Employing virtual advisors in preventive care for underserved communities: results from the COMPASS study
Open accessAbstract
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.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Most automated health behavior change interventions are designed to address only a single behavior.
“To date, most automated health behavior change interventions are designed to only address a single behavior [8, 9].”
From Engaging women with an embodied conversational agent to deliver mindfulness and lifestyle recommendations: A feasibility randomized control trial (2017) · cites this paper as [9]
The ECA shows particular promise for conveying behavioral change strategies to patients.
“One technology, called the embodied conversational agent (ECA), shows particular promise for conveying behavioral change strategies to patients [9, 12].”
From Engaging women with an embodied conversational agent to deliver mindfulness and lifestyle recommendations: A feasibility randomized control trial (2017) · cites this paper as [9]
Virtual patient advocates are well suited to deliver preconception care because they can reach many patients, reduce clinician time demands, control costs, and achieve high acceptability through culturally appropriate and low-health-literacy-appropriate content.
“VPAs are ideal for delivering PCC because they can potentially reach a large number of patients, alleviate clinician time restraints, and control costs while simultaneously having high patient acceptability through culturally appropriate content17 and information appropriate to those with low health literacy.18, 19”
From Reaching Women through Health Information Technology: The Gabby Preconception Care System (2013) · cites this paper as [17]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Social Cognitive Theory: An Agentic Perspective
Bandura, A. (2001) · Annual Review of Psychology · doi:10.1146/annurev.psych.52.1.1 · Cited by 15,510 · see citing works
‘Small Changes' to Diet and Physical Activity Behaviors for Weight Management
Hills, A. P., Byrne, N. M., Lindstrom, R. C., & Hill, J. O. (2013) · Obesity Facts · doi:10.1159/000345030 · Cited by 9,526 · see citing works
Development and validation of the working alliance inventory
Horvath, A. O., & Greenberg, L. S. (1989) · Journal of Counseling Psychology · doi:10.1037//0022-0167.36.2.223 · Cited by 3,520 · see citing works
Using Pedometers to Increase Physical Activity and Improve Health: A Systematic Review
Bravata, D. M., Smith-Spangler, C., Sundaram, V., Gienger, A. L., Lin, N., Lewis, R., Stave, C. D., Olkin, I., & Sirard, J. R. (2007) · JAMA · doi:10.1001/jama.298.19.2296 · Cited by 2,064 · see citing works
Revision of the Physical Activity Readiness Questionnaire (PAR-Q).
Thomas, S. G., Reading, J., & Shephard, R. J. (1992) · PubMed · Cited by 1,952 · see citing works
Establishing and maintaining long-term human-computer relationships
Bickmore, T. W., & Picard, R. W. (2005) · ACM Transactions on Computer-Human Interaction · doi:10.1145/1067860.1067867 · Cited by 1,333 · cited 1× · see citing works
“Although not explicitly included in this first-generation study, additional low-cost strategies for promoting continued use of the virtual advisor program could be formally included as part of the program (Bickmore & Picard, 2005).”
BackgroundCHAMPS Physical Activity Questionnaire for Older Adults: outcomes for interventions
Stewart, A. L., Mills, K. M., King, A. C., Haskell, W. L., Gillis, D., & Ritter, P. L. (2001) · Medicine & Science in Sports & Exercise · doi:10.1097/00005768-200107000-00010 · Cited by 1,250 · see citing works
Health Information on the Internet
Berland, G. K., Elliott, M. N., Morales, L. S., Algazy, J. I., Kravitz, R. L., Broder, M. S., Kanouse, D. E., Muñoz, J. A., Puyol, J.-A., Lara, M., et al. (2001) · JAMA · doi:10.1001/jama.285.20.2612 · Cited by 1,212 · see citing works
The Working Alliance: Theory, Research, and Practice
Bogart, G. (1995) · American Journal of Psychotherapy · doi:10.1176/appi.psychotherapy.1995.49.2.306 · Cited by 994 · see citing works
Understanding tailoring in communicating about health
Hawkins, R. P., Kreuter, M., Resnicow, K., Fishbein, M., & Dijkstra, A. (2008) · Health Education Research · doi:10.1093/her/cyn004 · Cited by 934 · see citing works
(2018) · Annals of Behavioral Medicine · doi:10.1007/12160.1532-4796 · Cited by 927 · see citing works
Forcing a sequential experiment to be balanced
EFRON, B. (1971) · Biometrika · doi:10.1093/biomet/58.3.403 · Cited by 873 · see citing works
The stages and processes of exercise adoption and maintenance in a worksite sample.
Marcus, B. H., Rossi, J. S., Selby, V. C., NIAURA, R. S., & Abrams, D. B. (1992) · Health Psychology · doi:10.1037/0278-6133.11.6.386 · Cited by 798 · see citing works
The role of culture in health communication.
Kreuter, M., & McClure, S. (2004) · Annual Review of Public Health · doi:10.1146/annurev.publhealth.25.101802.123000 · Cited by 709 · see citing works
Assessing motivational readiness and decision making for exercise.
Marcus, B. H., Rakowski, W., & Rossi, J. S. (1992) · Health Psychology · doi:10.1037//0278-6133.11.4.257 · Cited by 676 · see citing works
The LIFE Study Investigators* [*See Appendix for List of LIFE Study Investigators] (2006) · The Journals of Gerontology Series A · doi:10.1093/gerona/61.11.1157 · Cited by 661 · see citing works
A Review of eHealth Interventions for Physical Activity and Dietary Behavior Change
Norman, G. J., Zabinski, M. F., Adams, M. A., Rosenberg, D. E., Yaroch, A. L., & Atienza, A. A. (2007) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2007.05.007 · Cited by 605 · cited 1× · see citing works
“While electronically delivered health promotion (e-health) programs have proliferated, few have specifically targeted the needs and preferences of older adults (Norman et al., 2007).”
