Despite decades of research and recommendations, health disparities in birth outcomes persist for African American women who are more than two times as likely to deliver a low-birth weight infant and more than four times more likely to suffer life-threatening complications as compared to white women.

To help combat these disparities, Cook County Health is the first site in Illinois to offer Gabby, an online-artificial intelligence character that acts as a virtual patient advocate to help identify potential health risks in at-risk women who are planning to become pregnant. Gabby is specifically programmed and designed to screen African American women ages 18 to 39 years old for more than 100 general and reproductive health risks and to help them resolve those risks prior to pregnancy.

“Although we have made great advances in medicine over the last several decades, there has been only modest progress in implementing what is known about preconception care into clinical practice, and little research has been done to translate preconception care knowledge into health delivery systems,” said Dr. Mark Loafman, Chair of Family and Community Medicine for Cook County Health. “More importantly, infant mortality and healthy pregnancy rates among young African American women have not improved – in fact, outcomes have actually gotten worse. Emerging research is showing us that interventions like Gabby may be the breakthrough our patients need.”

The most recent issue of Lancet Digital Health Gabby reports on a pre-conception study among 528 African American women across the U.S. in 35 states and 242 cities. Women who used Gabby were 16 percent more likely to take steps aimed at reducing pregnancy-related risk factors as compared to a control group, and Gabby users maintained these health improvement efforts for the 12-month study period. Cook County Health has enrolled 32 patients with 26 already engaged in the Gabby program. The study concluded that Web-based technologies like Gabby are effective in facilitating self-directed risk reduction for African American women.

Cook County Health is currently offering Gabby to eligible patients at its Near South Health Center and its Englewood Health Center.

Women who are thinking about becoming pregnant or are pregnant have a virtual conversation with Gabby on a tablet, which takes into account a person’s health literacy and best tailors the process to the patient. Gabby’s communication with the patient includes guidance on how to utilize the health care system and other resources to address the woman’s most significant risk factors. The interactions with Gabby remain confidential, and the health care team can “see” the impact through the patient’s health-related behaviors and use of clinical services. Gabby was designed to be engaging, empathetic, culturally competent and knowledgeable in preconception care.

“Women who interact with Gabby are able to identify their most significant risk factors in relationship to their own reproductive goals and needs, and most importantly, Gabby facilitates evidence-based interventions to mitigate those risk factors,” added Dr. Loafman. “Ideally, women are empowered to identify and address their individual risk factors to help realize their own reproductive health goals.”

The implementation of this innovative technology at Cook County Health will help reduce health disparities in minority women and help them deliver babies more safely.

Elizabeth Pedersen, Communications Manager