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  <front>
    <journal-meta />
    <article-meta>
      <title-group>
        <article-title>Creating an Artificial Coaching Engine for Multi-domain Conversational Coaches in eHealth Applications</article-title>
      </title-group>
      <contrib-group>
        <contrib contrib-type="author">
          <string-name>Tessa Beinema</string-name>
          <email>t.beinema@rrd.nl</email>
          <xref ref-type="aff" rid="aff0">0</xref>
        </contrib>
        <contrib contrib-type="author">
          <string-name>Harm op den Akker</string-name>
          <email>h.opdenakker@rrd.nl</email>
          <xref ref-type="aff" rid="aff0">0</xref>
        </contrib>
        <contrib contrib-type="author">
          <string-name>Hermie Hermens</string-name>
          <email>h.hermens@rrd.nl</email>
          <xref ref-type="aff" rid="aff0">0</xref>
        </contrib>
        <aff id="aff0">
          <label>0</label>
          <institution>Roessingh Research and Development, Telemedicine group</institution>
          ,
          <addr-line>Enschede</addr-line>
          ,
          <country country="NL">The Netherlands</country>
        </aff>
      </contrib-group>
      <fpage>35</fpage>
      <lpage>39</lpage>
      <abstract>
        <p>In this paper the concept of an Artificial Coaching Engine is described, which is being developed for a state-of-the-art multi-agent multi-domain coaching application. The engine will fulfil three main functions in this application. First, it will serve as a knowledge base and user model, representing user, context, and artificial coach information. Second, it will represent and select the coaching goals that the coaches will coach towards. Third, it will select the most suitable coaching strategies for reaching the selected coaching goals. Following the description of the concept, we will discuss our approach and the challenges in the development of the Artificial Coaching Engine.</p>
      </abstract>
    </article-meta>
  </front>
  <body>
    <sec id="sec-1">
      <title>CCS CONCEPTS</title>
      <p>• Human-centered computing → HCI theory, concepts and
models; • Computing methodologies → Knowledge representation
and reasoning; • Social and professional topics → User
characteristics;</p>
    </sec>
    <sec id="sec-2">
      <title>INTRODUCTION</title>
      <p>
        The average age of the World’s population is increasing. In a 2017
report, the United Nations reports the number of persons aged 60
or above is expected to more than double by 2050 and even triple
by 2100 [
        <xref ref-type="bibr" rid="ref8">8</xref>
        ]. For Europe the expected increase by 2050 will be from
25% of the population to 35%.
      </p>
      <p>
        With the rising average age of the population there is also an
increasing percentage of the population that sufers from
noncommunicable diseases (NCDs) or chronic diseases. The main types of
such diseases are cardiovascular diseases, cancers, chronic
respiratory diseases and diabetes [
        <xref ref-type="bibr" rid="ref6">6</xref>
        ], but dementia and depression are also
common. While NCDs are responsible for 70% of all deaths globally
each year (that is, 40 million people), the length of time that people
sufer from them is also very long and puts a large drain on health
care resources and manpower.
      </p>
      <p>
        An efective approach for the prevention and control of NCDs is
reducing risk factors in multiple domains. For example, for
cardiovascular diseases and diabetes, this can involve the adoption of a
healthy diet and healthy exercise habits. More generally, adopting
a healthier lifestyle can delay NCDs and improve quality of life.
While the coaching approach that is most suitable varies between
target groups, research has shown that health coaching by health
care professionals improves the management of chronic diseases
[
        <xref ref-type="bibr" rid="ref3">3</xref>
        ]. Given the size of the challenge, the implementation of health
coaching by human coaches for a large target audience requires
more manpower and resources from the health sector.
      </p>
      <p>One solution for the limited availability of human coaches can
be found in eHealth applications for personalised coaching, or
e-coaching systems. These systems can be used to help people
with adopting a healthier lifestyle. Through coaching, users can be
informed, assisted and empowered.
1.1</p>
    </sec>
    <sec id="sec-3">
      <title>E-coaching systems</title>
      <p>We adopt the definition by Kamphorst as a description of e-coaching
systems:</p>
      <p>
        An e-coaching system is a set of computerized
components that constitutes an artificial entity that can
observe, reason about, learn from and predict a user’s
behaviours, in context and over time, and that engages
proactively in an ongoing collaborative conversation
with the user in order to aid planning and promote
efective goal striving through the use of persuasive
techniques [
        <xref ref-type="bibr" rid="ref2">2</xref>
        ].
