Download Holly Jimison, NSF Modeling Workshop 2016

Modeling Approaches for
Health Coaching Interventions
Holly Jimison, PhD, FACMI
College of Computer & Information Science
College of Health Sciences
Director,
Consortium on Technology for
Proactive Care
Northeastern University, Boston, MA, USA
NSF International Workshop on Dynamic Modeling of Health Behavior
Change and Maintenance, Sept 8-9, 2015, London, UK
Modeling for Coaching
Overview Points
 Use theoretical frameworks that health coaches
actually use (mix and match as needed)
 Use a decision theoretic framework (probabilities
and utilities for any action taken (alerts, messaging)
 Integrate intervention into daily life
 Devices: smart phones, calendars
 Coordinate with other interventions (stress
management, medications, exercise, etc.)
 Unobtrusive
Northeastern University
What does this mean for Skyler?
 Integrate intervention into daily life
 Coordinate with other interventions (stress management,
medications, exercise, sleep, etc.)
 Unobtrusive or minimally obtrusive sensors
 Smart phone for messaging, sensing voice quality, location
for context, rough level of activity, EMA assessments
 Credit card, debit card reports of food purchases
 Computer interactions (cognitive games, mouse, keyboard
interactions) for cognitive state
 Smart watch for EDA, HRV, SaO2, activity, messaging
 Bed sensor for HRV (stress recovery, sleep efficiency)
Northeastern University
Theoretical frameworks that
health coaches actually use:
• Backdrop:
– Collaborative, Tailored, Timely
– Develop a tailored shared action plan
– Monitor & provide feedback / encouragement
• Frameworks:
– Motivational Interviewing throughout
• Motivations, Barriers, Triggers
– Stages of Change for initial content & level of
detail in later stage messaging
– Self efficacy for preparation/action/maintenance
Northeastern University
Model Variables
• Baseline variables for all
modules
–
–
–
–
–
–
–
–
Behavior goals
Motivations
Barriers
Triggers
Stage of change
Self efficacy
Literacy/numberacy level
Contact info & preferences
• Monitored behaviors
–
–
–
–
–
Eating behaviors
Purchasing behaviors
Physical exercise
Socialization activities
Sleep efficiency
• Monitored physiology
– HRV, EDA, SaO2
• Context Variables
– Location
– Activity
– Inferred patient states
Northeastern
5 University
Model Variables
• Inferred Variables
–
–
–
–
Adherence to goals
Stage of change
Self efficacy
Patient states
• Quality of diet
• Stress level
• Cognitive functioning
• Physical functioning
• Socialization level
• Sleep quality
• Possible actions
– Tailored messaging
•
•
•
•
Reminders
Encouragement
Suggestions
Information
– Alerts
• Coach, Family, Clinician
– Interventions
• Lighting to highlight good
food choices
• Stress management
• …. other
Northeastern University
When to use which
type of computational model
• Sensor data models
– Sampling, filtering, summarization
– Data harmonization, representation, storage
• Sensor fusion models (not a simple average)
• Inference of patient state – statistical and
process models
• Tailored messaging – production rules; active
methods
• Alerting or assessment – decision theoretic
overlay
Northeastern University
Dynamic User Model to
Support Health Coaching
Intake Assessment
• Health Status
• Health Goals
• Motivations
• Barriers
• Stage of Change
• Social Support
• Preferred Name
• Contact Preferences
Dynamic User Model
• Current Goals
• Current Motivations
• Current Barriers
• Current Triggers
• Current Self Efficacy
• Current Patient States
Monitored Data
• Eating Behaviors
• Food Purchases
• Emotional Status
• Sleep Quality
• Cognitive Status
• Socialization
EMA Self Report
• As needed
Tailored
Data
Tailored
Action Summary Message
Plan
Generator
Family
Interface
Patient
Interface
Message Database
• Greetings
• Feedback Messages
• Recommendations
• Closings
• General Interest News
Coach
Interface
Northeastern University
Use decision theory framework
• Probabilities
– Patient state
– Patient activity
• Utilities for any action taken
– Messaging
– Assessments
– Alerts to coach, family, clinician
Northeastern University
Modeling for Alerts
• Decision Theory Framework
• Probabilities
• Utilities
Northeastern University
Example: Medication Adherence
Modeling for Alerts
• Decision Theory Framework
• Probabilities
• Utilities
Northeastern University
Example: Medication Alerts
• Model Variables
• Generate Alerts
– Importance of Drug
– Likelihood of
remembering
– Cost of alert (nagging)
– Patient Reminders
– Display to coach
– Display to family
– Display to clinician
M
U  A, C    p  q | A, C  uq  A, C 
q 1
U=Utility, A=Alerting Action, C=Context, q=patient state
Northeastern
12 University
Summary:
 Use theoretical frameworks that health coaches
actually use (mix and match as needed)
 Use computational models that fit the need
 Use a decision theoretic framework (probabilities
and utilities for any action taken
 Integrate intervention into daily life
 Holistic multifaceted approaches
 Think long-term sustainability
Northeastern University
Questions / Suggestions
Holly Jimison, PhD, FACMI
[email protected]