BackgroundMohr, D. C., Spring, B., Freedland, K. E., Beckner, V., Arean, P., Hollon, S. D., Ockene, J., & Kaplan, R. (2009) · Psychotherapy and Psychosomatics · doi:10.1159/000228248 · Cited by 565 · see citing works
Objective Light-Intensity Physical Activity Associations With Rated Health in Older Adults
Buman, M. P., Hekler, E. B., Haskell, W. L., Pruitt, L., Conway, T. L., Cain, K. L., Sallis, J. F., Saelens, B. E., Frank, L. D., & King, A. C. (2010) · American Journal of Epidemiology · doi:10.1093/aje/kwq249 · Cited by 528 · see citing works
Assessing motivational readiness and decision making for exercise.
Marcus, B. H., Rakowski, W., & Rossi, J. S. (1992) · Health Psychology · doi:10.1037/0278-6133.11.4.257 · Cited by 498 · see citing works
Establishing the computer-patient working alliance in automated health behavior change interventions
Bickmore, T., Gruber, A., & Picard, R. (2005) · Patient Education and Counseling · doi:10.1016/j.pec.2004.09.008 · Cited by 494 · see citing works
Self-citationWebster, J., & Treviño, L. K. (1995) · Academy of Management Journal · doi:10.2307/256843 · Cited by 457 · see citing works
An evaluation of three self-report physical activity instruments for older adults
Harada, N. D., Chiu, V. Y., King, A. C., & Stewart, A. L. (2001) · Medicine & Science in Sports & Exercise · doi:10.1097/00005768-200106000-00016 · Cited by 457 · see citing works
Marcus, B. H., & Simkin, L. R. (1994) · Medicine & Science in Sports & Exercise · doi:10.1249/00005768-199411000-00016 · Cited by 411 · see citing works
Promoting physical activity for older adultsThe challenges for changing behavior
Brawley, L. R. (2003) · American Journal of Preventive Medicine · doi:10.1016/s0749-3797(03)00182-x · Cited by 385 · see citing works
Interventions to Promote Physical Activity by Older Adults
King, A. C. (2001) · The Journals of Gerontology Series A · doi:10.1093/gerona/56.suppl_2.36 · Cited by 373 · see citing works
'It's just like you talk to a friend': relational agents for older adults
Bickmore, T. W., Caruso, L., Clough-Gorr, K., & Heeren, T. (2005) · Interacting with Computers · doi:10.1016/j.intcom.2005.09.002 · Cited by 341 · see citing works
King, A. C., Pruitt, L. A., Phillips, W. T., Oka, R. K., Rodenburg, A., & Haskell, W. L. (2000) · The Journals of Gerontology Series A · doi:10.1093/gerona/55.2.m74 · Cited by 314 · see citing works
Bodie, G. D., & Dutta, M. J. (2008) · Health Marketing Quarterly · doi:10.1080/07359680802126301 · Cited by 310 · see citing works
Bickmore, T. W., Pfeifer, L. M., Byron, D., Forsythe, S., Henault, L. E., Jack, B. W., Silliman, R., & Paasche-Orlow, M. K. (2010) · Journal of Health Communication · doi:10.1080/10810730.2010.499991 · Cited by 249 · see citing works
King, A. C., Baumann, K., O'Sullivan, P., Wilcox, S., & Castro, C. M. (2002) · The Journals of Gerontology Series A · doi:10.1093/gerona/57.1.m26 · Cited by 243 · see citing works
Health Disparities, Communication Inequalities, and eHealth
Viswanath, K., & Kreuter, M. W. (2007) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2007.02.012 · Cited by 238 · see citing works
Motion Sensor Accuracy under Controlled and Free-Living Conditions
Masurier, G. C. L., Lee, S. M., & Tudor-Locke, C. E. (2004) · Medicine & Science in Sports & Exercise · doi:10.1249/01.mss.0000126777.50188.73 · Cited by 229 · see citing works
Estimating activity energy expenditure: how valid are physical activity questionnaires?
Neilson, H. K., Robson, P. J., Friedenreich, C. M., & Csizmadi, I. (2008) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/87.2.279 · Cited by 211 · see citing works
Validity and Reliability of Omron Pedometers for Prescribed and Self-Paced Walking
Holbrook, E. A., Barreira, T. V., & Kang, M. (2009) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0b013e3181886095 · Cited by 191 · see citing works
Muñoz, R. F., & Mendelson, T. (2005) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.73.5.790 · Cited by 181 · see citing works
Hekler, E. B., Buman, M. P., Haskell, W. L., Conway, T. L., Cain, K. L., Sallis, J. F., Saelens, B. E., Frank, L. D., Kerr, J., & King, A. C. (2012) · Journal of Physical Activity and Health · doi:10.1123/jpah.9.2.225 · Cited by 159 · see citing works
Wilcox, S., Dowda, M. C., Leviton, L. C., Bartlett-Prescott, J., Bazzarre, T. L., Campbell‐Voytal, K., Carpenter, R. A., Castro, C. M., Dowdy, D. M., Dunn, A. L., et al. (2008) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2008.07.001 · Cited by 152 · see citing works
King, A. C., Friedman, R. H., Marcus, B. H., Castro, C. M., Napolitano, M. A., Ahn, D. K., & Baker, L. (2007) · Health Psychology · doi:10.1037/0278-6133.26.6.718 · Cited by 137 · see citing works
Telephone-Assisted Counseling for Physical Activity
Castro, C. M., & King, A. C. (2002) · Exercise and Sport Sciences Reviews · doi:10.1097/00003677-200204000-00004 · Cited by 133 · see citing works
Mediators of physical activity behavior change: A multivariate approach.
