OBJECTIVE: Digital behavior change interventions (DBCIs) are feasibly effective tools for addressing physical activity. However, in-depth understanding of participants' long-term engagement with DBCIs remains sparse. Since the effectiveness of DBCIs to impact behavior change depends, in part, upon participant engagement, there is a need to better understand engagement as a dynamic process in response to an individual's ever-changing biological, psychological, social, and environmental context. METHODS: The year-long micro-randomized trial (MRT) HeartSteps II provides an unprecedented opportunity to investigate DBCI engagement among ethnically diverse participants. We combined data streams from wearable sensors (Fitbit Versa, i.e., walking behavior), the HeartSteps II app (i.e. page views), and ecological momentary assessments (EMAs, i.e. perceived intrinsic and extrinsic motivation) to build the idiographic models. A system identification approach and a fluid analogy model were used to conduct autoregressive with exogenous input (ARX) analyses that tested hypothesized relationships between these variables inspired by Self-Determination Theory (SDT) with DBCI engagement through time. RESULTS: Data from 11 HeartSteps II participants was used to test aspects of the hypothesized SDT dynamic model. The average age was 46.33 (SD=7.4) years, and the average steps per day at baseline was 5,507 steps (SD=6,239). The hypothesized 5-input SDT-inspired ARX model for app engagement resulted in a 31.75 % weighted RMSEA (31.50 % on validation and 31.91 % on estimation), indicating that the model predicted app page views almost 32 % better relative to the mean of the data. Among Hispanic/Latino participants, the average overall model fit across inventories of the SDT fluid analogy was 34.22 % (SD=10.53) compared to 22.39 % (SD=6.36) among non-Hispanic/Latino Whites, a difference of 11.83 %. Across individuals, the number of daily notification prompts received by the participant was positively associated with increased app page views. The weekend/weekday indicator and perceived daily busyness were also found to be key predictors of the number of daily application page views. CONCLUSIONS: This novel approach has significant implications for both personalized and adaptive DBCIs by identifying factors that foster or undermine engagement in an individual's respective context. Once identified, these factors can be tailored to promote engagement and support sustained behavior change over time.

Research in the area of internet-of-things, cyberphysical-systems, and smart health often employ sensor systems at residences for continuous monitoring. Such research-oriented residential monitoring systems (RRMSs) usually face two major challenges, long-term reliable operation management and validation of system functionality with minimal human effort. Targeting these two challenges, this paper describes a monitor of monitoring systems with ground-truth validation capabilities, M2G. It consists of two subsystems, the Monitor2system and the Ground-truth validation system. The Monitor2system encapsulates a flexible set of general-purpose components to monitor the operation and connectivity of heterogeneous sensor devices (e.g. smart watches, smart phones, microphones, beacons, etc.), a local base-station, as well as a cloud server. It provides a user-friendly interface and supports different types of RRMSs in various contexts. The system also features a ground truth validation system to support obtaining ground truth in the field. Additionally, customized alerts can be sent to remote administrators and other personnel to report any dysfunction or inaccuracy of the system in real time. M2G is applied to three very different case studies: the M2FED system which monitors family eating dynamics [1], an in-home wireless sensing system for monitoring nighttime agitation [2], and the BESI system which monitors behavioral and environmental parameters to predict health events and to provide interventions [3]. The results indicate that M2G is a comprehensive system that (i) requires small cost in time and effort to adapt to an existing RRMS, (ii) provides reliable data collection and reduction in data loss by detecting faults in real-time, and (iii) provides a convenient and timely ground truth validation facility.

We describe a study that compares two types of backstories, fictional and realistic, of an autonomous Socially Assistive Robot (SAR) exercise buddy in a four-session exercise intervention with overweight adolescents aged 11–14. We find a positive participant response to the robot as an exercise buddy and a trend toward increased intrinsic motivation for physical activity post-intervention. We do not find differences in ratings of the two backstories or between pre- and post-intervention measures of physical activity enjoyment and activity level.

The obesity epidemic is the primary cause of recent increases in heart disease, diabetes, cancer, and other diseases that place an untenable strain on healthcare and public health. One of the primary behavioral causes, i.e. dietary intake, is a behavior that science has had little success in understanding, much less affecting. Current behavioral science suggests that family eating dynamics (FED) have high potential to impact child and parent dietary intake and obesity rates. In contrast to traditional obesity related approaches that focus on dietary intakes (e.g., what and how much is being eaten), FED based approaches focus on family mealtime and home food environment (e.g., who is eating, when, where, with whom, interpersonal stress) for modeling behavior and providing feedback that has potential for successful behavior modification. This poster briefly presents M2FED, an integrated system for monitoring and modeling FED. The system is under development, and it consists of in-situ and wearable sensors, and smartphones that collect synchronized real-time FED data used to iteratively develop dynamic, contextualized FED models.

This paper describes an extended (6-session) interaction between an ethnically and geographically diverse group of 26 first-grade children and the DragonBot robot in the context of learning about healthy food choices. We find that children demonstrate a high level of enjoyment when interacting with the robot, and a statistically significant increase in engagement with the system over the duration of the interaction. We also find evidence of relationship-building between the child and robot, and encouraging trends towards child learning. These results are promising for the use of socially assistive robotic technologies for long-term one-on-one educational interventions for younger children.

The use of biometric sensors for monitoring an individual’s health and related behaviors, continuously and in real time, promises to revolutionize healthcare in the near future. In an effort to better understand the complex interplay between one’s medical condition and social, environmental, and metabolic parameters, this article presents the KNOWME platform, a complete, end-to-end, body area sensing system that integrates off-the-shelf biometric sensors with a Nokia N95 mobile phone to continuously monitor the metabolic signals of a subject. With a current focus on pediatric obesity, KNOWME employs metabolic signals to monitor and evaluate physical activity. KNOWME development and in-lab deployment studies have revealed three major challenges: (1) the need for robustness to highly varying operating environments due to subject-induced variability, such as mobility or sensor placement; (2) balancing the tension between achieving high fidelity data collection and minimizing network energy consumption; and (3) accurate physical activity detection using a modest number of sensors. The KNOWME platform described herein directly addresses these three challenges. Design robustness is achieved by creating a three-tiered sensor data collection architecture. The system architecture is designed to provide robust, continuous, multichannel data collection and scales without compromising normal mobile device operation. Novel physical activity detection methods which exploit new representations of sensor signals provide accurate and efficient physical activity detection. The physical activity detection method employs personalized training phases and accounts for intersession variability. Finally, exploiting the features of the hardware implementation, a low-complexity sensor sampling algorithm is developed, resulting in significant energy savings without loss of performance.