Despite over thirty years of research and policy work, Black women are approximately twice as likely to deliver a preterm infant as white women. The current project is part of a new effort to focus on engaging young women before they become pregnant - a concept called preconception care. Simply, healthy women are more likely to have healthy babies. Intervention. This study is the first to examine the effectiveness of an innovative health communication system (Gabby) that provides preconception health care across 12 domains of health and utilizes advanced capabilities to remain current through story-telling functionality, and scales the intervention to a large number of women via its social marketing applications. Methods: A two-armed randomized controlled trial of African American women ages 18-25 recruited through community-based organizations. Both groups will undergo a comprehensive preconception health risk assessment. The intervention group will then receive the Gabby intervention. The control group will be sent a list of health risks generated by the health risk assessment. Outcomes: At twelve months, we will measure improvement in health risks. Secondary outcomes include measurement of usage rates, dose of exposure, attrition, patient and health worker and subject satisfaction, number of women with a personalized health plan, and timeliness of response. Sub analyses include the impact of perceived societal stress and health literacy on outcomes. Significance: The potential to create a low-cost, user-friendly, culturally competent, evidence-based, scalable intervention that is continuously refreshed (via the story telling function) and can be used across a range of health care, educational and community settings to improve the health of young African American women.

Public Health Relevance

In an effort to address health disparities in birth outcomes for African American women, this research aims to translate evidence-based preconception care guidelines into the clinical setting. Our computer-based intervention has the ability to provide standardized, comprehensive preconception care that is patient-centered and culturally competent. If proven effective, this intervention could be used by all women and adapted to other high-risk populations, with the goal of reducing disparities in newborn morbidity and mortality.

National Institute of Health (NIH)
National Institute on Minority Health and Health Disparities (NIMHD)
Research Project (R01)
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Special Emphasis Panel (ZMD1)
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Alvidrez, Jennifer L
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Boston Medical Center
United States
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Jack, Brian; Bickmore, Timothy; Hempstead, Megan et al. (2015) Reducing Preconception Risks Among African American Women with Conversational Agent Technology. J Am Board Fam Med 28:441-51
Manuvinakurike, Ramesh; Velicer, Wayne F; Bickmore, Timothy W (2014) Automated indexing of Internet stories for health behavior change: weight loss attitude pilot study. J Med Internet Res 16:e285