Abstract
Lack of physical activity (PA) is one major contributor to the high prevalence of modern-day chronic diseases. In this study, we design and implement an interactive PA motivation program for older adults (65+) and people with chronic conditions by adapting a commercially available artificial intelligence voice-assisted (AIVA) application and activity tracker (Alexa/Echo Show/Fitbit). Customized features are founded on persuasive technology theory and techniques- and evidence-based PA programs. A pilot study with four older adults for 5 days demonstrated moderate to good usability, learnability, satisfaction, and performance and key-persuasive techniques that enhance user experience and goal achievement. The study provides a tested model for PA behavior change using AIVA for feedback, education, and motivational guidance.
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References
World Health Organization, Global action plan for the prevention and control of noncommunicable diseases 2013–2020 (2013). Available at https://apps.who.int/iris/bitstream/handle/10665/94384/9789241506236_eng.pdf. Accessed on 26 Mar 2020
The Centers for Disease Control and Prevention, About chronic diseases (October 23, 2019). Available at https://www.cdc.gov/chronicdisease/about/index.htm. Accessed on 26 Mar 2020
World Health Organization. Chronic diseases and health promotion. Available at https://www.who.int/chp/about/integrated_cd/en/. Accessed on 26 Mar 2020
The Centers for Disease Control and Prevention’s National Center for Chronic Disease Prevention and Health Promotion, Chronic diseases in America (October 23, 2019). Available at https://www.cdc.gov/chronicdisease/resources/infographic/chronic-diseases.htm. Accessed on 26 Mar 2020
The Centers for Disease Control and Prevention, Lack of physical activity (September 25, 2019). Available at https://www.cdc.gov/chronicdisease/resources/publications/factsheets/physical-activity.htm. Accessed on 26 Mar 2020
P. Tuso, Strategies to increase physical activity. Perm. J. 19(4), 84–88 (2015). https://doi.org/10.7812/TPP/14-24
H.W. Simons, J. Morreale, B. Gronbeck, Persuasion in Society (Sage Publications, Thousand Oaks, 2001)
W.D. Crano, R. Prislin, Attitudes and persuasion. Annu. Rev. Pschol. 57, 13.1–13.30 (2005)
H. Oinas-Kukkonen, Discipline of information systems: A natural strategic alliance for web science, in Proceedings of the Second International on Web Science Conference (WebSci 10), Raleigh, NC, USA, 26–27 Apr 2010
S. Chatterjee, A. Price, Healthy living with persuasive technologies: Framework, issues, and challenges. J. Am. Med. Inform. Assoc. 16(2), 171–178 (2009). https://doi.org/10.1197/jamia.M2859
M. Cabrita, H. Op den Akker, M. Tabak, H.J. Hermens, M.M.R. Vollenbroek-Hutten, Persuasive technology to support active and healthy ageing: An exploration of past, present, and future. J. Biomed. Inform. 84, 17–30 (2018). https://doi.org/10.1016/j.jbi.2018.06.010
The Centers for Disease Control and Prevention, Why should people be active? (April 10, 2020). Available at https://www.cdc.gov/physicalactivity/activepeoplehealthynation/why-should-people-be-active.html. Accessed on 13 Apr 2020
J.E. Fulton, D.M. Buchner, S.A. Carlson, D. Borbely, K.M. Rose, A.E. O’Connor, J.P. Gunn, R. Petersen, CDC’s active people, healthy NationSM: Creating an active America, together. J. Phys. Act. Health 15(7), 469–473 (2018). https://doi.org/10.1123/jpah.2018-0249
The U.S. Department of Health & Human Services (HHS), Importance of physical activity (January 26, 2017). Available at https://www.hhs.gov/fitness/be-active/importance-of-physical-activity/index.html. Accessed on 26 Mar 2020
The Centers for Disease Control and Prevention, Adult physical inactivity prevalence maps by race/ethnicity (January 2020). Available at https://www.cdc.gov/physicalactivity/data/inactivity-prevalence-maps/index.html. Accessed on 2 Apr 2020
The Centers for Disease Control and Prevention, Active people, healthy NationSM (April 10, 2020). Available at https://www.cdc.gov/physicalactivity/activepeoplehealthynation/index.html. Accessed on 26 Mar 2020
