ◽  
Cross Sectional ◽  
Self Rated Health ◽  
Care Access

Health self-efficacy, a measure of one’s self-assurance in taking care of their own health, is known to contribute to a range of health outcomes that has been under examined among African American men. The purpose of this investigation was to identify and contextualize predictors of general health self-efficacy in this population. A cross-sectional sample of surveys from 558 African American was examined. These men were older than 18 years, could read and write English, and attended a hospital-based community health fair targeting minority men in 2011. The outcome of interest was health self-efficacy, which was assessed by asking, “Overall, how confident are you in your ability to take good care of your health?” Responses ranged from 1 ( not confident at all) to 5 ( completely confident). Covariates included age, self-rated health, health insurance status, having a regular physician, and being a smoker. The mean age of participants was 54.4 years, and 61.3% of participants indicated confidence in their ability to take good care of their health. Older age and being a smoker were inversely associated with the outcome. Good self-rated health, having health insurance, and having a regular doctor were positively associated with reports of health self-efficacy. Findings suggest that multiple points of connection to the health care system increase the likelihood of health self-efficacy for this sample and interventions to support older African American men who may evaluate their own health status as poor and who may face barriers to health care access are implicated.

scholarly journals Pilot Study Investigating the Effect of a Suppression Versus Mindfulness-Based Strategy in Coping with Cigarette Cravings

2021 ◽  
Author(s):  
Jenny Rogojanski
Keyword(s):  
Depressive Symptoms ◽  
Pilot Study ◽  
Negative Affect ◽  
Coping Strategies ◽  
Nicotine Dependence ◽  
Self Efficacy ◽  
Emotional Functioning ◽  
Cue Exposure ◽  
Cigarette Cravings

The current pilot study investigated the effectiveness of a brief suppression versus mindfulness-based strategy for coping with cigarette cravings. Participants (N = 61) were randomly assigned to one of the two coping strategies to manage cravings during an experimental cue exposure to cigarettes. Results indicate that participants in both conditions reported significantly reduced amounts of smoking and increased self-efficacy in coping with smoking urges at a seven-day follow-up. However, only participants in the mindfulness condition demonstrated reductions in negative affect, depressive symptoms, and reduced levels of nicotine dependence. These findings indicate that while both conditions were associated with improvements on smoking relevant outcomes, mindfulness was unique for its beneficial impacts on reported nicotine dependence and emotional functioning over the course of the study.

Educating African American men on prostate health and informed decision making: Initial report from a peer-education program in Louisiana.

2011 ◽  
Vol 29 (7_suppl) ◽  
pp. 211-211
Author(s):  
M. M. Robinson ◽  
A. O. Sartor ◽  
L. Jack
Keyword(s):  
Prostate Cancer ◽  
Health Care ◽  
Decision Making ◽  
African American ◽  
African American Men ◽  
Peer Education ◽  
Cancer Control ◽  
Informed Decision ◽  
Informed Decision Making

211 Background: Informed decision making for prostate cancer health is widely endorsed but systematic programs to address this need are sparse. Herein we report initial progress in a statewide effort targeting African American men. Methods: The Louisiana Cancer and Lung Trust Fund Board (LCLTFB) Prostate Cancer Program is funded via a “check box” on the state income tax form, in which a portion of refunds could be allocated for prostate cancer efforts. The LCLTFB partnered with the statewide comprehensive cancer control program to develop a pilot lay program to educate men on prostate informed decision. The program was developed and modeled after “My Brother's Keeper,” a CDC funded program and implemented in five regions of the state. African American men active in the cancer community and regional cancer coalitions were identified as possible trainers for the program. Staff members from “My Brother's Keeper” trained the Cancer Control regional staff, as well as the community trainers in a two day session. Upon completion, the community trainers were charged to go into their community and convene three education sessions. Educational sessions were conducted in local churches, head start centers, men social club meeting, Greek organizational meetings, and labor union meetings. Men attending the session received a short pre- and post-test assessing whether or not they had discussed prostate informed decision making with a health care provider, if they had made an appointment with a health care provider, or was any follow up from the educational session initiated. Results: A total of 250 African American men in Louisiana were educated by the program. Upon followup phone calls, 172 men self-reported that they had initiated some form of follow up as a consequence of the participation. 35 men were unable to be contacted for follow up (number no longer in service or no phone number listed) 43 men (messages left but no returned call). Conclusions: Peer education can engage African American men regarding informed decision making on prostate cancer health issues. More data are needed to verify and determine the type of followup that was initiated after the educational sessions. [Table: see text]

Impact of a Personal Health Record Intervention upon Surveillance Among Colorectal Cancer Survivors: Feasibility Study (Preprint)

