ArticleJournal of medical Internet research2025
Using a Multilingual AI Care Agent to Reduce Disparities in Colorectal Cancer Screening for Higher Fecal Immunochemical Test Adoption Among Spanish-Speaking Patients: Retrospective Analysis.
Article in Journal of medical Internet research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Chatbot Outreach in Value-Based Preventive Care: Retrospective Analysis.JMIR medical informatics · 2026Article
- Optimizing AI solutions for population health in primary care.NPJ digital medicine · 2025Article
- How generative AI voice agents will transform medicine.NPJ digital medicine · 2025Review
- Advancing health equity: evaluating AI translations of kidney donor information for Spanish speakers.Frontiers in public health · 2025Article
- Building competency in artificial intelligence and bias mitigation for nurse scientists and aligned health researchers.Nursing outlookArticle
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Authors and funding
12 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundColorectal cancer (CRC) screening rates remain disproportionately low among Hispanic and Latino populations compared to non-Hispanic White populations. While artificial intelligence (AI) shows promise in health care delivery, concerns exist that AI-based interventions may disadvantage non-English-speaking populations due to biases in development and deployment.
objectiveThis study aimed to evaluate the effectiveness of a multilingual AI care agent in engaging Spanish-speaking patients for CRC screening compared to that with English-speaking patients.
methodsThis retrospective analysis examined an AI-powered outreach initiative at WellSpan Health in Pennsylvania and Maryland during September 2024. The study included 1878 patients (517 Spanish-speaking, 1361 English-speaking) eligible for CRC screening who lacked active web-based health profiles. A multilingual AI conversational agent conducted personalized telephone calls in the patient's preferred language to provide education about CRC screening and facilitate fecal immunochemical test (FIT) kit requests. The primary outcome was the FIT test opt-in rate, with secondary outcomes including connect rates and call duration. Statistical analysis included descriptive statistics, bivariate comparisons, and multivariate logistic regression.
resultsSpanish-speaking patients demonstrated significantly higher engagement across all measures than English-speaking patients with respect to FIT test opt-in rates (18.2% vs 7.1%, P<.001), connect rates (69.6% vs 53.0%, P<.001), and call duration (6.05 vs 4.03 minutes, P<.001). Demographically, Spanish-speaking patients were younger (mean age 57 vs 61 years, P<.001) and more likely to be female (49.1% vs 38.4%, P<.001). In multivariate analysis, Spanish language preference remained an independent predictor of FIT test opt-in (adjusted odds ratio 2.012, 95% CI 1.340-3.019; P<.001) after controlling for demographic factors and call duration.
conclusionsAI-powered outreach achieved significantly higher engagement among Spanish-speaking patients, challenging the assumption that technological interventions inherently disadvantage non-English-speaking populations. The 2.6-fold higher FIT test opt-in rate among Spanish-speaking patients represents a notable departure from historical patterns of health care disparities. These findings suggest that language-concordant AI interactions may help address longstanding disparities in preventive care access. Study limitations include its single health care system setting, short duration, and lack of follow-up data on completed screenings. Future research should assess long-term adherence and whether higher engagement translates to improved clinical outcomes.
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