Napolitano, M. A., Papandonatos, G. D., Lewis, B. A., Whiteley, J. A., Williams, D. M., King, A. C., Bock, B. C., Pinto, B. M., & Marcus, B. H. (2008) · Health Psychology · doi:10.1037/0278-6133.27.4.409 · Cited by 97 · see citing works
Practical behavioral trials to advance evidence-based behavioral medicine
Glasgow, R. E., Davidson, K. W., Dobkin, P. L., Ockene, J. K., & Spring, B. J. (2006) · Annals of Behavioral Medicine · doi:10.1207/s15324796abm3101_3 · Cited by 76 · see citing works
A methodology for describing and decomposing complex psychosocial and behavioral interventions.
Czaja, S. J., Schulz, R., Lee, C. C., & Belle, S. H. (2003) · Psychology and Aging · doi:10.1037/0882-7974.18.3.385 · Cited by 75 · see citing works
Pedometer Indices for Weekly Physical Activity Recommendations in Postmenopausal Women
JORDAN, A. N., JURCA, G. M., TUDOR-LOCKE, C., Church, T. S., & Blair, S. N. (2005) · Medicine & Science in Sports & Exercise · doi:10.1249/01.mss.0000177455.58960.aa · Cited by 73 · see citing works
Randomized Controlled Trials Involving Multidisciplinary Interventions in the Community
Pahor, M. (2006) · The Journals of Gerontology Series A · doi:10.1093/gerona/61.5.472 · Cited by 73 · see citing works
Maximizing the Potential of an Aging Population
King, A. C., & Guralnik, J. M. (2010) · JAMA · doi:10.1001/jama.2010.1577 · Cited by 69 · see citing works
Age differences in the performance of information retrieval tasks
Freudenthal, D. T. (2001) · Behaviour and Information Technology · doi:10.1080/01449290110049745 · Cited by 68 · see citing works
An assessment of the psychometric properties of the computer attitude scale
Rainer, R. K., & Miller, M. D. (1996) · Computers in Human Behavior · doi:10.1016/0747-5632(95)00021-6 · Cited by 67 · see citing works
Strath, S. J., Swartz, A. M., Parker, S. J., Miller, N. E., Grimm, E. K., & Cashin, S. E. (2011) · Journal of Physical Activity and Health · doi:10.1123/jpah.8.s2.s267 · Cited by 58 · see citing works
Self-regulation and physical activity: the relationship in older adults.
Umstattd, M. R., Wilcox, S., Saunders, R. P., et al. (2008) · PubMed · doi:10.5555/ajhb.2008.32.2.115 · Cited by 46 · see citing works
Self-regulation and Physical Activity: The Relationship in Older Adults
Umstattd, M. (2008) · American Journal of Health Behavior · doi:10.5993/ajhb.32.2.1 · Cited by 41 · see citing works
Are daily fluctuations in perceived environment associated with walking?
Hekler, E. B., Buman, M. P., Ahn, D. K., Dunton, G. F., Atienza, A. A., & King, A. C. (2012) · Psychology and Health · doi:10.1080/08870446.2011.645213 · Cited by 36 · see citing works
ASSESSMENT OF DAILY PHYSICAL ACTIVITY BY A PEDOMETER
Harada, A., Kawakubo, K., & Lee, J. (2001) · Medicine & Science in Sports & Exercise · doi:10.1097/00005768-200105001-01412 · Cited by 26 · see citing works
The Quality of Spanish Health Information Websites
Cardelle, A. J. F., & Rodriguez, E. G. (2005) · Journal of Prevention & Intervention in the Community · doi:10.1300/j005v29n01_06 · Cited by 15 · see citing works
Fogg, B. J., Marshall, J. P., Kameda, T., Solomon, J., Rangnekar, A., Boyd, J., & Brown, B. (2001) · CHI Conference Extended Abstracts on Human Factors in Computing Systems (CHI EA) · doi:10.1145/634239.634242 · Cited by 3 · see citing works
Flagged first, then by citations
Research works printed but not linked: 1
- SAS Institute Inc. (2009). SAS/STAT 9.2 user’s guide (2nd ed.). Cary, NC: Author.
