Reaching women through health information technology: the Gabby preconception care system

PURPOSE: The Centers for Disease Control and Prevention have endorsed the concept of preconception care (PCC). New tools must be developed to promote PCC. DESIGN: Development and testing of a health information technology system to provide PCC. SETTING: An urban safety net hospital and an urban university. SUBJECTS: Community recruitment of 31 women in focus groups and 15 women participating in observed usability testing; 9 students recruited from the Office of Minority Health Preconception Peer Educators program participated in pilot testing for 2 months. INTERVENTION: Online interactive animated character ( Gabby ) designed to identify and modify preconception risks. MEASURES: Qualitative transcripts, preconception risk assessment, server data for system usage, self-administered satisfaction surveys, and follow-up phone calls. ANALYSIS: Descriptive statistics of subjects\u27 demographics, satisfaction, PCC risks, and system usage. Transcripts coded using NVIVO. RESULTS: Subjects (n = 24) reported an average of 23 preconception risks; in the pilot, 83% of risks added to the My Health To-Do List were addressed by the subject. Seventy-three percent of risks identified as contemplative progressed to action or maintenance. Differences were noted in effectiveness of the system based on initial stage of change for each risk. CONCLUSION: Results suggest that the PCC system could be effective in influencing positive behavior change. Adding stage of change-focused functionality might have added benefits. This system has great potential to assist in the delivery of PCC