Model-based Social-Cognitive mHealth Peter Pirolli NSF International Workshop on Dynamic Modeling of Health Behavior Change and Maintenance, Sept 8-9, 2015, London, UK

Health Behavior Change via Smartphone

AI-based coach & team leader Fittle+ (Nudg 2.0) Daily habits Small teams AI-based coach & team leader

Behavior-Change Programs Expert Conceptual Architecture Authoring Tool Behavior-Change Programs

Conceptual Architecture Expert Conceptual Architecture Authoring Tool Behavior-Change Programs Coaching Engine Rich Content Actions & Decision Rules Goals User Model User EMIs Team Team Model Planning & Optimization Team Posts Update Models Activity & Assessment Learning Interaction Analyzer

Computational Neurocognitive Theory (ACT-R) Redefine a “macro” theory of behavior change... Self-Efficacy Intention Behavior Social Cognitive Theory ...into a finer-grained computational simulation Manual Imaginal Visual Aural Production Declarative Goal Vocal manual imaginal goal vocal retrieval aural visual visual location Behavior ACT-R

Belief in capacity to execute behaviors Interventions Self-efficacy Belief in capacity to execute behaviors Interventions Guided Enactive Mastery Selective Self-monitoring Vicarious Experience …..

An ACT-R Model of Self-Efficacy: The Basic Idea Goal to do a set of activities A that I believe have some difficulty δg Call upon memory: What have I done that is similar to A? Blend memories to determine self- efficacy: Based on my memories of the difficulty δE of my successful past experiences, I believe my ability is θE Positive experiences (or thinking of them) increases the strength of those memories (increase Self- efficacy) Memory Goal

Fit of ACT-R-Based Model to 28-day Dstress mHealth Data Model Konrad, A., Bellotti, V., Crenshaw, N., Tucker, S., Nelson, L., Du, H., . . . Whittaker, S. (2015). Finding the Adaptive Sweet Spot: Balancing Compliance and Achievement in Automated Stress Reduction. Paper presented at the SIGCHI Conference on Human Factors in Computing Systems (CHI 2015), Seoul, Korea.

Assignment: What our Subject Matter Expert Wanted Assumed Goals Balanced regular meals, reduced snacking, processed foods, snacking, seets Approach: Healthy habits to replace poor ones Slow eating, healthy breakfast, 5 servings veggies… Environmental changes Kitchen makeover…. Initial testing (tailoring rules dependent on these) At least 8 blood/gene tests Battery of at least 12 different integrative behavior-change instruments (activity, diet, psycho-social states, health-behavior, stress, sleep, body composition, environmental inventory….) 2-4 week self-monitoring phase What are you doing? Food & feelings…. Not only for data—a healthy self-awareness habit Must be simple!!!!!

Geeky Need #1: Scalable Expert Knowledge Capture Authoring Tool Behavior-Change Programs S.M.A.R.T mHealth

Geeky Need #1: Scalable Expert Knowledge Capture Authoring Tool Crowdsourcing? Back-off to experts? How do we start with 50% coverage and grow to 99%? Behavior-Change Programs Tune and Expand Existing Program User EMI Gaps

Geeky Idea #2: System 2 EMAs & EMIs Mastering your inner elephant Symbolic System 2 (Explicit) Manual Imaginal Visual Aural Production Declarative Goal Vocal manual imaginal goal vocal retrieval aural visual visual location ACT-R System 1 (Implicit) Subsymbolic Dynamics Memory Blending

Geeky Idea #2: System 2 EMAs & EMIs Mastering your inner elephant Implicit taste vs health associations (System 1) modulate Choice Inhibitory control Self-efficacy Deliberate cognitive training can alter those associations and control systems System 2 (Explicit) System 1 (Implicit)

Implicit Attitudes Test (IAT) Healthy and Tasty Unhealthy and Not tasty Block 3,4,5; 20 trials each; Healthy+Tasty vs. Unhealthy+Not tasty Highlighted gray denotes selection Next trial is automatic upon selection Red X mark under stimuli if incorrect response, must press other option to fix error and move to next trial Items in middle include both words and stimuli LEFT RIGHT

Implicit Attitudes Test (IAT) Healthy and Tasty Unhealthy and Not tasty Feasible on smartphone Thousands take it online of their own volition Game-like and can be made more so Can be used in cognitive training(?) Block 3,4,5; 20 trials each; Healthy+Tasty vs. Unhealthy+Not tasty Highlighted gray denotes selection Next trial is automatic upon selection Red X mark under stimuli if incorrect response, must press other option to fix error and move to next trial Items in middle include both words and stimuli LEFT RIGHT

Geeky Need # 3: Simpler (but not automated!) Monitoring & Reflection Quantified Self Sensing How are you spending your day? Contexts, food & feelings, behaviors Experience sampling User tagging of automated logs Smart about prompting: Receptive, accurate, reflective Lifelogs

CMU LifeLogger Joy Zhang

THANK YOU.

Geeky Need #4: Deliberate (Virtual) Practice Must be feasible on smartphone System 2 Reflection on “virtual diary” Practice for upcoming situations (family banquet, holiday travel) … System 1 Cognitive training Implicit attitudes Regulatory responses

Underlying Computations for Self-efficacy

Impulse-like Nature of the ACT-R Model of Self-Efficacy