Technology & Integrative Medicine

During IMGV patients are introduced to a resource named Gabby

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Gabby is what we call an embodied conversational agent (ECA). Gabby was designed to be an interactive virtual health guide. She is available any hour of the day to review all of the topic learned throughout group visits. Patients are encouraged to practice MBSR techniques such as mediation and yoga on their own everyday, and Gabby is programmed to guide patients through these practices.

Gabby is an additional resources to further support and encourage patients to adhere to the IMGV curriculum

Dr. Gardiner was a co-investigator on a AHRQ funded project entitled “Using Innovative Communication Technology for the Health of African American Women”(PI Jack). This health technology system delivers a virtual patient advocate (Gabby) designed to improve preconception health. The goal is to provide tailored, patient-centered education and behavior change information to supplement the limited time that patients and providers have together. For this project is scripted and designed all content on stress, mind body techniques (mindfulness based stress reduction), exercise and nutrition. This system was tested with 100 African American women in a HRSA Maternal Child Health Bureau funded project showing that women receiving the Gabby intervention had significantly greater reduction in health risks compared to controls who received a letter asking them to see their clinician. We are now conducting a large-scale RCT funded by NIMHD of the same system. For her K award, Dr. Gardiner completed an implementation study showing that the Gabby system is feasible to implement in an outpatient chronically ill (chronic pain) population.

Gardiner P, Hempstead MB, Ring L, Bickmore T, Yinusa-Nyahkoon L, Tran H, Paasche-Orlow M, Damus K, Jack B. Reaching Women Through Health Information Technology: The Gabby Preconception Care System. American Journal of Health Promotion. 2013:27(Suppl):eS11-20. PMCID: PMC3779885

Jack B, Bickmore T, Hempstead M, Yinusa-Nyahkoon L, Sadikova E, Mitchell S, Gardiner P. Adigun F, Penti B. Schulman D, Damus K. Reducing Preconception Risks among African American Women with Conversational Agent Technology. J Am Board Fam Med 2015;28:441-451. doi:10.3122/jabfm.2015.04.140327. PMID: 26152434

In addition to her extensive work with Gabby, Dr. Gardiner has explored the feasibility of on-line training about the most commonly used dietary supplements. She began working with Dr. Kathie Kemper in delivering and evaluating online curricula in both R21 and R01 funded studies. This has been the basis for my research in exploring the feasibility of delivering an online dietary supplement patient safety curriculum for  clinicians to increase their inpatient safety knowledge and documentation of dietary supplements in the inpatient medical records. In an open study, 39 of 61 (64%) recruited clinicians completed all four patient cases and post-tests. Most (82%) were women and 59% were physicians. The mean dietary supplement knowledge test score increased after the curriculum  and the clinician confidence score also increased.

Kemper KJ, Gardiner P, Gobble J, Mitra A, Woods C. Randomized controlled trial comparing four strategies for delivering e-curriculum to health care professionals. BMC Med Ed, 2006;6(1):2, 1-11. PMCID: PMC1382227.

Gardiner P, Woods C, Kemper KJ. Dietary supplement use among health care professionals enrolled in an online curriculum on herbs and dietary supplements. BMC CAM, 2006;(6):21. PMCID:1526756.

Gardiner P, Filippelli A, Kabbara K, Lin S, Sadikova E, MPH, Kaptchuk T, Kemper K Online Education for Improving Communication and Documentation of Dietary Supplements among Health Professionals Practicing in a Hospital Setting, The Journal of Complementary and Alternative Medicine, 2015 Aug 13

Dr. Gardiner’s work in the OWL study also centers around technology. The goal of this Aetna funded research study is to increase knowledge about the utility of a technology tool for the management of chronic pain, Our Whole Lives (OWL). OWL is a web-based, holistic, mobile health (mHealth) tool which had reinforced group visits by helping patients self-manage their chronic pain in home and community settings. It can be used a website in a web browser on a computer, tablet or mobile phone. Through this study we hope to improve this tool such that it can be used outside of a group visit context.

For the first part of this project we will conduct a Science Café event with 30 individuals. This event will be a discussion with patients with chronic pain, those with family members experiencing chronic pain or other stakeholders in the chronic pain community. We will use this event to gather information on barriers and facilitators to chronic pain treatment. Based on this feedback and feedback from the IMGV study, we hope to improve OWL in terms of usability and access.

For the second part of this project we will have 40 patients with chronic pain use the OWL website (seen below)  for 9 weeks. These participants will be assessed for any reductions in pain impact or pain associated outcomes (like fatigue, sleep quality, anxiety, etc.). They will also offer further feedback on how to improve OWL, such that it can be used an a mobile health tool independent of group visits.

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