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Tailoring real-time physical activity coaching systems: a literature survey and model

Technology mediated healthcare services designed to stimulate patients’ self-efficacy are widely regarded as a promising paradigm to reduce the burden on the healthcare system. The promotion of healthy, active living is a topic of growing interest in research and business. Recent advances in wireless sensor technology and the widespread availability of smartphones have made it possible to monitor and coach users continuously during daily life activities. Physical activity monitoring systems are frequently designed for use over long periods of time placing usability, acceptance and effectiveness in terms of compliance high on the list of design priorities to achieve sustainable behavioral change. Tailoring, or the process of adjusting the system’s behavior to individuals in a specific context, is an emerging topic of interest within the field. In this article we report a survey of tailoring techniques currently employed in state of the art real time physical activity coaching systems. We present a survey of state of the art activity coaching systems as well as a conceptual framework which identifies seven important tailoring concepts that are currently in use and how they relate to each other. A detailed analysis of current use of tailoring techniques in real time physical activity coaching applications is presented. According to the literature, tailoring is currently used only sparsely in this field. We underline the need to increase adoption of tailoring methods that are based on available theories, and call for innovative evaluation methods to demonstrate the effectiveness of individual tailoring approaches.

Motivational cues as real-time feedback for changing daily activity behavior of patients with COPD

OBJECTIVE To investigate how COPD patients respond to motivational cues that aim to improve activity behavior and how these responses are related to cue- and context characteristics. In addition, to explore whether activity can be increased and better distributed over the day by providing such cues. METHODS Fifteen COPD patients participated. Patients used an activity sensor with a smartphone for four weeks, at least four days/week. Patients received motivational cues every 2h with advice on how to improve their activity, on top of real-time visual feedback. The response was calculated by the amount of activity 30 min before and after a cue. RESULTS In total, 1488 cues were generated. The amount of activity significantly decreased in the 30 min after a discouraging cue (p<0.001) and significantly increased (p<0.05) in the 10 min after an encouraging cue. The activity level increased with 13% in the intervention period compared to corrected baseline (p=0.008). The activity was not more balanced over the day. CONCLUSIONS COPD patients significantly change their activity level in response to motivational cues, based on continuous ambulatory assessment of activity levels. PRACTICE IMPLICATIONS Motivational cues could be a valuable component of telemedicine interventions that aim to improve activity behavior.

Ontology-based generation of dynamic feedback on physical activity

Improving physical activity patterns is an important focus in the treatment of chronic illnesses. We describe a system to monitor activity and provide feedback to help patients reach a healthy daily pattern. The system has shown positive effects in trials on patient groups including COPD and obese patients. We describe the design and implementation of a new feedback generation module which improves interaction with the patient by providing personalised dynamic context-aware feedback. The system uses an ontology of messages to find appropriate feedback using context information to prune irrelevant paths. The system adapts using derived probabilities about user preferences for certain message types. We aim to improve patient compliance and user experience.

Supporting Engagement and Floor Control in Hybrid Meetings

Remote participants in hybrid meetings often have problems to follow what is going on in the (physical) meeting room they are connected with. This paper describes a videoconferencing system for participation in hybrid meetings. The system has been developed as a research vehicle to see how technology based on automatic real-time recognition of conversational behavior in meetings can be used to improve engagement and floor control by remote participants. The system uses modules for online speech recognition, real-time visual focus of attention as well as a module that signals who is being addressed by the speaker. A built-in keyword spotter allows an automatic meeting assistant to call the remote participants attention when a topic of interest is raised, pointing at the transcription of the fragment to help him catch-up.

An ontology-based recommender system to promote physical activity for pre-frail elderly

The increasing ageing population and the prevalence of chronic diseases have introduced new challenges to healthcare systems motivating researchers to use telemonitoring solutions for providing care. In some solutions, a special focus has been given to promoting physical activity as it can decrease the risk of becoming frail and prevents further health complications. The focus of this research is to keep seniors physically active by designing and developing an intelligent system that recommends exercises tailored to an individual’s health status, goals and preferences hence aiming for an adaptive personalized solution.