W.L. Haskell, S.N. Blair, J.O. Hill, Physical activity: Health outcomes and importance for public health policy. Prev. Med. 49(4), 280–282 (2009)
M. Reiner, C. Niermann, D. Jekauc, A. Woll, R. Dishman, R. Washburn, et al., Long-term health benefits of physical activity – a systematic review of longitudinal studies. BMC Public Health 13(1), 813 (2013). https://doi.org/10.1186/1471-2458-13-813
P. Kokkinos, Physical activity, health benefits, and mortality risk. ISRN Cardiol 2012, 718789 (2012)
The Centers for Disease Control and Prevention, Overcoming barriers to physical activity (April 10, 2020). Available at https://www.cdc.gov/physicalactivity/basics/adding-pa/barriers.html. Accessed on 12 Apr 2020
P. Lally, B. Gardner, Promoting habit formation. Health Psychol. Rev. 7, S137–S158 (2013). https://doi.org/10.1080/17437199.2011.603640
M.S. Hagger, Habit and physical activity: Theoretical advances, practical implications, and agenda for future research, in Psychology of Sport & Exercise (2018). https://doi.org/10.1016/j.psychsport.2018.12.007
N. Kaushal, R. Rhodes, J. Spence, J. Meldrum, Increasing physical activity through principles of habit formation in new gym members: A randomized controlled trial. Ann. Behav. Med. 51, 578–586 (2017). https://doi.org/10.1007/s12160-017-9881-5
R. Orji, K. Moffatt, Persuasive technology for health and wellness: State-of-the-art and emerging trends. Health Informatics J. 1, 7–9 (2016). https://doi.org/10.1177/1460458216650979
H. Oinas-Kukkonen, M. Harjumaa, Persuasive systems design: Key issues, process model, and system features. Commun. Assoc. Inf. Syst. 24, 485–500 (2009)
E. Anderson, J.L. Durstine, Physical activity, exercise, and chronic diseases: A brief review. Sports Med. Health Sci. 1, 3–10 (2019)
D. Nunan, K.R. Mahtani, N. Roberts, C. Heneghan, Physical activity for the prevention and treatment of major chronic disease: An overview of systematic reviews. Syst. Rev. 2, 1–6 (2013)
J.L. Durstine, B. Gordon, Z. Wang, X. Luo, Chronic disease and the link to physical activity. J. Sport Health Sci. 2, 3–11 (2013)
Global action plan on physical activity 2018–2030: More active people for a healthier world. Geneva: World Health Organization; 2018. Licence: CC BY-NC-SA 3.0 IGO
Mayo Clinic, Exercise and chronic disease: Get the facts (2018). Available at https://www.mayoclinic.org/healthy-lifestyle/fitness/in-depth/exercise-and-chronic-disease/art-20046049. Accessed on 26 Mar 2020
D.E. Warburton, C.W. Nicol, S.S. Bredin, Health benefits of physical activity: The evidence. CMAJ 174(6), 801–809 (2006). https://doi.org/10.1503/cmaj.051351
F.W. Booth, C.K. Roberts, M.J. Laye, Lack of exercise is a major cause of chronic diseases. Compr. Physiol. 2(2), 1143–1211 (2012). https://doi.org/10.1002/cphy.c110025
K. González, J. Fuentes, J.L. Márquez, Physical inactivity, sedentary behavior and chronic diseases. Korean J. Fam. Med. 38(3), 111–115 (2017). https://doi.org/10.4082/kjfm.2017.38.3.111
World Health Organization. Physical activity. Available at https://www.who.int/health-topics/physical-activity. Accessed on 26 Mar 2020
J.A. Knight, Physical inactivity: Associated diseases and disorders. Ann. Clin. Lab. Sci. 42, 320–337 (2012)
The U.S. Department of Health and Human Services, The physical activity guidelines for Americans (2018). Available at https://health.gov/sites/default/files/2019-09/Physical_Activity_Guidelines_2nd_edition.pdf. Accessed on 26 Mar 2020
D. Riebe et al. (eds.), ACSM’s Guidelines for Exercise Testing and Prescription, 10th edn. (Wolters Kluwer Health Lippincott Williams & Wilkins, Philadelphia, 2018)
B.K. Pedersen, B. Saltin, Exercise as medicine - Evidence for prescribing exercise as therapy in 26 different chronic diseases. Scand. J. Med. Sci. Sports 25 Suppl 3, 1–72 (2015). https://doi.org/10.1111/sms.12581
W. Ijsselsteijn, Y. De Kort, C. Midden, B. Eggen, E. van den Hoven, Persuasive technology for human well-being: Setting the scene (2006), pp. 1–5. https://doi.org/10.1007/11755494_1
D.E. Conroy, C.H. Yang, J.P. Maher, Behavior change techniques in top-ranked mobile apps for physical activity. Am. J. Prev. Med. 46, 649–652 (2014). https://doi.org/10.1016/j.amepre.2014.01.010
