=Paper= {{Paper |id=Vol-2448/SSS19_Paper_Upload_228 |storemode=property |title=Interpretable AI for Well-Being Using Mobile Health |pdfUrl=https://ceur-ws.org/Vol-2448/SSS19_Paper_Upload_228.pdf |volume=Vol-2448 |authors=Peter Pirolli |dblpUrl=https://dblp.org/rec/conf/aaaiss/Pirolli19 }} ==Interpretable AI for Well-Being Using Mobile Health== https://ceur-ws.org/Vol-2448/SSS19_Paper_Upload_228.pdf
                   Interpretable AI for Well-Being Using Mobile Health


                                                               Peter Pirolli
                                             Florida Institute for Human and Machine Cognition
                                                                ppirolli@ihmc.us



                            Abstract                                     attrition and improve achievement of behavior change goals.
  Mobile health (mHealth) and other highly pervasive, interac-           Intelligent mHealth systems that utilize multiple ap-
  tive and adaptive digital systems offer an enormous oppor-             proaches, automate personalization, and increase social sup-
  tunity for enabling theory-based health behavior-change in-            port can be a scalable approach to current healthcare chal-
  terventions that are replicable, scalable, and sustainable. Such
                                                                         lenges.
  advances could have great impact, and they offer great op-
  portunities for advances in artificial intelligence (AI), psy-            Novel computational theories of the psychological and
  chology, and social science. Unfortunately, the technical              social mechanisms of behavior change are needed in order
  challenges of developing AI to support healthier behaviors             to accelerate the development of mHealth systems so that
  generally fall into the category of “not suitable for machine          they can help people build healthier lifestyles (Riley et al.,
  learning.” This presentation will summarize recent research
                                                                         2011; Spruijt-Metz et al., 2015). In turn, we could use
  with the Fittle+ mHealth systems and predictive models of
  the daily effects of individual-level mHealth interventions.           mHealth systems as experimental platforms for accelerated
  The models are developed in a computational cognitive ar-              development of such theories. These theoretical and empir-
  chitecture and rely on Instance Based Learning Theory and              ical foundations would then provide a basis for intelligent
  ACT-R learning mechanisms.                                             interactive agents that reason about causal models of the dy-
                                                                         namics of individual human behavior--models that enable
                                                                         the planning and delivery of interventions and assessments
                        Introduction
                                                                         that optimize the acquisition and maintenance of healthy
Mobile health (mHealth) systems offer an opportunity for                 habits.
pervasive support of health behavior change in the actual
ecology of people’s everyday environments. Such advances
could have vast impact since individual and social behavior,              Human Goal-Striving and Habit Formation
including poor diet, sedentary lifestyle, and social isolation
are central to the etiology and management of many health                An unhealthy lifestyle can be viewed, in part, as a complex
outcomes, and yet are typically resistant to change (Klein et            set of interrelated habits that need to be switched out for
al., 2014). It is estimated that 70% of health care costs are            healthy ones, a few tiny habits at a time (Fogg & Hreha,
due to changeable behavior, and behavioral and environ-                  2010). Commercial and health-care provider weight loss
mental factors account for more deaths than genetics (Riley,             programs can often involve months to years of counseling,
Nilsen, Manolio, Masys, & Lauer, 2015).                                  which suggests thousands to tens of thousands of elementary
   However, the mHealth field is still relatively new and                habits being acquired (Feltovich, Prietula, & Ericsson,
lacks integrated theories of long-term behavior change that              2006). The working assumption for our own mobile health
address multiple interventions and a multiplicity of individ-            research is that to master the complex fabric of a new
ual, social, and environmental factors. As with digital health           healthy lifestyle, one must master and weave together a new
interventions in general, mHealth systems suffer high attri-             set of elementary habits
tion rates (Eysenbach, 2005). However, recent research sug-                 Unfortunately, modeling human behavior change and in-
gests that mHealth systems that adapt to the individual                  tervening in ways that shape healthier habits is enormously
(Konrad et al., 2015; Pirolli, 2016), use evidence-based in-             challenging and not suitable for current machine learning
terventions (Pirolli et al., 2018), and include online social            approaches (Brynjolfsson & Mitchell, 2017). This presenta-
support (Du, Venkatakrishnan, Youngblood, Ram, &                         tion gives a theoretical approach and several computational
Pirolli, 2016; Du, Youngblood, & Pirolli, 2014) reduce
models that provide an integrated account of multiple mech-        Programs. Paper presented at the Proceedings of the Wireless
anisms associated with people striving to achieve healthier        Health 2014 on National Institutes of Health, Bethesda, MD, USA.
