Effect of Values and Technology Use on Exercise: Implications for Personalized Behavior Change Interventions

Technology has recently been recruited in the war against the ongoing obesity crisis; however, the adoption of Health & Fitness applications for regular exercise is a struggle. In this study, we present a unique demographically representative dataset of 15k US residents that combines technology use logs with surveys on moral views, human values, and emotional contagion. Combining these data, we provide a holistic view of individuals to model their physical exercise behavior. First, we show which values determine the adoption of Health & Fitness mobile applications, finding that users who prioritize the value of purity and de-emphasize values of conformity, hedonism, and security are more likely to use such apps. Further, we achieve a weighted AUROC of .673 in predicting whether individual exercises, and we also show that the application usage data allows for substantially better classification performance (.608) compared to using basic demographics (.513) or internet browsing data (.546). We also find a strong link of exercise to respondent socioeconomic status, as well as the value of happiness. Using these insights, we propose actionable design guidelines for persuasive technologies targeting health behavior modification

Towards a Reference Architecture for Female-Sensitive Drug Management

Due to various biological factors, males and females differ in their response to drug treatment. However, there is still a lack of knowledge of the effects resulting from sex-differences in the medical field, especially due to the issue of underrepresentation of females in clinical studies. Considering severe diseases that are related to the cardiovascular system, which are likely to be perilous, counteracting this lack and emphasizing the need for sex-dependent drug treatment is of high importance. Thus, this research-in-progress paper aims at strengthening the female perspective in drug management by proposing design considerations on IS regarding recommender systems in healthcare for reinforcing shared decision-making and person-centered care. The resulting artefact presented will be a reference architecture with a mobile application as the interface to patients and healthcare professionals as well as a data- driven backend to collect and process data on sex specificity in the medical treatment of cardiovascular diseases (CVD)

Contributions to the psychological evaluation of UK exercise referral: the ER-QLS a measure of exercise-related life-quality

The benefits of physical activity for health are sufficient enough to be incorporated into UK public health policy and the exercise referral scheme is a popular method of engaging sedentary individuals into a more active lifestyle. However, the evidence base as to the extent to which such schemes impact upon holistic health outcomes is limited. This deficit is particularly apparent for psychological measures, despite these being reported as the most likely outcomes of a referral into exercise. The primary reason for this problem is the lack of tools available to exercise professionals with which to capture this valuable data. This thesis proposes that, in addition to the more commonplace monitoring of physiological outcomes and physical activity level, that psychological responses to, and outcomes of, a referral into exercise should be monitored as part of routine practice. The complete thesis provides an exercise referral sensitive quality of life measure, the Exercise Referral Quality of Life Scale (ER-QLS), which is intended for use in practice and/or for the purposes of research. Five stages of research were undertaken to produce the final measure. Two were qualitative and three were quantitative

Incorporating complex domain knowledge into a recommender system in the healthcare sector

In contrast to other domains, recommender systems in health sector may benefit particularly from the incorporation of medical domain knowledge, as it provides meaningful and personalised recommendations. With recent advances in the area of representation learning enabling the hierarchical embedding of health knowledge into the hyperbolic Poincaré space, this thesis proposes a recommender system for patient-doctor matchmaking based on patients’ individual health profiles and consultation history. In doing so, a dataset from a private healthcare provider is enriched with Poincaré embeddings of the ICD-9 codes. The proposed model outperforms its conventional counterpart in terms of recommendation accuracy

A survey of recommender systems for energy efficiency in buildings: Principles, challenges and prospects