Cited by
Sorted by citations
Health literacy in the eHealth era: A systematic review of the literature
Kim, H., & Xie, B. (2017) · Patient Education and Counseling · doi:10.1016/j.pec.2017.01.015 · Cited by 457 · see citing works
Survey of conversational agents in health
Montenegro, J. L. Z., da Costa, C. A., & da Rosa Righi, R. (2019) · Expert Systems with Applications · doi:10.1016/j.eswa.2019.03.054 · Cited by 322 · see citing works
King, A. C., Hekler, E. B., Grieco, L. A., Winter, S. J., Sheats, J. L., Buman, M. P., Banerjee, B., Robinson, T. N., & Cirimele, J. (2013) · PLoS ONE · doi:10.1371/journal.pone.0062613 · Cited by 330 · see citing works
Persuasive technology in mobile applications promoting physical activity: a systematic review
Matthews, J., Win, K. T., Oinas-Kukkonen, H., & Freeman, M. (2016) · Journal of Medical Systems · doi:10.1007/s10916-015-0425-x · Cited by 239 · see citing works
Muellmann, S., Forberger, S., Möllers, T., Bröring, E., Zeeb, H., & Pischke, C. R. (2017) · Preventive Medicine · doi:10.1016/j.ypmed.2017.12.026 · Cited by 252 · see citing works
Cheng, C. C., Beauchamp, A., Elsworth, G. R., & Osborne, R. H. (2020) · Journal of Medical Internet Research · doi:10.2196/18476 · Cited by 219 · see citing works
Mönninghoff, A., Kramer, J.-N., Hess, A. J., Ismailova, K., Teepe, G. W., Car, L. T., Müller‐Riemenschneider, F., & Kowatsch, T. (2021) · Journal of Medical Internet Research · doi:10.2196/26699 · Cited by 187 · see citing works
Digital Technologies for Health Promotion and Disease Prevention in Older People: Scoping Review
Santis, K. K. D., Mergenthal, L., Christianson, L., Bußkamp, A., Vonstein, C., & Zeeb, H. (2023) · Journal of Medical Internet Research · doi:10.2196/43542 · Cited by 163 · see citing works
Gardiner, P. M., McCue, K. D., Negash, L. M., Cheng, T., White, L. F., Yinusa-Nyahkoon, L., Jack, B. W., & Bickmore, T. W. (2017) · Patient Education and Counseling · doi:10.1016/j.pec.2017.04.015 · Cited by 139 · see citing works
Disparities in Access and Quality of Obesity Care
Washington, T. B., Johnson, V. R., Kendrick, K., Ibrahim, A. A., Tu, L., Sun, K., & Stanford, F. C. (2023) · Gastroenterology Clinics of North America · doi:10.1016/j.gtc.2023.02.003 · Cited by 141 · see citing works
Kwan, R. Y. C., Salihu, D., Lee, P. H., Tse, M. Y. M., Cheung, D. S. K., Roopsawang, I., & Choi, K. (2020) · European Review of Aging and Physical Activity · doi:10.1186/s11556-020-00239-5 · Cited by 133 · see citing works
Developing Embodied Conversational Agents for Coaching People in a Healthy Lifestyle: Scoping Review
Kramer, L. L., ter Stal, S., Mulder, B. C., de Vet, E., & van Velsen, L. (2020) · Journal of Medical Internet Research · doi:10.2196/14058 · Cited by 121 · see citing works
“Study designs varied from a randomized controlled trial (RCT) [3,4,17,19-23,25-30,32,33] to a pretest-posttest design, either with [31] or without control a control group [5,18,30].”
BackgroundMethodInfluentialReducing preconception risks among African American women with conversational agent technology
Jack, B., Bickmore, T., Hempstead, M., Yinusa-Nyahkoon, L., Sadikova, E., Mitchell, S., Gardiner, P., Adigun, F., Penti, B., Schulman, D., et al. (2015) · The Journal of the American Board of Family Medicine · doi:10.3122/jabfm.2015.04.140327 · Cited by 99 · see citing works
Reaching Women through Health Information Technology: The Gabby Preconception Care System
Gardiner, P., Hempstead, M. B., Ring, L., Bickmore, T., Yinusa-Nyahkoon, L., Tran, H., Paasche-Orlow, M., Damus, K., & Jack, B. (2013) · American Journal of Health Promotion · doi:10.4278/ajhp.1200113-quan-18 · Cited by 88 · see citing works
Self-citationAcceptability and feasibility of a virtual counselor (VICKY) to collect family health histories
Wang, C., Bickmore, T., Bowen, D. J., Cunningham, T. N., Campion, M. W., Cabral, H., Winter, M. R., & Paasche‐Orlow, M. K. (2015) · Genetics in Medicine · doi:10.1038/gim.2014.198 · Cited by 88 · see citing works
Winter, S. J., Sheats, J. L., & King, A. C. (2016) · Progress in Cardiovascular Diseases · doi:10.1016/j.pcad.2016.02.005 · Cited by 90 · see citing works
Rehabilitation, the Great Absentee of Virtual Coaching in Medical Care: Scoping Review
Tropea, P., Schlieter, H., Sterpi, I., Judica, E., Gand, K., Caprino, M., Gabilondo, I., Gomez-Esteban, J. C., Busnatu, S., Sinescu, C., et al. (2019) · Journal of Medical Internet Research · doi:10.2196/12805 · Cited by 73 · see citing works
Computer-Controlled Virtual Humans in Patient-Facing Systems: Systematic Review and Meta-Analysis
Chattopadhyay, D., Ma, T., Sharifi, H., & Martyn-Nemeth, P. A. (2020) · Journal of Medical Internet Research · doi:10.2196/18839 · Cited by 66 · see citing works
Lisón, J. F., Palomar, G., Mensorio›, M. S., Baños, R., Cebolla, A., Botella, C., Benavent-Caballer, V., & Rodilla, E. (2020) · Journal of Medical Internet Research · doi:10.2196/14196 · Cited by 69 · see citing works
Ryu, H., Kim, S., Kim, D., Han, S., Lee, K., & Kang, Y. (2020) · Proceedings of the ACM on Human-Computer Interaction · doi:10.1145/3415223 · Cited by 66 · see citing works
Owens, O. L., Felder, T., Tavakoli, A. S., Revels, A. A., Friedman, D. B., Hughes-Halbert, C., & Hébert, J. R. (2019) · American Journal of Health Promotion · doi:10.1177/0890117118786866 · Cited by 65 · see citing works
Virtual Coaches for Older Adults’ Wellbeing: A Systematic Review
Kamali, M. E., Angelini, L., Caon, M., Carrino, F., Röcke, C., Guye, S., Rizzo, G., Mastropietro, A., Sykora, M. D., Elayan, S., et al. (2020) · IEEE Access · doi:10.1109/access.2020.2996404 · Cited by 60 · see citing works
The digital transformation of medicine can revitalize the patient-clinician relationship
Warraich, H. J., Califf, R. M., & Krumholz, H. M. (2018) · npj Digital Medicine · doi:10.1038/s41746-018-0060-2 · Cited by 57 · see citing works
The Atrial Fibrillation Health Literacy Information Technology System: Pilot Assessment
Magnani, J. W., Schlusser, C. L., Kimani, E., Rollman, B. L., Paasche-Orlow, M. K., & Bickmore, T. W. (2017) · JMIR Cardio · doi:10.2196/cardio.8543 · Cited by 46 · see citing works
“These results are similar to our prior work with relational agents, where we have used the relational agent as a nonjudgmental, empathetic coach to offer patient-centered guidance [15,41,42].”
