Recruiting study participants has long been one of the toughest challenges for clinical researchers. It is all too common for members of the public to be reluctant to take part in studies—whether it's due to lack of knowledge about the basics of research, concerns about safety or privacy, or other issues. 

This state of affairs is particularly problematic when it comes to health care for diverse populations in the United States. Communities of color and other minority groups are substantially underrepresented in clinical research. As a result, there are gaps in the scientific data necessary to form evidence-based guidelines about healthcare for different portions of the population. 

Developing innovative ways to eliminate health disparities and improve access to health care for people from all communities and backgrounds is one of the core missions of the Southern California Clinical and Translational Science Institute (SC CTSI), based at USC and Children's Hospital Los Angeles (CHLA). But every community is unique, so the SC CTSI must devise and test different strategies to find the best methods to engage with each one, explained Michele D. Kipke, PhD., Co-Director of the SC CTSI and the Principal Investigator on the Virtual Research Navigator project. 

"Now more than ever we are seeing the success and impact of a lot of targeted projects that address health disparities and access to care," said Kipke. 

Zippy, the Virtual Research Navigator
One of the SC CTSI's newest projects seeks to engage children (and their parents) in the Los Angeles area that are receiving care at CHLA. Zippy, a Virtual Research Navigator, was developed through a partnership of CHLA, the SC CTSI (which provided funding), and USC's Institute for Creative Technologies (ICT). ICT brings film and game industry artists together with computer and social scientists to develop media technologies that can help solve important problems facing society; it has been an important partner with the SC CTSI in the development of innovative technology to address pressing health needs.   

Zippy is an animated robot character that children and adults can converse with—currently, via a Microsoft Surface tablet computer—to learn about clinical research, and better understand what it means to be involved in a research study. In effect, Zippy is designed to take people on a journey through the research process, and ideally, all the way to enrolling them in an actual study.

"Our hypothesis is that if people understand more fully what's involved in clinical studies—including the regulations and ethical guidelines that govern clinical research—then maybe we can help address the mistrust and the misconceptions many have about research and get more people involved, said Kipke.

Younger children understandably find it difficult to understand details about medicine and research delivered by their doctors. But an animated robot can be fun to talk to—and might break the ice better than a human doctor. "Zippy has been designed to appeal to a wide audience at CHLA and to involve both parents and children," said Kipke.

Users can ask questions about different aspects of the clinical research process, and Zippy can answer verbally, using everyday terminology that kids and laypeople can understand.

The project team from CHLA developed the questions and content about health and clinical research, while the technologists at ICT brought Zippy to life through sound and animation. "ICT has been an extraordinary resource and we have leveraged their expertise in virtual navigation and coaching, artificial intelligence and speech recognition technologies that foster natural interaction to develop the VRN platform," said Kipke.

Initial tests of Zippy were conducted with patients at CHLA, and now a second iteration is being finalized. Next up is a pilot study that will insert Zippy into the clinical workflow when patients see their doctor at CHLA. The designers' long term goal is to introduce the Zippy platform into different sorts of hospitals, working with different populations and different health research aims.

"Zippy was designed to help families feel more comfortable about getting involved in research, and most of all to convey that their participation in research can help improve healthcare for the larger population."