Abstract

Poor diet and physical inactivity are two of the biggest healthcare challenges we are facing, and are related to individuals lifestyle. In fact, a poor lifestyle is strongly correlated to chronic diseases, the leading causes for morbidity and mortality. Adhering to a healthy diet and following an active lifestyle are thus necessary to promote the overall health. However, maintaining a healthy diet and physically active lifestyle is hard. This is due to poor health literacy, lack of awareness, motivation and effective intervention support. Recent years have seen a blast of mHealth apps for health promotion, targeting in particular dietary behavior change. However, reviews showed difficulties in effective adoption and use of these applications in long-term health promotion. Contemporary approaches have focused on tracking user condition and few have analyzed aspects of user interaction with the system. To promote individuals health, users can benefit from some form of tailored guidance or coaching. That said, to ensure adequate users support, personalized care with a human agent in the loop can enhance the care delivery. Due to the increasing demand for continuous care by users and the shortage of caregiver resources, current health services are inefficient relative to user support and decreasing caregivers workload. Digital health devices can act as a key player in providing interactive health activities (via mobile and telemedicine systems), enhancing self-monitoring (through wearable tracker) and tailored coaching (using either automated or manual coaching systems). However, they’re ineffective in providing continuous health services and creating a balance between users support and caregivers workload. In addition, even with the technology existence, there is low motivation to maintain a healthy diet or exercise routines. Individuals use messaging applications as part of their regular daily routines. We harness the power of messaging chatbot systems to provide behavior change interventions for healthy lifestyle promotion. We particularly introduce the role of chatbot in task automation and adhering users to a health plan. Thus, in this thesis we present the concept of "Conversational User Interface in Health Coaching Interventions" that consists of a just-in-time health services to users and caregivers. We discuss ways to integrate the chatbot to assist caregivers with their tasks and support users with their condition. We get users to cue themselves to action by attaching the chatbot with users’ daily messaging routines. The service will eliminate the technology barrier and impairment for the users i.e., elderly. The chatbot accesses reliable user compliance data, sets adherence reminders by condition, and reports daily individuals adherence. The chatbot alerts the coach through a web application in critical cases. The approach facilitates adherence to health interventions by investigating a human-virtual agent mediated coaching approach on user motivation to adhere to the health promotion plan. The approach was validated with different experimentation phases. Using multiple research methods, this dissertation has made several contributions to the understanding of user motivation and the role of a semi-automated system with a human and virtual agent in tracking individuals with poor lifestyle. We will discuss the main contributions and experimentation results throughout the thesis.