ResultMirbabaie, M., Hofeditz, L., Frick, N., & Stieglitz, S. (2021) · AI & Society · doi:10.1007/s00146-021-01239-4 · Cited by 61 · see citing works
Effectiveness of User- and Expert-Driven Web-based Hypertension Programs: an RCT
Liu, S., Brooks, D., Thomas, S. G., Eysenbach, G., & Nolan, R. P. (2018) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2018.01.009 · Cited by 55 · see citing works
Spanish-Language Consumer Health Information Technology Interventions: A Systematic Review
Chaet, A., Morshedi, B., Wells, K. M., Barnes, L. E., & Valdez, R. S. (2016) · Journal of Medical Internet Research · doi:10.2196/jmir.5794 · Cited by 54 · see citing works
Hernandez-Ramos, R., Aguilera, A., Garcia, F., Miramontes-Gomez, J., Pathak, L. E., Figueroa, C. A., & Lyles, C. R. (2021) · JMIR Formative Research · doi:10.2196/25299 · Cited by 53 · see citing works
Results of MyPlan 2.0 on Physical Activity in Older Belgian Adults: Randomized Controlled Trial
Dyck, D. V., Herman, K., Poppe, L., Crombez, G., Bourdeaudhuij, I. D., & Gheysen, F. (2019) · Journal of Medical Internet Research · doi:10.2196/13219 · Cited by 50 · see citing works
Safety First: Conversational Agents for Health Care
Bickmore, T., Trinh, H., Asadi, R., & Olafsson, S. (2018) · Human–Computer Interaction Series · doi:10.1007/978-3-319-95579-7_3 · Cited by 50 · see citing works
Self-citationMartinengo, L., Jabir, A. I., Goh, W. W. T., Lo, N. Y. W., Ho, M. R., Kowatsch, T., Atun, R. A., Michie, S., & Car, L. T. (2022) · Journal of Medical Internet Research · doi:10.2196/39243 · Cited by 48 · see citing works
King, A. C., Campero, M. I., Sheats, J. L., Castro, C. M., Garcia, D. M., Chazaro, A., Blanco, G., Hauser, M. E., Fierros, F., Ahn, D. K., et al. (2017) · Contemporary Clinical Trials · doi:10.1016/j.cct.2017.07.020 · Cited by 47 · see citing works
Guhl, E., Althouse, A. D., Pusateri, A., Kimani, E., Paasche‐Orlow, M. K., Bickmore, T., & Magnani, J. W. (2020) · JMIR Cardio · doi:10.2196/17162 · Cited by 45 · see citing works
Community-Based Cultural Tailoring of Virtual Agents
O’Leary, T. K., Stowell, E., Kimani, E., Parmar, D., Ólafsson, S., Hoffman, J. A., Parker, A. G., Paasche‐Orlow, M. K., & Bickmore, T. (2020) · ACM International Conference on Intelligent Virtual Agents (IVA) · doi:10.1145/3383652.3423875 · Cited by 44 · see citing works
Systematic Review of Physical Activity Interventions in Hispanic Adults
Loya, J. (2018) · Hispanic Health Care International · doi:10.1177/1540415318809427 · Cited by 43 · see citing works
Karran, E. L., Grant, A. R., Lee, H., Kamper, S. J., Williams, C. M., Wiles, L. K., Shala, R., Poddar, C. V., Astill, T., & Moseley, G. L. (2023) · BMC Public Health · doi:10.1186/s12889-023-15329-z · Cited by 39 · see citing works
Kamali, M. E., Angelini, L., Caon, M., Andreoni, G., Khaled, O. A., & Mugellini, E. (2018) · ACM International Joint Conference on Pervasive and Ubiquitous Computing (UbiComp) · doi:10.1145/3267305.3274188 · Cited by 39 · see citing works
Muellmann, S., Bragina, I., Voelcker‐Rehage, C., Rost, E., Lippke, S., Meyer, J., Schnauber, J., Wasmann, M., Toborg, M., Koppelin, F., et al. (2017) · BMC Public Health · doi:10.1186/s12889-017-4446-x · Cited by 38 · see citing works
Win, K. T., Roberts, M., & B, H. O.-K. A. (2018) · Informatics for Health and Social Care · doi:10.1080/17538157.2018.1511565 · Cited by 38 · see citing works
Gustafson, D. H., Kornfield, R., Mares, M., Johnston, D. C., Cody, O. J., Yang, E. F., Gustafson, D. H., Hwang, J., Mahoney, J., Curtin, J. J., et al. (2021) · Journal of General Internal Medicine · doi:10.1007/s11606-021-06888-1 · Cited by 41 · see citing works
Ethical, legal, and social implications (ELSI) of virtual agents and virtual reality in healthcare
Rudschies, C., & Schneider, I. (2023) · Social Science & Medicine · doi:10.1016/j.socscimed.2023.116483 · Cited by 36 · see citing works
King, A. C., Campero, M. I., Sheats, J. L., Castro, C. M., Hauser, M. E., Garcia, D. M., Chazaro, A., Blanco, G., Banda, J. A., Ahn, D. K., et al. (2020) · JAMA Internal Medicine · doi:10.1001/jamainternmed.2020.4143 · Cited by 36 · see citing works
Rosas, L. G., Lv, N., Xiao, L., Lewis, M. A., Ζavella, P., Kramer, M. K., Luna, V., & Ma, J. (2016) · Contemporary Clinical Trials · doi:10.1016/j.cct.2016.03.003 · Cited by 33 · see citing works
Adapting a Persuasive Conversational Agent for the Chinese Culture
Zhou, S., Zhang, Z., & Bickmore, T. (2017) · 2017 International Conference on Culture and Computing (Culture and Computing) · doi:10.1109/culture.and.computing.2017.42 · Cited by 31 · see citing works