K. Mercer, M. Li, L. Giangregorio, C. Burns, K. Grindrod, Behavior change techniques present in wearable activity trackers: A critical analysis. JMIR Mhealth Uhealth 4(2), e40 (2016)
A. Direito, L.P. Dale, E. Shields, R. Dobson, R. Whittaker, R. Maddison, Do physical activity and dietary smartphone applications incorporate evidence-based behaviour change techniques? BMC Public Health 14, 646 (2014). https://doi.org/10.1186/1471-2458-14-646
B.J. Fogg, Fogg behavior model (2009). Available at https://behaviordesign.stanford.edu/fogg-behavior-model. Accessed on 2 Apr 2020
B.J. Fogg, A behavior model for persuasive design, in Persuasive '09. 2009 Presented at: 4th International Conference on Persuasive Technology (April 26–29 2009), Claremont, CA, USA
B.J. Fogg, Persuasive Technology: Using Computers to Change What We Think and Do (Morgan Kauffman Publishing, Amsterdam/Boston, 2003)
H. Oinas-Kukkonen, M. Harjumaa, Towards deeper understanding of persuasion in software and information systems, in Proceedings of the First International Conference on Advances in Human-Computer Interaction (ACHI 2008) (2008). electronic publication. ISBN 978-0-7695-3086-4, pp. 200–205
K. Bosworth, D.H. Gustafson, R.P. Hawkins, B. Chewning, P.M. Day, BARNY: A computer based health information system for adolescents. J. Early Adolesc. 1(3), 315–321 (1981)
H. Oinas-Kukkonen, A foundation for the study of behavior change support systems. Pers. Ubiquit. Comput. 17, 1223–1235 (2013). https://doi.org/10.1007/s00779-012-0591-5
H. Oinas-Kukkonen, Behavior change support systems: A research model and agenda, in Proceedings of the Persuasive Technology Conference (2010), pp. 4–14
W.C. King, M.M. Dent, E.W. Miles, The persuasive effect of graphics in computer-mediated communication. Comput. Hum. Behav. 7(4), 269–279 (1991)
H.C. Kelman, Compliance, identification, and internalization: Three processes of attitude change. J. Confl. Resolut. 2(1), 51–60 (1958). https://doi.org/10.1177/002200275800200106
A. Bandura, Self-Efficacy: The Exercise of Self-Control (W.H. Freeman, New York, 1997)
A. Bandura, Social Foundations of Thought and Action: A Social Cognitive Theory. Prentice Hall Series in Social Learning Theory (Prentice Hall, Englewood Cliffs, 1986), p. 617
A. Bandura, Health promotion from the perspective of social cognitive theory. Psychol. Health 13(4), 623–649 (1998). https://doi.org/10.1080/08870449808407422
S. Michie, S. Ashford, F.F. Sniehotta, S.U. Dombrowski, A. Bishop, D.P. French, A refined taxonomy of behaviour change techniques to help people change their physical activity and healthy eating behaviours: The CALO-RE taxonomy. Psychol. Health 26(11), 1479–1498 (2011)
M.S. Hagger, D.A. Keatley, D.K.-C. Chan, CALO-RE taxonomy of behavior change techniques, in Encyclopedia of Sport and Exercise Psychology, ed. by R. C. Eklund, G. T. Tenenbaum, (SAGE, Thousand Oaks, 2014), pp. 100–105
A.N. Sullivan, M.E. Lachman, Behavior change with fitness technology in sedentary adults: A review of the evidence for increasing physical activity. Front. Public Health 4, 289 (2016)
C.J. Greaves, K.E. Sheppard, C. Abraham, et al., Systematic review of reviews of intervention components associated with increased effectiveness in dietary and physical activity interventions. BMC Public Health 11, 119 (2011). https://doi.org/10.1186/1471-2458-11-119
S. Consolvo, P. Klasnja, D. McDonald, J. Landay, Goal-setting considerations for persuasive technologies that encourage physical activity, in Proceedings of the 4th International Conference on Persuasive Technology (Persuasive ’09) (2009). Association for Computing Machinery, New York, NY, USA, Article 8, 1–8. https://doi.org/10.1145/1541948.1541960
L. Lewis, A. Rowlands, P. Gardiner, M. Standage, C. English, T. Olds, Small steps: Preliminary effectiveness and feasibility of an incremental goal-setting intervention to reduce sitting time in older adults. Maturitas 85, 64–70 (2016). https://doi.org/10.1016/j.maturitas.2015.12.014