                                                                   http://dl.acm.org/citation.cfm?doid=2668883.2668887
behavior and their long-term habit formation. Interestingly,
                                                                   Eysenbach, G. (2005). The law of attrition. Journal of medical
the mechanisms modeled in health-behavior change are also
                                                                   Internet research, 7(1), e11. doi:10.2196/jmir.7.1.e11
implicated in well-known human cognitive biases (Lebiere
                                                                   Feltovich, P. J., Prietula, M. J., & Ericsson, K. A. (2006). Studies
et al., 2013) and, in a sense, the success of the interventions    of expertise from psychological perspectives. In K. A. Ericsson, N.
we have studied appears to be the result of taking advantage       Charness, P. J. Feltovich, & R. R. Hoffman (Eds.), The Cambridge
of those biases.                                                   handbook of Expertise and Expert Performance (pp. 41-67).
   I will present an overview of the Fittle+ mHealth systems       Cambridge, MA: Cambridge University Press.
(Pirolli et al., 2018) that have been used to study several        Fogg, B. J., & Hreha, J. (2010). Behavior Wizard: A Method for
evidence-based behavior change interventions. These sys-           Matching Target Behaviors with Solutions. In T. Ploug, P. Hasle,
                                                                   & H. Oinas-Kukkonen (Eds.), Persuasive Technology (Vol. 6137,
tems provide scaffolding interventions: Behavior-change
                                                                   pp. 117-131): Springer Berlin Heidelberg.
techniques and associated mHealth interactions (e.g., SMS
                                                                   Klein, W. M. P., Bloch, M., Hesse, B. W., McDonald, P. G.,
reminders; chatbot dialogs; user interface functionality; etc.)    Nebeling, L., O’Connell, M. E., . . . Tesauro, G. (2014). Behavioral
that support the acquisition and maintenance of healthy hab-       Research in Cancer Prevention and Control: A Look to the Future.
its.                                                               American journal of preventive medicine, 46(3), 303-311.
   I will present models developed in the ACT-R computa-           doi:10.1016/j.amepre.2013.10.004
tional cognitive architecture (Anderson, 2007) that address        Konrad, A., Bellotti, V., Crenshaw, N., Tucker, S., Nelson, L., Du,
data collected about individual-level daily achievement of         H., . . . Whittaker, S. (2015). Finding the Adaptive Sweet Spot:
                                                                   Balancing Compliance and Achievement in Automated Stress
behavioral goals for improved eating and exercise using Fit-
                                                                   Reduction. Paper presented at the SIGCHI Conference on Human
tle+ mHealth applications. The models refine the psycho-           Factors in Computing Systems (CHI 2015), Seoul, Korea.
logical constructs of perceived goal difficulty, self-efficacy     Kukla, A. (1972). Foundations of an attributional theory of
(Bandura, 1998) and intended effort (a kind of motivation)         performance.       Psychological      Review,     79(6),    454-470.
(Kukla, 1972). The models provide a plausible account of           doi:10.1037/h0033494
how intentions can lead to the initial effortful striving to       Lebiere, C., Pirolli, P., Thomson, R., Paik, J., Rutledge-Taylor, M.,
carry out goals, how repeated execution of behaviors can be-       Staszewski, J., & Anderson, J. R. (2013). A functional model of
come automated habits, and how specific intervention tech-         sensemaking in a neurocognitive architecture. Comput Intell
                                                                   Neurosci, 2013, 921695. doi:10.1155/2013/921695
niques support the development of habits. Together the
models map a trajectory from initial effortful pursuit of a        Pirolli, P. (2016). A computational cognitive model of self-efficacy
                                                                   and daily adherence in mHealth. Translational behavioral
behavior-change goal to new stable habits.                         medicine, 6(4), 1-13. doi:10.1007/s13142-016-0391-y
   The motivation for developing these models is that they
                                                                   Pirolli, P., Youngblood, G. M., Du, H., Konrad, A., Nelson, L., &
may serve as a foundation for intelligent mHealth interac-         Springer, A. (2018). Scaffolding the Mastery of Healthy Behaviors
tion algorithms. By developing these in a cognitive architec-      with Fittle+ Systems: Evidence-Based Interventions and Theory.
ture, the models are not only predictive, but provide insight      Human–Computer                      Interaction,               1-34.
as to the underlying causal mechanisms, which is necessary         doi:10.1080/07370024.2018.1512414
for reasoning about optimal personalized interventions that        Riley, W. T., Nilsen, W. J., Manolio, T. A., Masys, D. R., & Lauer,
help people achieve healthy lifestyles.                            M. (2015). News from the NIH: potential contributions of the
                                                                   behavioral and social sciences to the precision medicine initiative.
                                                                   Translational        behavioral     medicine,      5(3),    243-246.
                                                                   doi:10.1007/s13142-015-0320-5
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