Masri, A. E., Kolt, G. S., & George, E. S. (2019) · Ethnicity and Health · doi:10.1080/13557858.2019.1658183 · Cited by 30 · see citing works
Health-Related Applications of Socially Interactive Agents
Bickmore, T. (2022) · ACM eBooks · doi:10.1145/3563659.3563672 · Cited by 30 · see citing works
Sezgın, E., Kocaballi, A. B., Dolcé, M., Skeens, M. A., Militello, L. K., Huang, Y., Stevens, J. H., & Kemper, A. R. (2024) · JMIR Human Factors · doi:10.2196/57114 · Cited by 32 · see citing works
Design of a Culturally-Informed Virtual Human for Educating Hispanic Women about Cervical Cancer
Mendu, S., Boukhechba, M., Gordon, J. R., Datta, D., Molina, E., Arroyo, G., Proctor, S. K., Wells, K. J., & Barnes, L. E. (2018) · Proceedings of the 12th EAI International Conference on Pervasive Computing Technologies for Healthcare · doi:10.1145/3240925.3240968 · Cited by 28 · see citing works
Avila-Garcia, P., Hernandez-Ramos, R., Nouri, S. S., Cemballi, A. G., Sarkar, U., Lyles, C. R., & Aguilera, A. (2019) · JAMIA Open · doi:10.1093/jamiaopen/ooz049 · Cited by 28 · see citing works
The Role of Mobile Health in Elderly Populations
Gilbert, B. J., Goodman, E. B., Chadda, A., Hatfield, D. P., Forman, D. E., & Panch, T. (2015) · Current Geriatrics Reports · doi:10.1007/s13670-015-0145-6 · Cited by 28 · see citing works
King, A. C., Campero, M. I., Garcia, D. M., Blanco-Velazquez, I., Banchoff, A., Fierros, F., Escobar, M., Cortes, A. L., Sheats, J. L., Hua, J., et al. (2021) · Contemporary Clinical Trials · doi:10.1016/j.cct.2021.106526 · Cited by 26 · see citing works
Márquez, D. X., Wilbur, J., Hughes, S. L., Wilson, R. S., Büchner, D. M., Berbaum, M. L., McAuley, E., Aguiñaga, S., Balbim, G. M., Vásquez, P. M., et al. (2022) · Annals of Behavioral Medicine · doi:10.1093/abm/kaac009 · Cited by 26 · see citing works
A Virtual Self-care Coach for Individuals with Spinal Cord Injury
Shamekhi, A., Trinh, H., Bickmore, T., DeAngelis, T. R., Ellis, T. D., Houlihan, B. V., & Latham, N. K. (2016) · International ACM SIGACCESS Conference on Computers and Accessibility (ASSETS) · doi:10.1145/2982142.2982199 · Cited by 25 · see citing works
The Role of Chatbots in Enhancing Health Care for Older Adults: A Scoping Review
Zhang, Q., Wong, A. K. C., & Bayuo, J. (2024) · Journal of the American Medical Directors Association · doi:10.1016/j.jamda.2024.105108 · Cited by 24 · see citing works
Wang, Z. J., Chan, P. S.-F., Fang, Y., Yu, F.-Y., Ye, D., Zhang, Q., Wong, M. C. S., & Mo, P. K. H. (2023) · JAMA Network Open · doi:10.1001/jamanetworkopen.2023.32568 · Cited by 23 · see citing works
The Effectiveness of Social Influence Tactics when Used by a Virtual Agent
Lucas, G., Lehr, J., Krämer, N. C., & Gratch, J. S. (2019) · ACM International Conference on Intelligent Virtual Agents (IVA) · doi:10.1145/3308532.3329464 · Cited by 23 · see citing works
Kim, D. S., Eltahir, A. A., Ngo, S., & Rodríguez, F. (2024) · Current Atherosclerosis Reports · doi:10.1007/s11883-024-01249-9 · Cited by 22 · see citing works
Using Virtual Doppelgängers to Increase Personal Relevance of Health Risk Communication
Ahn, S. J., Fox, J., & Hahm, J. M. (2014) · Lecture notes in computer science · doi:10.1007/978-3-319-09767-1_1 · Cited by 22 · see citing works
Greco, G., Poli, L., Clemente, F. M., Fischetti, F., & Cataldi, S. (2023) · Health & Social Care in the Community · doi:10.1155/2023/2803620 · Cited by 22 · see citing works
Effects of Perceived Agency and Message Tone in Responding to a Virtual Personal Trainer
Lucas, G., Krämer, N. C., Peters, C., Taesch, L.-S., Mell, J., & Gratch, J. S. (2018) · ACM International Conference on Intelligent Virtual Agents (IVA) · doi:10.1145/3267851.3267855 · Cited by 21 · see citing works
Christopoulou, S., Kotsilieris, T., & Anagnostopoulos, I. (2018) · Healthcare · doi:10.3390/healthcare6030109 · Cited by 20 · see citing works
Culture, Errors, and Rapport-building Dialogue in Social Agents
Lucas, G., Boberg, J., Traum, D. R., Artstein, R., Gratch, J. S., Gainer, A., Johnson, E., Leuski, A., & Nakano, M. (2018) · ACM International Conference on Intelligent Virtual Agents (IVA) · doi:10.1145/3267851.3267887 · Cited by 20 · see citing works
Adapting Technological Interventions to Meet the Needs of Priority Populations
Linke, S., Larsen, B. A., Marquez, B., Mendoza-Vasconez, A. S., & Marcus, B. H. (2016) · Progress in Cardiovascular Diseases · doi:10.1016/j.pcad.2016.03.001 · Cited by 19 · see citing works
Ethics, Medicine, and Information Technology
Goodman, K. W. (2015) · Cambridge University Press eBooks · doi:10.1017/cbo9781139600330 · Cited by 40 · see citing works
Physical Activity Psychology Research: Where Have We Been? Where Are We Going?
