Wilson-Howard Danyell, Vilaro Melissa J, Neil Jordan M, Cooks Eric J, Griffin Lauren N, Ashley Taylor T, Tavassoli Fatemeh, Zalake Mohan S, Lok Benjamin C, Odedina Folakemi T, Modave Francois, Carek Peter J, George Thomas J, Krieger Janice L
Department of Natural Sciences, Bethune Cookman University, Daytona, FL, United States.
STEM Translational Communication Center, College of Journalism, University of Florida, Gainesville, FL, United States.
JMIR Form Res. 2021 Dec 24;5(12):e28709. doi: 10.2196/28709.
Traditionally, promotion of colorectal cancer (CRC) screening among Black men was delivered by community health workers, patient navigators, and decision aids (printed text or video media) at clinics and in the community setting. A novel approach to increase CRC screening of Black men includes developing and utilizing a patient-centered, tailored message delivered via virtual human technology in the privacy of one's home.
The objective of this study was to incorporate the perceptions of Black men in the development of a virtual clinician (VC) designed to deliver precision messages promoting the fecal immunochemical test (FIT) kit for CRC screening among Black men in a future clinical trial.
Focus groups of Black men were recruited to understand their perceptions of a Black male VC. Specifically, these men identified source characteristics that would enhance the credibility of the VC. The modality, agency, interactivity, and navigability (MAIN) model, which examines how interface features affect the user's psychology through four affordances (modality, agency, interactivity, and navigability), was used to assess the presumed credibility of the VC and likability of the app from the focus group transcripts. Each affordance triggers heuristic cues that stimulate a positive or a negative perception of trustworthiness, believability, and understandability, thereby increasing source credibility.
In total, 25 Black men were recruited from the community and contributed to the development of 3 iterations of a Black male VC over an 18-month time span. Feedback from the men enhanced the visual appearance of the VC, including its movement, clothing, facial expressions, and environmental surroundings. Heuristics, including social presence, novelty, and authority, were all recognized by the final version of the VC, and creditably was established. The VC was named Agent Leveraging Empathy for eXams (ALEX) and referred to as "brother-doctor," and participants stated "wanting to interact with ALEX over their regular doctor."
Involving Black men in the development of a digital health care intervention is critical. This population is burdened by cancer health disparities, and incorporating their perceptions in telehealth interventions will create awareness of the need to develop targeted messages for Black men.
传统上，在诊所和社区环境中，通过社区卫生工作者、患者导航员以及决策辅助工具（印刷文本或视频媒体）来推动黑人男性进行结直肠癌（CRC）筛查。一种增加黑人男性CRC筛查率的新方法包括开发并利用以患者为中心的定制信息，通过虚拟人技术在个人家中私密环境下传递。
本研究的目的是在开发虚拟临床医生（VC）的过程中纳入黑人男性的看法，该虚拟临床医生旨在传递精准信息，以促进在未来的临床试验中黑人男性使用粪便免疫化学检测（FIT）试剂盒进行CRC筛查。
招募黑人男性焦点小组以了解他们对黑人男性VC的看法。具体而言，这些男性确定了能够增强VC可信度的来源特征。模态性、能动性、交互性和可导航性（MAIN）模型通过四种可供性（模态性、能动性、交互性和可导航性）来研究界面特征如何影响用户心理，该模型被用于根据焦点小组记录评估VC的假定可信度和应用的受欢迎程度。每种可供性都会触发启发式线索，这些线索会激发对可信度、可信度和可理解性的正面或负面看法，从而提高来源可信度。
总共从社区招募了25名黑人男性，他们在18个月的时间跨度内为黑人男性VC的3个迭代版本开发做出了贡献。这些男性的反馈改善了VC的视觉外观，包括其动作、服装、面部表情和环境背景。最终版本的VC识别出了包括社交临场感、新颖性和权威性在内的启发式线索，并建立了可信度。该VC被命名为“Exam的共情杠杆代理”（ALEX），并被称为“兄弟医生”，参与者表示“希望与ALEX互动，而不是他们的常规医生”。
让黑人男性参与数字医疗干预的开发至关重要。这一人群深受癌症健康差距之苦，将他们的看法纳入远程医疗干预将使人们意识到有必要为黑人男性制定有针对性的信息。
