Reaching women through health information technology: the Gabby preconception care system

Abstract

Purpose: The Centers for Disease Control and Prevention have endorsed the concept of preconception care (PCC). New tools must be developed to promote PCC.

Design: Development and testing of a health information technology system to provide PCC.

Setting: An urban safety net hospital and an urban university.

Subjects: Community recruitment of 31 women in focus groups and 15 women participating in observed usability testing; 9 students recruited from the Office of Minority Health Preconception Peer Educators program participated in pilot testing for 2 months.

Intervention: Online interactive animated character ("Gabby") designed to identify and modify preconception risks.

Measures: Qualitative transcripts, preconception risk assessment, server data for system usage, self-administered satisfaction surveys, and follow-up phone calls.

Analysis: Descriptive statistics of subjects' demographics, satisfaction, PCC risks, and system usage. Transcripts coded using NVIVO.

Results: Subjects (n = 24) reported an average of 23 preconception risks; in the pilot, 83% of risks added to the "My Health To-Do List" were addressed by the subject. Seventy-three percent of risks identified as contemplative progressed to action or maintenance. Differences were noted in effectiveness of the system based on initial stage of change for each risk.

Conclusion: Results suggest that the PCC system could be effective in influencing positive behavior change. Adding stage of change-focused functionality might have added benefits. This system has great potential to assist in the delivery of PCC.

Figure 1

An image of “Gabby,” the preconception care virtual patient advocate