      </p>
      <p>Within e-coaching, there are many applications that focus on
a single domain or target group. Examples of domains include:
healthy eating, physical activity, diabetes management or mental
health. Examples of target groups are: the elderly, chronic pain
patients or obese children. In recent years there is also an increase
of applications that have the focus on a combination of two domains,
for example, healthy eating and physical activity. However, since
the risk factors for NCDs can be found across multiple domains,
we believe that a holistic approach to healthy living is crucial and
thus e-coaching should also focus on aiding the user in multiple
domains.</p>
      <p>
        Apart from the coaching domain and target audience, other
important aspects for e-coaching systems that focus on health
promotion are that they should be interactive, interoperable, personally
engaging, contextually tailored and that they should be suitable to
deliver to mass audiences [
        <xref ref-type="bibr" rid="ref4">4</xref>
        ].
      </p>
      <p>
        An application in development that will incorporate the aspects
mentioned above is the Council of Coaches [
        <xref ref-type="bibr" rid="ref5">5</xref>
        ]. The Council of
Coaches will be a state-of-the-art multi-agent e-coaching
application that will combine holistic behaviour analysis, smart adaptive
coaching, dialogue management (using the DGEP platform [
        <xref ref-type="bibr" rid="ref1">1</xref>
        ]), and
realistic embodied conversational agents (using the GRETA/VIB
platform [
        <xref ref-type="bibr" rid="ref7">7</xref>
        ] and ASAP platform [
        <xref ref-type="bibr" rid="ref9">9</xref>
        ]) to aid its users in obtaining
a healthier lifestyle. The three initial target groups will be people
with Age Related Impairments, Type 2 Diabetes, or Chronic Pain.
      </p>
      <p>The Council of Coaches application will involve multiple
embodied conversational coaches, each with their own expertise. The
presence of multiple coaches allows for multi-coach strategies, for
example, a coach explaining something to another coach to teach
the user or ‘good coach - bad coach’. There are many interesting
facets to the project, and in this paper we focus on one of them: the
development of the Artificial Coaching Engine.
2</p>
    </sec>
    <sec id="sec-4">
      <title>THE ARTIFICIAL COACHING ENGINE</title>
      <p>The Artificial Coaching Engine will fulfil the role of the
intelligent coaching component in the Council of Coaches system. As can
be seen in Figure 1 it has a central place in the system connecting
the components that are responsible for gathering data and those
generating the embodied conversational agents, the dialogues and
their behaviour. Taking this role in the system, there are three main
functions that the Artificial Coaching Engine will fulfil, namely, as
a knowledge base, as a goal selector and as a strategy selector. A
schematic overview of how these elements influence each other
can be found in Figure 2, and an overview of process within the
Artificial Coaching Engine can be found in Figure 3.
2.1</p>
    </sec>
    <sec id="sec-5">
      <title>Knowledge base</title>
      <p>The first function of the Artificial Coaching Engine is to serve as
a knowledge base, and it will contain three types of knowledge
(see Figure 2). Dynamic knowledge relates to knowledge that can
quickly change, such as, for example, information available about
the current user. Semi-static knowledge relates to knowledge that
is quite static, but that might be updated, such as, for example,
knowledge about what a healthy diet entails. Static knowledge
relates to knowledge that is not expected to change, such as, for
example, a user’s brother is someone that shares the same parents.
The represented information will be leveraged by the coaching
modules in the coaching engine as well as by multiple components
of the overall system for tailoring their output.</p>
      <p>The representation of the user in the coaching engine will contain
information from two main sources. Firstly, information on the
user’s short-term and long-term behaviours will be represented
which is gathered by the system’s sensing component (for example,
physical activity or facial expressions). The sensing component
will also detect changes in behaviour and it will provide context
information. Secondly, information obtained through the user’s
interaction with the system will be represented.</p>
      <p>The representation of the coaches includes predefined
knowledge for each coach on their personalities, domains, mannerisms,
backstories, etc. It will also include a representation of the coaching
goals and available coaching strategies for each coach (which will
be elaborated on in the next two subsections). Within the
coaching engine, each coach has an individual knowledge base, which
contains the knowledge necessary to coach in their domain.
