Employing Virtual Advisors in Preventive Care for Underserved Communities: Results From the COMPASS Study

Abstract

Electronically delivered health promotion programs that are aimed primarily at educated, health-literate individuals have proliferated, raising concerns that such trends could exacerbate health disparities in the United States and elsewhere. The efficacy of a culturally and linguistically adapted virtual advisor that provides tailored physical activity advice and support was tested in low-income older adults. Forty inactive adults (92.5% Latino) 55 years of age and older were randomized to a 4-month virtual advisor walking intervention or a waitlist control. Four-month increases in reported minutes of walking/week were greater in the virtual advisor arm (mean increase = 253.5 ± 248.7 minutes/week) relative to the control (mean increase = 26.8 ± 67.0 minutes/week; p = .0008). Walking increases in the virtual advisor arm were substantiated via objectively measured daily steps (slope analysis p = .002). All but one intervention participant continued some interaction with the virtual advisor in the 20-week poststudy period (mean number of poststudy sessions = 14.0 ± 20.5). The results indicate that a virtual advisor delivering culturally and linguistically adapted physical activity advice led to meaningful 4-month increases in walking relative to control among underserved older adults. This interactive technology, which requires minimal language and computer literacy, may help reduce health disparities by ensuring that all groups benefit from e-health opportunities.

Acknowledgments

The authors thank the senior citizens and staff of the Eastside Neighborhood Center, San Jose, California, including Milton Cadena, Center Director, for support and participation. Dulce Garcia's assistance in data collection was greatly appreciated. The authors also thank Juan Fernandez, Dharma Cortez, and Donna Byron, Northeastern University, for programming work, Dr. David Ahn for contributions in the area of statistical analysis, Drs. Cynthia Castro, Stanford Prevention Research Center, and Guido Urizar, Jr., California State University-Long Beach, California, for input during project development, and Randall Stafford, M.D., Ph.D., Stanford University School of Medicine, for helpful advice in reviewing earlier drafts of this article.

This research was supported by PHS grant # R21CA127511 from the National Cancer Institute awarded to Dr. King. The clinicaltrials.gov registry number for this study is NCT01144767.

Notes

Note. Values reported as n and % except where noted as M (SD).