CCIS professor works to end health disparities with computer counseling

December 23, 2015

Log on to the Online Gabby System and you’ll be greeted by Gabby, an animated African American character. She’s there to help. Gabby can guide you through tackling any of 107 different factors identified as risks that cause health disparities in African American women, including diet, smoking and access to birth control.

A male character, tentatively named Gabe, will soon join Gabby and bring the same mitigation of risk factors to African American men.

The researchers behind Gabby and Gabe are working to address health disparities that lead to high infant mortality and low infant birth weight in African American families. Timothy Bickmore, an associate professor in CCIS, is working with Boston Medical Center to develop Gabe. He’s been working with the Gabby project for seven years, and The Online Gabe System: Promoting Health in Young Black Men is an outgrowth of that work. That project just received funding from the Kellogg Foundation: $770,000 in all, with $330,000 of that sum subcontracted to Northeastern. Both the Gabe and Gabby project ultimately focus on the offspring produced by African American men and women, and aim to reduce the health disparities faced by these communities.

“The projects that we’ve been working on in the past have been on preconception care for young African American women,” Bickmore says. “There’s a large range of health behaviors that need to be intervened on in order to address this disparity. These are health issues that need to be addressed in women before they conceive to ensure that their babies are as healthy as possible.”

By targeting men, Bickmore’s work acknowledges that fathers play a significant role in ending health disparities and that their risk factors must also be mitigated. “There’s very little prior work being done to intervene on this particular population – young African American men – specifically with the ultimate goal of improving the health of their children,” Bickmore says. “There are obvious places of overlap – things like family planning, life planning, which are mutual decisions – but also the health of the father, the father being in the home, there being a stable home environment, addressing things like domestic violence and so on. That’s where this current project came in.”

The project is still in its early development stages. Right now, the researchers are working to identify the issues faced by the demographic and the best way to talk to men about the issues. A national advisory board comprised of experts from around the country has met to discuss the project, and a program coordinator who works with men re-entering into society after incarceration has also been brought on board. The coordinator, Pam Linder, works with those men to discuss the barriers they face as they reintegrate into society, and the themes that emerged from a discussion with her are being used to shape the risk factors that Gabe will ultimately address.

“For 25 year old African American males, they have a 69 percent chance of having been incarcerated at some point in their lives,” Bickmore says. “It’s really prevalent in this population. Talking to them about that experience and how they reintegrate once they come out is an important aspect of having a stable family and home life.”

So far, it appears that the factors that create health disparities for African American men tend to be more social than for women, for whom the disparities were driven more by medical factors. The complete list of risk factors for men has yet to be identified.

“People seem to be expecting more social factors,” says Stefan Olafsson, a Ph.D. candidate in the Personal Health Informatics program who is working with Bickmore on the Gabe project. “We’ve seen that so far – social determinants of health seem to be more prevalent.”These might include poverty, access to healthcare and whether they have a primary care provider.

The grant from the Kellogg Foundation funds this project for three years. The first year will be spent doing qualitative research through focus groups, the second working on technical development and the final on a pilot study and evaluation. Whether Gabe will remain Gabe is to be determined – the focus groups will reveal whether the men respond better to a male or female character.

A randomized controlled trial of 100 women demonstrated that those who talked to Gabby for six months took care of more health risks compared to a control group.

The women enlisted in the study with Gabby log on to the system and are greeted by an animation of a smiling African American woman. They choose a topic to address – for example, access to birth control. Gabby asks questions, and the user selects the best fit from a list of answers that pop up. Finally, Gabby displays a list of three birth control methods based on the preferences indicated by the user.

“Based on your rankings, here are three birth control methods that might work for you. This chart has some information about each one,” Gabby says.

Gabe and Gabby are here to help.