Opportunities for smart & tailored activity coaching

This short paper describes how emerging technologies can be used to augment the effectivenes of activity coaching applications through tailoring.

Automated personalized goal-setting in an activity coaching application

The ageing population and the increase in sedentary lifestyles of knowledge workers has led to increasing concerns about the physical activity habits of the European population. Pervasive technologies and theories of behavioral change are being combined in an effort to promote physical activity. The Activity Coach is an example of one such system. Whereas the previous version of the Activity Coach set a fixed and permanent daily goal, in this work we describe the addition of an automatically adaptive goal-setting feature to this existing system. With the new feature, the daily goals for physical activity are set based on the users routine, contributing to the personalization of the system. A technical evaluation was performed to test the systems adaptation to the users routine. Additionally, a conversion factor between a unit of energy expenditure and number of steps was determined. The evaluation indicates that our method of goal-setting provides more challenging but still attainable goals when compared to the previous version. Additional evaluations are recommended to evaluate the users perception and effects on physical activity behavior change of this new feature. The results of this research are implemented in the existing Activity Coach and will be used in future patient evaluations.

Council of Coaches - A Novel Holistic Behavior Change Coaching Approach

A modern way of life needs a modern way of coaching. Despite the proliferation of ICT solutions for personalized health care, there is still no easy way to provide older adults with integrated coaching services. In this paper we introduce the concept of Council of Coaches — a radically new virtual coaching concept based on multiple autonomous, embodied virtual coaches, which form together a personal council that fulfills the needs of older adults in an integrated way. In this concept, coaching takes the form of an open dialog in which clients co-construct together with a selected number of coaches their own plans to go for a healthier lifestyle. Virtual coaches are presented to users by means of embodied conversational social characters. We discuss technical and social challenges on the path towards realizing the Council of Coaches concept, a radically new view of health coaching that involves the state of the art in human-computer interaction, natural dialogue, and argumentation technology.

A Remote Home Monitoring System to Support Informal Caregivers of People with Dementia.

Informal caregivers of people with dementia have a high risk of becoming overburdened. Health informatics for aging in place can provide them support by deploying unobtrusive remote home monitoring systems to assess real-time events and monitor changes in the behavior of the person with dementia (PwD). In this paper, we describe the concept, development, and evaluation of an intelligent remote Home Monitoring System (HMS) that provides support to informal caregivers by giving key information related to the health and independent living of the PwD. The HMS consists of a Sensor System that monitors low-level behaviors of the PwD, a Decision Support System that translates this into high-level behaviors, and a connected Smartphone Application that allows the caregiver to receive notifications, review behavioral information at a glance, and facilitates the collaborative care process between informal caregivers. The final HMS prototype was evaluated and scored high in terms of usability and quality of the Smartphone Application. The Sensor System showed no significant flaws during testing, and the Decision Support System is considered a viable proof of concept. The next step is to evaluate the HMS in a real-life setting in terms of offering peace of mind and reducing the burden of care.

Persuasive technology to support active and healthy ageing: An exploration of past, present, and future

The age of the population worldwide is rapidly increasing, bringing social and economic challenges. Persuasive technology can alleviate the burden on traditional healthcare services when used to support healthy behaviors, for instance in the prevention and treatment of chronic diseases. Additionally, healthy behaviors are key factors for active and healthy ageing by delaying or even reversing functional decline. In this manuscript, we present a multi-perspective analysis of technologies that can be used in the support of active and healthy ageing in the daily life. First, we take the perspective of physical and mental health, by focusing on the promotion of physical activity and emotional wellbeing. From a temporal perspective, we look at how technology evolved from past, present and future. The overview of the literature is structured in four main sections: (1) measurement of current behavior (monitoring), (2) analysis of the data gathered to derive meaningful information (analyzing & reasoning), (3) support the individual in the adoption or maintenance of a behavior (coaching), and (4) tools or interfaces that provide the information to the individual to stimulate the desired behavior (applications). Finally, we provide recommendations for the design, development and implementation of future technological innovations to support Active and Healthy Ageing in daily life.