1. Employing ‘Virtual Advisors’ to Promote Physical Activity in Underserved Communities: Results from the COMPASS Study Abby King, Tim Bickmore, Ines Campero, Leslie Pruitt, Langxuan Yin Stanford University School of Medicine Northeastern University NIH R21CA127511 © Stanford University

4. Stanford Health Aging Studies Technology Team Tim Bickmore, Northeastern University

7. (Culturally adapted, bi-lingual) © Stanford University Carmen

13. COMPASS - RESULTS 4-mos Change in Minutes of Walking/Wk [CHAMPS] (N = 39) * * p < .0008 Reported Change in Mins/Wk 0 50 100 150 200 250 300 © Stanford University

14. 4-month Change in Daily Steps (Omron Pedometer) Intervention Participants (n = 20) * Slope analysis: p = .002; Spearman rho with CHAMPS walking items = .47 ( p =.04) Week 1 Week 16 Mean Daily Steps 0 3000 4000 5000 6000 7000 8000 COMPASS Study *

15. Baseline-adjusted mean * p < .03 vs. Control 0 1.0 1.5 2.0 2.5 3.0 3.5 4.0 4.5 Substituting Alternatives Rewarding Oneself Committing Oneself * * * * Control Reminding Oneself COMPASS 4-month Motivational Processes of Change * Understanding Risks

16. AFTER the 4-month Study Period . . . • ‘ Carmen’ remained in Senior Center for additional 20 weeks (in response to participant requests) • All but 1 intervention participant accessed ‘Carmen’ during this post-study period • Participants accessed ‘Carmen’ mean of 14 additional times (range of <1 to 4.5 times/week)

17. At 4-month Post-test, Intervention participants indicated that . . . • ‘ Carmen’ cared about them (average rating = 6.2 out of 7) • Felt close to ‘Carmen’ (average = 6 out of 7) • Trusted ‘Carmen’ (average = 6 out of 7) • Felt that length of talks with ‘Carmen’ was “just about right” • Were interested in continuing to work with ‘Carmen’

18. Conclusions • Intervention participants reported ~30 minute/day increase in usual walking activity relative to modest changes in controls by 4 months • Daily pedometer steps in last intervention month (~6800) generally commensurate with National Recs. in this age group

19. Conclusions - continued • Program was safe (no significant PA injuries) • Program found to be easy to use/engaging for this less educated, low computer-literate sample • 95% of intervention participants accessed the Virtual Advisor after the study ended

20. Next Steps • Expand community venues & populations in which to test ‘Carmen’, as well as lengthen time period e.g., clinics, pharmacies, libraries, recreation centers • Explore which subgroups may do better with Carmen vs. other intervention sources & delivery channels • Explore this technology further for other health behaviors

21. THANK YOU!