Cardinal, B. J. (2014) · Kinesiology Review · doi:10.1123/kr.2014-0036 · Cited by 20 · see citing works
Harris, D., Dlima, S. D., Gluchowski, A., Hall, A., Elliott, E., & Munford, L. A. (2024) · International Journal of Behavioral Nutrition and Physical Activity · doi:10.1186/s12966-024-01666-8 · Cited by 18 · see citing works
Hekler, E. B., Buman, M. P., Otten, J. J., Castro, C. M., Grieco, L. A., Marcus, B. H., Friedman, R. H., Napolitano, M. A., & King, A. C. (2013) · International Journal of Behavioral Nutrition and Physical Activity · doi:10.1186/1479-5868-10-109 · Cited by 18 · see citing works
The Impact of Virtual Humans on Psychosomatic Medicine
Loveys, K., Sagar, M. A., Antoni, M. H., & Broadbent, E. (2023) · Psychosomatic Medicine · doi:10.1097/psy.0000000000001227 · Cited by 18 · see citing works
Usability of Online Assistance From Semiliterate Users’ Perspective
Ahmad, N., Shoaib, U., & Prinetto, P. (2014) · International Journal of Human-Computer Interaction · doi:10.1080/10447318.2014.925772 · Cited by 16 · see citing works
Hahn, L., Rathbun, S. L., Schmidt, M. D., Johnsen, K., Annesi, J. J., & Ahn, S. J. (2020) · Cyberpsychology Behavior and Social Networking · doi:10.1089/cyber.2019.0491 · Cited by 17 · see citing works
A systematic review on eHealth technology personalization approaches
ten Klooster, I., Kip, H., van Gemert‐Pijnen, J. E. W. C., Crutzen, R., & Kelders, S. M. (2024) · iScience · doi:10.1016/j.isci.2024.110771 · Cited by 18 · see citing works
Designing and Evaluating a Digital Family Health History Tool for Spanish Speakers
Diez, M. C., Cortés, D. E., Trevino‐Talbot, M., Bangham, C., Winter, M. R., Cabral, H., Cunningham, T. N., Toledo, D. M., Bowen, D. J., Paasche‐Orlow, M. K., et al. (2019) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph16244979 · Cited by 14 · see citing works
King, A. C. (2013) · Annals of Behavioral Medicine · doi:10.1007/s12160-013-9530-6 · Cited by 12 · see citing works
Design of interactive cancer education technology for Latina farmworkers
Wu, Y., Samant, D., Squibbs, K., Chaet, A., Morshedi, B., & Barnes, L. E. (2014) · Systems and Information Engineering Design Symposium · doi:10.1109/sieds.2014.6829908 · Cited by 11 · see citing works
Use of Relational Agents to Improve Family Communication in Type 1 Diabetes: Methods
Thompson, D. I., Cullen, K. W., REDONDO, M. J., & Anderson, B. J. (2016) · JMIR Research Protocols · doi:10.2196/resprot.5817 · Cited by 12 · see citing works
Adapting a Geriatrics Health Counseling Virtual Agent for the Chinese Culture
Zhe, Z., Trinh, H., Chen, Q., & Bickmore, T. (2015) · Lecture notes in computer science · doi:10.1007/978-3-319-21996-7_28 · Cited by 11 · see citing works
Increasing the Engagement of Conversational Agents through Co-Constructed Storytelling
Cristina Battaglino, A., & Bickmore, T. (2015) · Proceedings of the AAAI Conference on Artificial Intelligence and Interactive Digital Entertainment · doi:10.1609/aiide.v11i4.12832 · Cited by 11 · see citing works
King, A. C., Campero, M. I., Sheats, J. L., Castro, C. M., Espinosa, P. R., Garcia, D. M., Hauser, M. E., Done, M. E., Patel, M. L., Parikh, N. M., et al. (2020) · Contemporary Clinical Trials · doi:10.1016/j.cct.2020.106084 · Cited by 11 · see citing works
Langener, S., Kolkmeier, J., VanDerNagel, J., Klaassen, R., van Manen, J. G., & Heylen, D. (2023) · JMIR Formative Research · doi:10.2196/42523 · Cited by 10 · see citing works
Investigating the Synonyms of Conversational Agents to Aid Cross-Disciplinary CA Research
Wang, L., Chen, C., & Huh, J. (2023) · CHI Conference Extended Abstracts on Human Factors in Computing Systems (CHI EA) · doi:10.1145/3544549.3585640 · Cited by 9 · see citing works
Magnani, J. W., Ferry, D., Swabe, G. M., Martin, D., Chen, X., Brooks, M. M., & Khoudary, S. R. E. (2021) · American Heart Journal Plus Cardiology Research and Practice · doi:10.1016/j.ahjo.2021.100017 · Cited by 8 · see citing works
Win, K. T., Ramaprasad, A., & Syn, T. (2019) · Journal of Medical Systems · doi:10.1007/s10916-019-1159-y · Cited by 8 · see citing works
Culturally-Aware Healthcare Systems
Yin, L., & Bickmore, T. (2017) · Intelligent systems reference library · doi:10.1007/978-3-319-67024-9_5 · Cited by 8 · see citing works
Bernard, E., Brewer, N., Prorok, J. C., Kim, P., & Muscedere, J. (2025) · The Journal of Frailty & Aging · doi:10.1016/j.tjfa.2025.100034 · Cited by 7 · see citing works
Evidence-based health and clinical informatics: a systematic review on randomized controlled trials
Christopoulou, S. C., Kotsilieris, T., & Anagnostopoulos, I. E. (2017) · Health and Technology · doi:10.1007/s12553-016-0170-2 · Cited by 7 · see citing works