H. op den Akker, V.M. Jones, H.J. Hermens, Tailoring real-time physical activity coaching systems: A literature survey and model user model. User-adapt. Interact. 24(5), 351–392 (2014) https://doi.org/10.1007/s11257-014-9146-y
J. Fanning, S.P. Mullen, E. Mcauley, Increasing physical activity with mobile devices: A meta-analysis. J. Med. Internet Res. 14(6), e161 (2012). https://doi.org/10.2196/jmir.2171
W.N. Wan Ahmad, N. Mohamad Ali, A study on persuasive technologies: The relationship between user emotions, trust and persuasion. Int. J. Interactive Multimed. Artif. Intell. 5(1), 57–61 (2018). https://doi.org/10.9781/ijimai.2018.02.010
W.N. Wan Ahmad, N. Mohamad Ali, Engendering trust through emotion in designing persuasive application, in Advances in Visual Informatics, ed. by H. B. Zaman, P. Robinson, P. Olivier, T. K. Shih, S. Velastin, vol. 8237, (Springer International Publishing. Lecture Notes in Computer Sciences, Cham, 2013), pp. 707–717
S. Berkovsky, J. Freyne, H. Oinas-Kukkonen, Influencing individually: Fusing personalization and persuasion. ACM Trans. Interact. Intell. Syst. 2(2), 9 (2012)
D.H. MacKenzie, Effects of various physical activities on the physical fitness of university men. Res. Q. Am. Phys. Educ. Assoc. 6, 125–143 (1935)
Z. Ruttkay, J. Zwiers, H. van Welbergen, D. Reidsma, Towards a reactive virtual trainer, in Intelligent Virtual Agents. IVA 2006. Lecture Notes in Computer Science, ed. by J. Gratch, M. Young, R. Aylett, D. Ballin, P. Olivier, vol. 4133, (Springer, Berlin, Heidelberg, 2006)
H.B. Jimison, Patient specific interfaces to health and decision-making information, in Health Promotion and Interactive Technology: Theoretical Applications and Future Directions, ed. by R. L. Street, W. R. Gold, T. Manning, (Lawrence Erlbaum, New Jersey, 1997)
R.P. Hawkins, M. Kreuter, K. Resnicow, M. Fishbein, A. Dijkstra, Understanding tailoring in communicating about health. Health Educ. Res. 23(3), 454–466 (2008). https://doi.org/10.1093/her/cyn004
M.W. Kreuter, V.J. Strecher, Do tailored behavior change messages enhance the effectiveness of health risk appraisal? Results from a randomized trial. Health Educ. Res. 11(1), 97–105 (1996). https://doi.org/10.1093/her/11.1.97
K. Peffers, T. Tuunanen, M.A. Rothenberger, S. Chatterjee, A design science research methodology for information systems research. J. Manag. Inf. Syst. 24(3), 45–77 (2008)
A. Albergoni, F.J. Hettinga, A. La Torre, M. Bonato, F. Sartor, The role of technology in adherence to physical activity programs in patients with chronic diseases experiencing fatigue: A systematic review. Sports Med Open. 5(1), 41 (2019). https://doi.org/10.1186/s40798-019-0214-z
M. Friedrich, G. Gittler, Y. Halberstadt, T. Cermak, I. Heiller, Combined exercise and motivation program: Effect on the compliance and level of disability of patients with chronic low back pain: A randomized controlled trial. Arch. Phys. Med. Rehabil. 79(5), 475–487 (1998)
A. Linden, S.W. Butterworth, J.O. Prochaska, Motivational interviewing-based health coaching as a chronic care intervention. J. Eval. Clin. Pract. 16(1), 166–174 (2010). https://doi.org/10.1111/j.1365-2753.2009.01300.x
C. Tudor-Locke, C.L. Craig, Y. Aoyagi, R.C. Bell, K.A. Croteau, I. De Bourdeaudhuij, B. Ewald, A.W. Gardner, Y. Hatano, L.D. Lutes, S.M. Matsudo, How many steps/day are enough? For older adults and special populations. Int. J. Behav. Nutr. Phys. Act. 8, 80 (2011). https://doi.org/10.1186/1479-5868-8-80
F. Davis, Perceived usefulness, perceived ease of use, and user acceptance of information technology. MIS Q. 13(3), 319–340 (1989). https://doi.org/10.2307/249008
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Schooley, B., Akgun, D., Duhoon, P., Hikmet, N. (2021). Persuasive AI Voice-Assisted Technologies to Motivate and Encourage Physical Activity. In: Arabnia, H.R., Deligiannidis, L., Shouno, H., Tinetti, F.G., Tran, QN. (eds) Advances in Computer Vision and Computational Biology. Transactions on Computational Science and Computational Intelligence. Springer, Cham. https://doi.org/10.1007/978-3-030-71051-4_29
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