Targeting the automatic: Nonconscious behaviour change using technology

Digital interventions have great potential to support people to change their behaviour. However, most interventions focus on strategies that target limited conscious resources, reducing their potential impact. We outline how these may fail in the longer-term due to issues with theory, users and technology. We propose an alternative: the direct targeting of nonconscious processes to achieve behaviour change. We synthesise Dual Process Theory, modern habit theory and Goal Setting Theory, which together model how users form and break nonconscious behaviours, into an explanatory framework to explore nonconscious behaviour change interventions. We explore the theoretical and practical implications of this approach, and apply it to a series of empirical studies. The studies explore nonconscious-targeting interventions across a continuum of conscious attention required at the point of behavioural action, from high (just-in-time reminders within Implementation Intentions) to medium (training paradigms within cognitive bias modification) to low (subliminal priming). The findings show that these single-nonconscious-target interventions have mixed results in in-the-wild and semi-controlled conditions. We conclude by outlining how interventions might strategically deploy multiple interventions that target the nonconscious at differing levels of conscious attention, and by identifying promising avenues of future research

Interaction Issues in Computer Aided Semantic\ud Annotation of Multimedia

The CASAM project aims to provide a tool for more efficient and effective annotation of multimedia documents through collaboration between a user and a system performing an automated analysis of the media content. A critical part of the project is to develop a user interface which best supports both the user and the system through optimal human-computer interaction. In this paper we discuss the work undertaken, the proposed user interface and underlying interaction issues which drove its development

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Will the sedentary smartphone owner please stand up?: Breaking bad health habits using technology

There is mounting evidence that sedentary lifestyles can seriously impact on health, contributing to obesity, cardiovascular problems and early mortality. At the same time, the increasing ownership of smartphones equipped with sensors that can accurately detect sedentary patterns presents an opportunity for pervasive technological interventions that target sedentary behaviour. Several approaches have been developed within the Human-Computer Interaction (HCI) field of persuasive technology. However, such approaches tend to overlook existing research from psychology that demonstrates that strongly habitual behaviour is relatively impervious to interventions that simply provide information and feedback. This poster explores the application of habit formation and dual process theories to the practical development of effective pervasive persuasive sedentary behaviour change interventions. It explores theoretical underpinnings of why people develop sedentary habits, how technology could help to break these habits and form healthier ones, the expected difficulties that need to be overcome, and the proposed methodological approaches to evaluating such interventions