2.2</p>
    </sec>
    <sec id="sec-6">
      <title>Automatic goal selection</title>
      <p>The second function of the Artificial Coaching Engine is to select the
coaching goals for the coaches. For an e-coaching system to coach
people, it should be clear what the goal of the provided coaching
is. That is, there should be (intermediary) goals which are aimed
for when interacting with the user. Examples can be to achieve a
change in behaviour, the assimilation of transferred information,
or to help a user feel more empowered.</p>
      <p>In the Council of Coaches system there are multiple embodied
conversational coaches, who will all coach in their own domain. As
can be seen in Figure 2, each of the coaches will have a personal
implementation of a shared goal model. That is, the model is the
same, but the priorities for the goals may be diferent for diferent
coaches. In the goal model it is represented what each goal is and
how the goals can be related to each other. Each goal must at
least include the domain or domains to which it belongs, what the
prerequisites are for the goal to be allowed to be set, and if it has
been completed or if it perhaps is irrelevant for the current user.
The task of the automatic goal selector is to decide which goal
is most relevant to pursue for the coach based on the available
knowledge.
2.3</p>
    </sec>
    <sec id="sec-7">
      <title>Tailored coaching strategies</title>
      <p>The third function of the Artificial Coaching Engine is to select the
coaching strategies that are most suitable for reaching a coaching
goal (again, see Figure 2). Once a goal has been selected for a coach,
a coaching strategy can guide that coach’s interactions with the
user to reach that goal. Each coach will have a set of coaching
strategies available, and, while that set might partly be the same as
for other coaches, the strategies that are available to a coach are
selected to be suitable for that coach’s domain.</p>
      <p>The most suitable strategy for reaching a goal will be determined
based on the available information about the user. For example,
if the goal is to inform a user about the importance of physical
exercise, for a well-informed user a coach might ask that user what
they know, so that they can correct flaws in their knowledge, while
for a very uncertain user the strategy might involve dropping subtle
hints about the topic and giving compliments.</p>
      <p>The definition of coaching strategies starts by designing
strategies using literature on behaviour change and e-coaching, and the
expertise of domain experts. These strategies then need to be
modelled to create a technical representation. The modelled strategies
should contain a set of defined prerequisites and clearly structured
contents. In the end, the selected strategy (or strategies if there
are multiple suitable candidates) is sent to the dialogue
management component and agent representation component to guide the
coach’s dialogue actions and behaviour.
2.4</p>
    </sec>
    <sec id="sec-8">
      <title>Research questions</title>
      <p>The development of the Artificial Coaching Engine brings a number
of research questions with it. The main questions are:
• What is the knowledge about the user and their context that
needs to be available to be able to coach?
• How do we represent this knowledge?
• How do we represent and how do we select the coaching
goals?
• How do we handle diferent goals for diferent coaches?
• Which coaching strategies are relevant for the coaching
domains?
• How do we represent and select the coaching strategies?
3</p>
    </sec>
    <sec id="sec-9">
      <title>APPROACH AND CHALLENGES</title>
      <p>The realisation of the Artificial Coaching Engine brings with it
many challenges. In the following subsections we describe our
approach for the development of the engine’s three main functions
and we discuss the main challenges in that process. We also discuss
evaluation, which can be challenging for a component in an
ecoaching system that aims for behaviour change.
3.1</p>
    </sec>
    <sec id="sec-10">
      <title>Knowledge modelling</title>
      <p>As mentioned previously, the knowledge base will contain a
representation of information on the user and a representation of
the coaches. The design of the user model will be based on
observations from the literature on behaviour change, the behaviours
and behaviour changes measured by the sensing platform and the
information resulting from interactions with the user.</p>
      <p>The first step will be to create a framework that models the
aspects of a user’s physical state, mental state, and context that
influence behaviour change processes. Initially the models in this
framework will involve the, often abstract, concepts that can be
deduced from theories about behaviour change. While theories of
behaviour change describe the underlying processes of behaviour
change in persons, we will use these theories to infer concepts
that can be build up from the data that we obtain through sensors
and interaction. We will make these concepts more concrete by
mapping them to the possible means of measurement. The final
implementation of the knowledge for the system will be refined
from this set of measurable features based on the requirements
resulting from the prerequisites of the sets of goals and strategies
that the coaches will have.</p>
      <p>The representation of the coaches will be based on character
designs and implemented following the requirements of the system’s
agent representation component. That is, for example, personality
and mannerisms will be implemented in such a way that they can
be used in the generation of the coaches’ behaviours and
adjustment of their dialogue actions. We discuss the representation of the
goals and strategies, which are a part of the coaches as well, in the
following two subsections.
