How would you like to
see a doctor who takes the time to evaluate your smoking, alcohol and HIV/STD risks, and
in about 15 minutes receive nonjudgmental support and advice about how to reduce risks and
improve your health?
Recently, the UCSF Center for Health Improvement and Prevention Studies (CHIPS)
received funding ($117,000) from the Robert Wood Johnson Foundation, to continue its work
on multimedia, interactive computer technology as an adjunct to primary care.
A UCSF team plans to integrate a Video Doctor Risk Assessment and Brief Intervention
Program into routine primary care to support patients in reducing their health behavior
risks. If the Video Doctor program successfully assesses risk and supports patients in
reducing risk behaviors, it could be seamlessly integrated into health settings, according
to the experts.
Principal investigator of the CHIPS studies is Barbara Gerbert, PhD, UCSF professor and
chair of the division of behavioral sciences in the UCSF School of Dentistry. Gerbert has
developed and is implementing a Video Doctor program to assess and intervene with smoking,
alcohol and HIV risks. The new program would support busy physicians in providing health
behavior counseling to large groups of patients and would provide information for the
health care provider about intervention strategies for patient risks. The current
RWJ-funded study to integrate the Video Doctor with a primary care site will provide
researchers with answers about how physicians and patients could routinely benefit from
the use of this state-of-the-art technology.
"We want to simplify visits to a doctor, to make it easier for patients and
clinicians to benefit from this kind of risk assessment," Gerbert said. "Also,
physicians can get harried and busy, but the Video Doctor doesn't."
The Video Doctor Risk Assessment program is easy to use and accessible to patients with
low literacy, no previous computer experience and to Spanish speakers. The program
simulates a live risk assessment interview with a physician.
To answer the Video Doctor's questions, a patient clicks on the correct key on a
simplified keyboard. And if the patient is confused, the Video Doctor will restate the
question. "The program allows patients anonymity and privacy so the answers are
easier to give," Gerbert said. After assessing patient risks, the Video Doctor will
provide individualized advice messages to support and motivate patients to reduce their
The program was tested at three primary care sites, including UCSF Mount Zion, the UCSF
Ambulatory Care Center, both part of the UCSF Medical Center, and Highland Hospital in
Oakland, Calif. Patients said they liked using the Video Doctor and found it easy.
The Video Doctor has worked well in the past. Previous funding from the National
Institute of Mental Health (NIMH) gave health psychology researchers funding, developing
an interactive Video Doctor which asked patients about their risks for HIV and sexually
More recently, the researchers have been investigating the use of a Video Doctor to
study people's preference about the race and gender of their physicians. Last year, with
funding from the National Institute of Alcohol Abuse and Alcoholism, the researchers went
to a shopping mall in the San Francisco Bay Area and asked nearly 400 shoppers from
diverse racial backgrounds to select one of six Video Doctors. The choices were both male
and female who were either African American, Latin or Caucasian.
Although the majority of the people chose a female physician (85 percent of females and
65 percent of males), the results documented that from the public's point of view,
physicians of both genders and all races can possess desired qualities in a physician. The
results also demonstrated that people may be receptive to any physician who has qualities
such as being a good listener and non-judgemental, regardless of gender and race.
Participants in the study knew that the Video Doctor was an actor, and yet they reported
that they responded to her or him as a "real" physician.
While the program received high ratings from all participants, it received the highest
from African Americans, Hispanics, those with less education and older people, groups that
previously were thought to be more difficult to reach with computer interventions.
Colleagues for the Video Doctor studies include Stephen McPhee, MD, UCSF professor of
medicine and co-principal investigator; Judith Wofsy, MD, division chief of primary care
at Highland Hospital department of medicine; Dale Danley, MPH, UCSF project coordinator of
the RWJ project and Steven Berg-Smith, MA, project coordinator for the Video Doctor
project at UCSF waiting rooms and Highland Hospital.