Interactive voice response system advancements: Culturally-sensitive call flows

For 20 years, Interactive Voice Response (IVR) has provided phone-based outreach to hard-to-reach populations to support health and advocate for behavior change. Messages can be tailored to specific populations by gender, age, benefit structure, community-based supports or other demographic information. The objective of this presentation is to describe and present findings related to a recent advance in health outreach, the culturally-sensitive call structure. Culturally-sensitive call flows communicate content tailored for racial, ethnic or socio-economic status based on database variables or on information shared by a participant during a call. This talk reports on an outreach to commercial members of a health plan with an ICD-9 diagnosis of diabetes who are, based on claims data, non-compliant with some of their preventive testing. In addition to standard IVR English and Spanish call content, the program included a culturally sensitive call in English with 400 members who were flagged as possibly Hispanic, based on first and last name, and who declined the offer to speak Spanish. Call flow, questions and feedback for issues that could relate to a lower socio-economic status were each optimized with culturally-specific information. Outcomes were compared to the culturally-neutral English script. Conclusions about the efficacy of the outreach continue to be evaluated at this time. Preliminary findings are that branching call content based on racial or ethnic information results in wider receptivity to messaging and higher rates of call engagement. More qualitative analysis is currently in progress. Discussion points include other outreach opportunities for culturally-sensitive calls and tying learning back to behavior-change approaches that are known to be successful in an IVR format.