Automated interventions for multiple health behaviors using conversational agents

Abstract

Objective: An automated health counselor agent was designed to promote both physical activity and fruit and vegetable consumption through a series of simulated conversations with users on their home computers.

Methods: The agent was evaluated in a 4-arm randomized trial of a two-month daily contact intervention comparing: (a) physical activity; (b) fruit and vegetable consumption; (c) both interventions; and (d) a non-intervention control. Physical activity was assessed using daily pedometer steps. Daily servings of fruit and vegetables were assessed using the NIH/NCI self-report Fruit and Vegetable Scan.

Results: Participants in the physical activity intervention increased their walking on average compared to the control group, while those in the fruit and vegetable intervention and combined intervention decreased walking. Participants in the fruit and vegetable intervention group consumed significantly more servings per day compared to those in the control group, and those in the combined intervention reported consuming more compared to those in the control group.

Conclusion: Automated health intervention software designed for efficient re-use is effective at changing health behavior.

Practice implications: Automated health behavior change interventions can be designed to facilitate translation and adaptation across multiple behaviors.

Keywords: Behavioral informatics; Dialog system; Diet promotion; Embodied conversational agent; Fruit and vegetable consumption promotion; Health behavior change intervention; Ontology; Physical activity promotion; Relational agent; Walking promotion.

Figure 1

Sample Excerpt of User-Agent Counseling Dialog (‘A’ precedes agent utterances; ‘U’ precedes user utterances).

Figure 2

Conversational Agent User Interface

Figure 3

Patient Flow in Study (Consort Diagram)

Figure 4

Pedometer Steps by Study Group

Figure 5

Fruit & Vegetable Consumption by Study Condition