Neil‐Sztramko, S., Smith‐Turchyn, J., Richardson, J. A., & Dobbins, M. (2019) · Journal of Medical Internet Research · doi:10.2196/13965 · Cited by 7 · see citing works
Magnani, J. W., Plevniak, K., Ferry, D., Martin, D., Brooks, M. M., Kimani, E., Ólafsson, S., Rollman, B. L., Paasche‐Orlow, M. K., Khoudary, S. R. E., et al. (2025) · International Journal of Cardiology · doi:10.1016/j.ijcard.2025.133575 · Cited by 6 · see citing works
Monteiro, M. D. S., Salgado, L. C. D. C., Seixas, F. L., & Santana, R. F. (2020) · Lecture notes in computer science · doi:10.1007/978-3-030-50249-2_12 · Cited by 6 · see citing works
Lu, Z., Xiang, J. Y., Li, S., Zhang, C., & Wu, C. (2025) · BMC Psychology · doi:10.1186/s40359-025-03217-7 · Cited by 6 · see citing works
Digital Human Representations for Health Behavior Change: A Structured Literature Review
Adam, M. T. P., Dreyer, S., Gimpel, H., Olenberger, C., & Fraunhofer, F. I. T. (2022) · AIS Transactions on Human-Computer Interaction · doi:10.17705/1thci.00171 · Cited by 5 · see citing works
e-Health Interventions for Promoting Physical Activity in Aging Adults: A Scoping Review
Walha, R., Koubaa, N., Chagnon, M., Lortie-Milner, É., Aubertin‐Leheudre, M., Levasseur, M., & Boissy, P. (2025) · Telemedicine Journal and e-Health · doi:10.1089/tmj.2024.0414 · Cited by 4 · see citing works
COVID-19 health communication strategies for older adults: Chatbots and traditional media
Olszewski, R., Watros, K., Brzeziński, J., Owoc, J., Mańczak, M., Targowski, T., & Jeziorski, K. (2024) · Advances in Clinical and Experimental Medicine · doi:10.17219/acem/195242 · Cited by 4 · see citing works
Zhang, Q., Wong, A. K. C., & Hui, V. C. C. (2025) · Systematic Reviews · doi:10.1186/s13643-025-02996-9 · Cited by 3 · see citing works
Omole, T. D., Mrkva, A., Ferry, D., Shepherd, E., Caratelli, J., Davis, N., Akatue, R., Bickmore, T., Paasche‐Orlow, M. K., & Magnani, J. W. (2025) · JMIR Cardio · doi:10.2196/66436 · Cited by 5 · see citing works
Hypertension Treatment Using an Internet-based Lifestyle Intervention
Liu, S. X. (2015) · TSpace (University of Toronto) · Cited by 3 · see citing works
Hamilton, F. L., Imran, S., Mahmood, A., Dobbin, J., Bradbury, K. J., Poduval, S., Scuffell, J., Thomas, F., & Stevenson, F. A. (2025) · Health and Social Care Delivery Research · doi:10.3310/gjhg1331 · Cited by 4 · see citing works
Cultural Considerations for Exercise in Older Adults
Correa‐de‐Araujo, R. (2015) · Springer eBooks · doi:10.1007/978-3-319-16095-5_7 · Cited by 2 · see citing works
Rovniak, L. S., & King, A. C. (2017) · Transport and sustainability · doi:10.1108/s2044-994120170000009015 · Cited by 2 · see citing works
Human Telephone vs Text Message Counseling and Physical Activity Among Midlife and Older Adults
King, A. C., Campero, M. I., Espinosa, P. R., Garcia, D. M., Corral, C., Castro, C. M., Xiao, L., Royer, M. F., Zamora, A. N., Cortes, A. L., et al. (2025) · JAMA Network Open · doi:10.1001/jamanetworkopen.2025.28858 · Cited by 1 · see citing works
Johnson, T., & Gaissmaier, W. (2026) · JMIR AI · doi:10.2196/87034 · Cited by 1 · see citing works
- Authors
- King, A. C., Bickmore, T. W., Campero, M. I., Pruitt, L. A., & Yin, J. L.
- Affiliations
- Stanford Medicine (US)
- Northeastern University (US)
- Corresponding author
- King, Abby C.
- Venue
- Journal of Health Communication
- Publisher
- Informa UK Limited
- Published
- 2013-12
- Volume
- 18
- Issue
- 12
- Pages
- 1449-1464
- ISSN
- 1081-0730 (ISSN-L)
- 1087-0415
- PMC
- PMC7187757
- OpenAlex
- W2012861762
- Cited by
- 114
- References
- 53
- Citations by year
- 2026: 3 · 2025: 11 · 2024: 8 · 2023: 9 · 2022: 7 · 2021: 9 · 2020: 12 · 2019: 11 · 2018: 11 · 2017: 10 · 2016: 7 · 2015: 8 · 2014: 4 · 2013: 4
- FWCI
- 13.89
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Health Communication (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Cancer Institute (R21CA127511)
- Topics
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Social Sciences › Demography › Technology Use by Older Adults
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Keywords
- virtual advisors, walking intervention, physical activity promotion, older adults, Latino older adults, low-income populations, e-health, health disparities, preventive medicine, health promotion, step count, underserved populations
- MeSH terms
- Aged, Aged, 80 and over, California, Community Health Services, Culture, Female, Follow-Up Studies, Health Promotion, Hispanic or Latino, Humans, Language, Male, Medically Underserved Area, Middle Aged, Poverty, User-Computer Interface, Walking, Multilingualism, Sedentary Behavior
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