Recommender systems have significantly developed in recent years in parallel with the witnessed advancements in both internet of things (IoT) and artificial intelligence (AI) technologies. Accordingly, as a consequence of IoT and AI, multiple forms of data are incorporated in these systems, e.g. social, implicit, local and personal information, which can help in improving recommender systems' performance and widen their applicability to traverse different disciplines. On the other side, energy efficiency in the building sector is becoming a hot research topic, in which recommender systems play a major role by promoting energy saving behavior and reducing carbon emissions. However, the deployment of the recommendation frameworks in buildings still needs more investigations to identify the current challenges and issues, where their solutions are the keys to enable the pervasiveness of research findings, and therefore, ensure a large-scale adoption of this technology. Accordingly, this paper presents, to the best of the authors' knowledge, the first timely and comprehensive reference for energy-efficiency recommendation systems through (i) surveying existing recommender systems for energy saving in buildings; (ii) discussing their evolution; (iii) providing an original taxonomy of these systems based on specified criteria, including the nature of the recommender engine, its objective, computing platforms, evaluation metrics and incentive measures; and (iv) conducting an in-depth, critical analysis to identify their limitations and unsolved issues. The derived challenges and areas of future implementation could effectively guide the energy research community to improve the energy-efficiency in buildings and reduce the cost of developed recommender systems-based solutions.Comment: 35 pages, 11 figures, 1 tabl

The AI Ethics Principle of Autonomy in Health Recommender Systems

The application of health recommender systems (HRSs) in the mobile-health (m-health) industry, especially for healthy active aging, has grown exponentially over the past decade. However, no research has been conducted on the ethical implications of HRSs and the ethical principles for their design. This paper aims to fill this gap and claims that an ethically informed re-definition of the AI ethics principle of autonomy is needed to design HRSs that adequately operationalize (that is, respect and promote) individuals’ autonomy over ageing. To achieve this goal, after having clarified the state-of-the-art on HRSs, I present the reasons underlying the need to focus on autonomy as a prominent ethical issue and principle for the design of HRSs. Then, I pursue an inquiry on autonomy in HRSs and show that HRSs can both promote individuals’ autonomy and undermine it, also leading to phenomena of passive ageing. In particular, I claim that this is also due to the concept of autonomy underlying the debate on HRSs-based m-health, which is sometimes misleading, as it mainly coincides with informational self-determination. Using ethical reasoning, I shed light on a more complex account of autonomy and I redefine the AI ethics principle of autonomy accordingly. I show that autonomy and informational self-determination do not overlap. I also show that autonomy encompasses also a socio-relational dimension and that it requires both authenticity conditions and social recognition conditions. Finally, I analyze the implications of my ethical redefinition of autonomy for the design of autonomy-enabling HRSs for healthy active ageing

Development and Pilot of a Patient Reported Outcome Measure for Proximal Thoracic Aortic Aneurysms

Background: Disease specific questionnaires are increasingly being used to evaluate treatment outcomes from the perspective of patients. There are currently no validated questionnaires that measure patient reported outcomes after proximal thoracic aortic aneurysm surgery. Objectives: To develop and pilot a newly formulated patient focussed questionnaire that measures the patient’s health status and health related quality of life before and after proximal thoracic aortic aneurysm surgery. Methods: Based on a literature review, a thematic analysis of audio recorded patient interviews and expert clinical testimony, a pool of items was generated to form a new questionnaire instrument. Suitable patients who were scheduled for elective aortic surgery at Liverpool Heart and Chest Hospital were identified and invited to participate in the pilot study. Patients were asked to complete the questionnaire prior to surgery and then at 6 weeks and 3 months after their operation. The newly developed instrument underwent preliminary testing for its appropriateness, acceptability, feasibility, interpretability, precision, reliability and responsiveness. Results: Several items from the CROQ (Coronary Revascularisation Outcomes Questionnaire) formed the basis of the instrument, with the addition of 10 items derived from a newly formulated conceptual model of proximal thoracic aortic disease. The items were arranged into four domains (symptoms, physical, psychosocial and cognitive). Initial testing showed that the newly developed instrument performed to acceptable standards. It showed good internal consistency (Cronbach’s alpha results for all domains >0.85), and test retest reliability (intraclass correlation coefficient for all domains >0.85). In paired sample tests, the values in each domain led to statistically significant differences from baseline at either 6 weeks or 3 months (p<0.05), supporting the construct validity and responsiveness of the instrument. Conclusions: The new instrument demonstrated satisfactory validity as well as good internal reliability and test retest reliability for each item across all four domains. The initial findings suggest that the measure is sensitive and responsive to the effects of surgical treatment for proximal thoracic aortic aneurysms

