Leveraging Technology to Change Behavior: Measurement is a Necessary but Not Sufficient Condition...
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Leveraging Technology to Change Behavior:
Measurement is a Necessary but Not Sufficient Condition
William Riley, Ph.D.Chief, Science of Research and Technology BranchDivision of Cancer Control and Population Science
National Cancer Institute
"Nearly all the grandest discoveries of science have been but the rewards of accurate measurement." Lord Kelvin, 1872
Previous State of Behavioral Measurement
Technological Advances in Behavioral Measurement
• Item Response Theory (IRT) and Computer Adaptive Testing (CAT)
• Ecological Momentary Assessment (EMA)
• Passive Sensor Technologies
Leverage Better Measurement for Modeling Behavior
Barrientos, Rivera, and Collins (2010). A dynamical model for describing behavioral interventions for weight loss and body composition change. Mathematical and Computer Modeling of Dynamical Systems.
Leveraging Better Measurement for Behavioral Interventions
• Measurement alone does not improve health • Behavior change is the core of nearly every
tech-delivered health intervention• To improve health, we must leverage
technology not only to measure behavior, but to change behavior
Rely on Health Professionals to Close the Loop
Inputs
User Integration & Analytics
Health Professional
Weaknesses of the Health Professional Closing the Loop
Drinking through a firehose• Data = Liability• Set alert
parameters • Optimize
healthcare interface
Univ. of MarylandHuman Computer Interface Lab
Weaknesses of the Health Professional Closing the Loop
• Assumes healthcare professional will intervene appropriately
Cabana, et al. JAMA 1999;282:1458-1465
Prompting
Inputs
User Integration & Analytics
• Provides a cue to action for the desired behavior• Assumes “forgetting” is the cause of inaction• Often fails to pair with or build naturalistic prompts
Feedback to the Patient
Inputs
User Integration & Analytics
• Bolsters self-regulatory processes• Assumes lack of info is the cause of inaction (or over-action)• Must be digestible and actionable to change behavior
Self-Efficacy Behavior
Observational Learning
Mini-goals
O
O
O
Michie et al., 2013. The Behavior Change Technique Taxonomy (v1) of 93 Hierarchically Clustered Techniques: Building an International Consensus for the Reporting of Behavior Change Interventions. Annals Behavioral Medicine,
Reminders of a Few “Laws” of Behavior Change
• Habituation• Respondent (Pavlovian) Conditioning• Operant Conditioning • Observational Learning• Skills Training
Expanding Our Output Modalities
• On demand video trainings• Rich media presentations• Proactive social support• Monetary incentives via mBanking, etc.• Adaptive– To behavioral context– To prior intervention responses
• Theoretically and Empirically Grounded – especially in behavior change
NCI Science of Research and Technology Branch Priorities
• Theory development, testing and application;• Measure development and testing, particularly of
antecedents to, changes in, and consequences of health behavior;
• Technology development and application;• Methodological innovation, particularly in analytic
approaches;• Data harmonization and research synthesis; and• Team science and cross-disciplinary approaches.