2021 ◽  
Author(s):  
Eric Vachon ◽  
Bruce W. Robb ◽  
David A. Haggstrom
Keyword(s):  
Colorectal Cancer ◽  
Feasibility Study ◽  
Self Efficacy ◽  
Personal Health Record ◽  
Personal Health ◽  
Health Record ◽  
Post Intervention ◽  
Patient Centered ◽  
Patient Beliefs

BACKGROUND There are currently an estimated 1.5 million individuals living in the United States (US) with colorectal cancer (CRC), and although the five-year survival rate has increased, survivors are at risk for recurrence, particularly within the first 2-3 post-treatment. National guidelines recommend continued surveillance post-resection, in order to identify recurrence early on. Adherence among survivors ranges from 49%-94%. Novel interventions are needed to increase CRC survivors’ knowledge and confidence in managing their cancer and thus increase adherence to follow-up surveillance. OBJECTIVE The objective of this study was to develop and test the feasibility and efficacy of a web-based personal health record (PHR) to increase surveillance adherence among CRC survivors, with patient beliefs about surveillance as secondary outcomes. METHODS A pre- and post-intervention feasibility trial was conducted testing the efficacy of the Colorectal Cancer Survivor (CRCS)-PHR, which had been previously developed using an iterative, user-centered design approach. The CRCS-PHR includes surveillance guidelines, treatment tracking, potential treatment toxicities, as well as a journaling tab and communities to interact with other CRC survivors. A total of 28 stage I-III CRC survivors (9 colon, 18 rectal, 1 unknown) were recruited from an academic medical center in the Midwest US. At enrollment, patient demographics and cancer characteristics were gathered via medical record audit. Following enrollment, patients completed surveys at baseline and 6 months post-intervention asking about adherence to colonoscopy, computed tomography (CT) scan, and carcinoembryonic antigen (CEA) and beliefs about surveillance (barriers, benefits, self-efficacy, and knowledge). Paired t-test analyses were used to compare pre- and post-intervention ratings for each of the four patient beliefs categories and surveillance adherence. RESULTS The average age of the sample was 58 years old, with 57% males and the majority being married and employed full time. We observed a significant increase in adherence to colonoscopy (pre: 52% vs. post: 86%, p<.01) and CEA (67% vs. 95%, p=.01), as well as a slight increase in CT scans (67% vs. 84%, p=.1). The only significant impact on secondary outcome (patient beliefs) was benefits of CEA test (p=.04), as most of the beliefs were high at baseline. CONCLUSIONS This feasibility study lays the groundwork for continued development of the CRCS-PHR to increase CRC surveillance. Patient-centered technologies, such as the CRCS-PHR, represent an important potential approach to improving the receipt of guideline-concordant care and follow-up surveillance, not just for CRC survivors. Researchers should continue to develop patient-centered health technologies with clinician implementation in mind to increase patient self-efficacy and surveillance adherence.

Evaluation of a Computer-Based Decision Aid for Promoting Informed Prostate Cancer Screening Decisions Among African American Men: iDecide

2018 ◽  
Vol 33 (2) ◽  
pp. 267-278 ◽  
Author(s):  
Otis L. Owens ◽  
Tisha Felder ◽  
Abbas S. Tavakoli ◽  
Asa A. Revels ◽  
Daniela B. Friedman ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Decision Making ◽  
African American ◽  
Cancer Screening ◽  
Technology Use ◽  
Self Efficacy ◽  
African American Men ◽  
Prostate Cancer Screening ◽  
Informed Decision ◽  
Informed Decision Making

Purpose: To evaluate the effects of iDecide on prostate cancer knowledge, informed decision-making self-efficacy, technology use self-efficacy, and intention to engage in informed decision-making among African American men. Design: One-group, pretest/posttest. Setting: Community settings in South Carolina. Participants: African American men, ages 40 years +, without a prior prostate cancer diagnosis (n = 354). Intervention: iDecide, an embodied conversational agent-led, computer-based prostate cancer screening decision aid. Measures: Prostate cancer knowledge, informed decision-making self-efficacy, technology use self-efficacy, and intention to engage in informed decision-making. Analysis: Descriptive statistics, paired t tests, general linear modeling, Spearman correlations. Results: On average, participants experienced significant improvements in their prostate cancer knowledge ( P ≤ .001), informed decision-making self-efficacy ( P ≤ .001), and technology use self-efficacy ( P ≤ .001), postintervention. Additionally, 67% of participants reported an intention to engage in informed decision-making. Conclusion: Given the significant improvements across all measures, this research demonstrates that embodied conversational agent-led decision aids can be used to enhance the capacity for making informed prostate cancer screening decisions among African American men and increase their technology use self-efficacy. One critical limitation of this study is that most men had received prostate cancer screening prior to engaging in our intervention, so the implications of this intervention may be different for men who do not have a history of screening. Additionally, actual engagement in informed decision-making postintervention was not assessed.

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