Development and validation of a diabetes-specific health state classification system and valuation function based on the multi-attribute theory

Preference-Based Measures of Health (PBMH) provide \u27preference\u27 or \u27utility\u27 weights that enable the calculation of quality-adjusted life years for the economic evaluations of interventions. The Diabetes Utility Index (DUI) was developed as a two-page, self-administered diabetes-specific PBMH that can replace expensive time-consuming interviews with patients to estimate their health state utilities. Inputs from theory, an existing diabetes-specific measure of quality of life, and statistical analyses were submitted to a clinical expert panel. After three rounds of pilot surveys (n1=52, n2=65, n3=111) at primary care clinics in Morgantown, WV, five attributes and severity categories for each attribute were finalized on the basis of the results of Rasch Analysis and consultations with the panel. The final attributes were: \u27Physical Ability & Energy\u27, \u27Relationships\u27, \u27Mood & Feelings\u27, \u27Enjoyment of Diet\u27, and \u27Satisfaction with Management of diabetes\u27. The next step involved obtaining preferences for health states based on combinations of DUI attributes and severity levels from 100 individuals with diabetes, recruited from primary care and community settings in and around Morgantown, WV, in hour-long one-on-one interviews. These health states were anchor states, single-attribute level states including corner states, and marker states. The interviews provided data to calculate a Multi-Attribute Utility Function (MAUF) that calculates utilities for any of the 768 health states that can be defined by the DUI, on a scale where 1.00=Perfect Health and 0.00=the all worse \u27Pits\u27 state, from respondents\u27 answers to its five questions. In addition to an overall index score, attribute-level preference scores were also calculable by the function. Finally, a validation survey was conducted in collaboration with the West Virginia University (WVU) Diabetes Institute. For concurrent and construct validation purposes, the DUI was mailed to individuals with diabetes along with generic PBMH like the EuroQol EQ-5D, the SF-6D and other patient-reported outcomes measures like the Diabetes Symptoms Checklist-Revised, the Short Form 12 (SF-12) and the Well-Being Questionnaire (W-BQ12), and their surveys responses (n=396) were merged with a clinical database consisting of ICD-9 diagnosis codes. The DUI utilities were found to be largely free of socio-demographic effects and its scores were well distributed between 0.00 and 1.00. The DUI moderately correlated with generic PBMH and distinguished between severity groups based on diabetes symptoms and complications. The scoring function of the DUI calculated utilities favorably compared against cardinal Standard Gamble utilities obtained directly from patients for three DUI health states. These results show evidence of the feasibility and validity of the DUI. Further research is suggested to demonstrate the generalizability of these findings, to study the responsiveness of the DUI, and to examine the clinical meaningfulness of the DUI change scores

Family’s health: Opportunities for non-collocated intergenerational families collaboration on healthy living

When a family is engaged in healthy living practices together, it enhances the quality of life for all individuals. However, when members in families are separated over distance, the everyday encouragement and support may shift and obstacles arise within the family. In this study, we investigate non-collocated family members’ practices of healthy living, their perspectives on their family’s healthy living activities, and what obstacles exist regarding collaboration on their family health. We conducted an interview study with 26 independently living participants representing “elderly parents” and “adult children” in a family dynamic. We present members’ practices and strategies for sustainable healthy living activities. We also explore members’ creative use of technology for health promotion and describe existing obstacles that prevent families to effectively collaborate in healthy living. Based on our findings, we suggest design implications to support family members living apart on their efforts to cultivate health within their families