3.2</p>
    </sec>
    <sec id="sec-11">
      <title>Automatic goal selection</title>
      <p>The construction of the automatic goal selection module brings two
main challenges. The first is the modelling of the goals. A single
goal will have prerequisites and can be a super- and or subgoal of
other goals. But, and especially when dealing with multiple coaches
that all have their own domains such as in the Council of Coaches
system, there is no obvious hierarchy in which goals from multiple
domains are already related to each other. For example, a goal
contributing to a relaxed and happy user might take some efort to
balance with goals on physical exercise or dieting.</p>
      <p>The second challenge involves the selection of goals. When
presented with a hierarchical network, one might envision a manner
of going through that network and selecting the next goals on the
basis of being relevant or ‘to be completed’. Again, the
introduction of multiple coaches with multiple domains makes this more
challenging. If in the system each coach has its own representation
of the goal model, this means that the goals that are selected for
the coaches should be goals that can coexist.
3.3</p>
    </sec>
    <sec id="sec-12">
      <title>Strategy definition and representation</title>
      <p>Once a coaching goal has been selected, the coach or a combination
of coaches can employ a coaching strategy to reach that goal. The
development of these strategies brings with it some design choices.
To start, what is, for example, the ‘duration’ of a coaching strategy?
That is, can a strategy for coaching the user to move more involve
simply telling the user ‘You need to move more!’, or is it a longer
conversation where the coach tells the user how much they have
been moving in the past few weeks, what their new step target is,
why this is important, why they can do it and helps them plan to
reach the behaviour?</p>
      <p>Once a decision on the duration of strategies has been made,
the second step is to define informally what the various coaching
strategies are that are valid options for reaching the coaching goals.
Of course there can be multiple strategies that are suitable for
reaching those goals, depending on the knowledge about the user,
the coaches available and other goals.</p>
      <p>After the informal definition of the coaching strategies, they
should be modelled so that this technical representation can be
used to filter the possible dialogue actions. As can be seen in Figure
2 a strategy can be seen as a template that can be filled in by certain
coaching actions. These coaching actions in turn can consist of one
or more dialogue actions, which can also be responses to replies
from the user.</p>
      <p>The challenge in creating the coaching strategies lies in not only
developing them for single coaches, but also for a joint coaching
approach between two or more coaches at the same time. An
example could be the ‘good coach, bad coach’-strategy, in which one
coach might take on a very empathic role while the other might
enquire why the user did, for example, not reach their step goal for
that day.
3.4</p>
    </sec>
    <sec id="sec-13">
      <title>Evaluation</title>
      <p>Another challenge in the development of the Artificial Coaching
Engine is its evaluation, both for intermediate versions and for the
ifnal version of the engine. That is, the aim for the Artificial
Coaching Engine is to select strategies that can be deployed to change the
user’s behaviour. Since behaviour change is an efect that can only
be measured after a longer period of use, this also means that the
possibility exists that the user’s (lack of) behaviour change might
have been caused by external factors. While measuring behaviour
change is challenging in itself, in addition to the external factors,
the influence of the components layered between the coaching
engine and the user, such as the dialogue management and agent
representation platforms, should also be taken into account.</p>
      <p>One possible approach for evaluation could be to artificially
generate users, and to, for these users, output the selected goals
and strategies. This output can then be evaluated on whether it
indeed is the response the system should generate.
4</p>
    </sec>
    <sec id="sec-14">
      <title>CONCLUSION</title>
      <p>In this paper we described the concept of the Artificial Coaching
Engine. We have illustrated its functions and the challenges that
must be faced in the development process. In future research we
will describe how we have tackled these challenges and report on
the implementation of the Artificial Coaching Engine itself and its
components.</p>
    </sec>
    <sec id="sec-15">
      <title>ACKNOWLEDGMENTS</title>
      <p>The Council of Coaches project, of which this research is a part, has
received funding from the European Union’s Horizon 2020 research
and innovation programme under Grant Agreement #769553. This
result only reflects the author’s view and the EU is not responsible
for any use that may be made of the information it contains.</p>
    </sec>
  </body>
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