Feasibility and Acceptability of Mobile Phone–Based Auto-Personalized Physical Activity Recommendations for Chronic Pain Self-Management: Pilot Study on Adults

Background: Chronic pain is a globally prevalent condition. It is closely linked with psychological well-being, and it is often concomitant with anxiety, negative affect, and in some cases even depressive disorders. In the case of musculoskeletal chronic pain, frequent physical activity is beneficial. However, reluctance to engage in physical activity is common due to negative psychological associations (eg, fear) between movement and pain. It is known that encouragement, self-efficacy, and positive beliefs are effective to bolster physical activity. However, given that the majority of time is spent away from personnel who can give such encouragement, there is a great need for an automated ubiquitous solution. Objective: MyBehaviorCBP is a mobile phone app that uses machine learning on sensor-based and self-reported physical activity data to find routine behaviors and automatically generate physical activity recommendations that are similar to existing behaviors. Since the recommendations are based on routine behavior, they are likely to be perceived as familiar and therefore likely to be actualized even in the presence of negative beliefs. In this paper, we report the preliminary efficacy of MyBehaviorCBP based on a pilot trial on individuals with chronic back pain. Methods: A 5-week pilot study was conducted on people with chronic back pain (N=10). After a week long baseline period with no recommendations, participants received generic recommendations from an expert for 2 weeks, which served as the control condition. Then, in the next 2 weeks, MyBehaviorCBP recommendations were issued. An exit survey was conducted to compare acceptance toward the different forms of recommendations and map out future improvement opportunities. Results: In all, 90% (9/10) of participants felt positive about trying the MyBehaviorCBP recommendations, and no participant found the recommendations unhelpful. Several significant differences were observed in other outcome measures. Participants found MyBehaviorCBP recommendations easier to adopt compared to the control (βint=0.42, P<.001) on a 5-point Likert scale. The MyBehaviorCBP recommendations were actualized more (βint=0.46, P<.001) with an increase in approximately 5 minutes of further walking per day (βint=4.9 minutes, P=.02) compared to the control. For future improvement opportunities, participants wanted push notifications and adaptation for weather, pain level, or weekend/weekday. Conclusions: In the pilot study, MyBehaviorCBP’s automated approach was found to have positive effects. Specifically, the recommendations were actualized more, and perceived to be easier to follow. To the best of our knowledge, this is the first time an automated approach has achieved preliminary success to promote physical activity in a chronic pain context. Further studies are needed to examine MyBehaviorCBP’s efficacy on a larger cohort and over a longer period of time

Leveraging Multi-Modal Sensing for Mobile Health: A Case Review in Chronic Pain

Active and passive mobile sensing has garnered much attention in recent years. In this paper, we focus on chronic pain measurement and management as a case application to exemplify the state of the art. We present a consolidated discussion on the leveraging of various sensing modalities along with modular server-side and on-device architectures required for this task. Modalities included are: activity monitoring from accelerometry and location sensing, audio analysis of speech, image processing for facial expressions as well as modern methods for effective patient self-reporting. We review examples that deliver actionable information to clinicians and patients while addressing privacy, usability, and computational constraints. We also discuss open challenges in the higher level inferencing of patient state and effective feedback with potential directions to address them. The methods and challenges presented here are also generalizable and relevant to a broad range of other applications in mobile sensing

Personalization Paradox in Behavior Change Apps:Lessons from a Social Comparison-Based Personalized App for Physical Activity

Social comparison-based features are widely used in social computing apps. However, most existing apps are not grounded in social comparison theories and do not consider individual differences in social comparison preferences and reactions. This paper is among the first to automatically personalize social comparison targets. In the context of an m-health app for physical activity, we use artificial intelligence (AI) techniques of multi-armed bandits. Results from our user study (n=53) indicate that there is some evidence that motivation can be increased using the AI-based personalization of social comparison. The detected effects achieved small-to-moderate effect sizes, illustrating the real-world implications of the intervention for enhancing motivation and physical activity. In addition to design implications for social comparison features in social apps, this paper identified the personalization paradox, the conflict between user modeling and adaptation, as a key design challenge of personalized applications for behavior change. Additionally, we propose research directions to mitigate this Personalization Paradox

MyBehavior: automatic personalized health feedback from user behaviors and preferences using smartphones

Mobile sensing systems have made significant advances in tracking human behavior. However, the development of personalized mobile health feedback systems is still in its infancy. This paper introduces MyBehavior, a smartphone application that takes a novel approach to generate deeply personalized health feedback. It combines state-of-the-art behavior tracking with algorithms that are used in recommendation systems. MyBehavior automatically learns a user's physical activity and dietary behavior and strategically suggests changes to those behaviors for a healthier lifestyle. The system uses a sequential decision making algorithm, Multi-armed Bandit, to generate suggestions that maximize calorie loss and are easy for the user to adopt. In addition, the system takes into account user's preferences to encourage adoption using the pareto-frontier algorithm. In a 14-week study, results show statistically significant increases in physical activity and decreases in food calorie when using MyBehavior compared to a control condition

Objective Measurement of Sociability and Activity: Mobile Sensing in the Community

PURPOSE Automated systems able to infer detailed measures of a person’s social interactions and physical activities in their natural environments could lead to better understanding of factors influencing well-being. We assessed the feasibility of a wireless mobile device in measuring sociability and physical activity in older adults, and compared results with those of traditional questionnaires

StressSense: Detecting Stress in Unconstrained Acoustic Environments using Smartphones

Stress can have long term adverse effects on individuals’ physical and mental well-being. Changes in the speech production process is one of many physiological changes that happen during stress. Microphones, embedded in mobile phones and carried ubiquitously by people, provide the opportunity to continuously and non-invasively monitor stress in real-life situations. We propose StressSense for unobtrusively recognizing stress from human voice using smartphones. We investigate methods for adapting a one-size-fitsall stress model to individual speakers and scenarios. We demonstrate that the StressSense classifier can robustly identify stress across multiple individuals in diverse acoustic environments: using model adaptation StressSense achieves 81 % and 76 % accuracy for indoor and outdoor environments, respectively. We show that StressSense can be implemented on commodity Android phones and run in real-time. To the best of our knowledge, StressSense represents the first system to consider voice based stress detection and model adaptation in diverse real-life conversational situations using smartphones