Jorge Gamaniel Ruiz*, University of Miami Miller School of Medicine, Miami, United States Allen Dominic Andrade, Bruce W. Carter Miami VAMC, Miami, United States Chandana Karanam, Bruce W. Carter Miami VAMC, Miami, United States Dhurga Krishnamurthy, Bruce W. Carter Miami VAMC, Miami, United States Lorena Nino, Bruce W. Carter Miami VAMC, Miami, United States Ramankumar Anam, Bruce W. Carter Miami VAMC, Miami, United States Joseph Sharit, University of Miami, Miami, United States Track: Research Presentation Topic: Persuasive communication and technology Presentation Type: Poster presentation Submission Type: Single Presentation Last modified: 2014-05-16

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Background: Communicating patients their numerical estimates of cardiovascular risk can encourage risk reduction actions. Cardiovascular risk (CVR) reduction entails a set of healthy behaviors and as such may be amenable to persuasion. Virtual humans (avatars) may enhance the ability of the CVR reduction message to improve persuasion and contribute to better knowledge and persistent adherence to healthy behaviors. The purpose of this study is to compare the efficacy of a computer-based aid communicating global CVR with or without animated avatars for improving intention to adhere to lifestyle changes.
Method: Male veterans, age greater than twenty, non-depressed, cognitively intact and with an intermediate to high CVR were recruited from a primary care setting into a two arm randomized controlled trial. Participants viewed a multimedia computer-based aid with information regarding CVR followed by the presentation of their individual CVR. The aid was presented in two versions: 1) Animated Avatars with Voice: An animated avatar delivered the information including CVR to participants using voice synchronized with text bullets; 2) Voice Alone: In this condition, the participants viewed an identical version of the aid without an avatar. We collected demographic data, comorbidities, health literacy, numeracy, lifestyle behaviors, familiarity with heart disease, attitudes towards the computer program, and risk understanding and recall.
Results: Forty-one participants completed the study (animated avatar, n = 19; voice alone, n = 22,). Participants were generally older (M = 64, SD = 7), African American 46%, White 52%, and Hawaiian or Pacific Islander 2%. There were no baseline differences in demographics, comorbidities, health literacy, numeracy, lifestyle behaviors, familiarity with heart disease, and risk understanding and recall between the groups. Participants were somewhat familiar with heart disease M = 5.39, SD = 2.76, on a 13 point, with average intermediate risk of cardiovascular disease (M = 15%, SD = 4.29%). Participants in the avatar (M= 32, SD = 4.35) and voice (M = 33.36, SD = 4.37) versions had similar positive attitudes towards the computer aid on a 42-point instrument. Two tailed independent samples t test of intent to adhere to lifestyle change for the next 6 weeks showed a significant effect favoring the animated avatar version (M = 12.63, SD = 2.29) over voice alone (M = 9.0, SD = 4.29) demonstrating a large effect size (Cohen d = 1.05). There were no differences in self-efficacy to change behavior over the next 10 years. An ANCOVA was run to determine the effect of the two different computer aids on post-risk perception and emotional response after controlling for pre-intervention scores, which showed no difference for either risk perception or emotional response.
Conclusions: A computer-based aid delivering individualized CVR significantly increase participants’ intention to adhere to lifestyle changes as compared with the same aid without avatars.