The WOOL Dialogue Platform: Enabling Interdisciplinary User-Friendly Development of Dialogue for Conversational Agents

Health coaching applications can include (embodied) conversational agents as coaches. The development of these agents requires an interdisciplinary cooperation between eHealth application developers, interaction designers and domain experts. Therefore, proper dialogue authoring tools and tools to integrate these dialogues in a conversational agent system are essential in the process of creating successful agent-based applications. However, we found no existing open source, easy-to-use authoring tools that support multidisciplinary agent development. To that end, we developed the WOOL Dialogue Platform. The WOOL Dialogue Platform provides the eHealth and conversational agent communities with an open source platform, consisting of a set of easy to use tools that facilitate virtual agent development. The platform consists of a dialogue definition language, an editor, application development libraries and a web service. To illustrate the platform’s possibilities and use in practice, we describe two use cases from EU Horizon 2020 research projects. The WOOL Dialogue Platform is an ‘easy to use, and powerful if needed’ platform for the development of conversational agent applications that is seeing a slow but steady increase in uptake in the eHealth community. Developed to support dialogue authoring for embodied conversational agents in the health coaching domain, this platform’s strong points are its ease of use and ability to let domain experts and agents technology experts work together by providing all parties with tools that support their work effectively.

Online health promotion program and individualized health coaching for veteran wellbeing

The pandemic has highlighted the need for accessible and effective health promotion as Canadians are isolated from their communities during social distancing measures. A web-based health promotion program in which participants also received individualized email-based health coaching from medical students has been available during the pandemic to empower veterans and their family members to engage in healthy lifestyle change. Health coaches’ email interactions with participants used techniques of motivational interviewing, including an empathetic style, statements of affirmation, and reflections. Open-ended questions were useful in gaining insight into the participant’s current lifestyle, including habits, challenges, and coping strategies. As services have transitioned online and individuals have become more isolated, the connection formed between online health coaches and individuals participating in the health promotion program became crucial in countering the mental and physical health repercussions of the pandemic. In a preliminary analysis, we show that web-based health promotion with health coaching, for Canadian Veterans and their families, leads to significant weight loss, increased activity and improvement in wellbeing metrics such as sleep and stress. The medical students acting as health coaches were able to gain a deeper understanding of the challenges involved in behaviour change, something that is seldom covered in detail in the medical school curricula. Medical students were also able to practice their motivational counseling skills surrounding lifestyle changes. Given the lack of available evidence for web-based health promotion that targets veterans and their families, these preliminary results appear promising, with longer-term follow-up planned for the next two years.

Acceptability and feasibility of an online physical activity program for women over 50: a pilot trial

Regular physical activity benefits health across the lifespan. Women in middle-age often juggle carer and work responsibilities, are often inactive, and may benefit from tailored support to increase physical activity. Establish the acceptability, feasibility, and impact on physical activity of a scalable program for women 50+ years. This pilot trial randomized participants to immediate program access, or to a wait-list control. [Active Women over 50 Online] program included: (1) study-specific website, (2) 8 emails or 24 SMS motivation-based messages, (3) one telephone health-coaching session. Outcomes, at 3 months, were acceptability (recommend study participation, intervention uptake), feasibility (recruitment, reach, completion), intervention impact (physical activity), intervention impressions. At baseline, 62 participants of mean (SD) age 59 (±7) years took 7459 (±2424) steps/day and most (92%) reported ≥2 medical conditions. At 3 months, acceptability and impact data were available for 52 (84%) and 57 (92%) participants, respectively. Study participation was recommended by 83% of participants. Participants mostly agreed to receive health coaching (81%) and messages (87%: email = 56%, SMS = 44%), opened 82% of emails and accessed the website 4.8 times on average. Respondents reported the intervention supported their physical activity. Intervention participants were more likely to increase steps from baseline by 2000+/day (OR: 6.31, 95% CI: 1.22 to 32.70, p = .028) than controls, and trended toward more light-intensity (p = .075) and moderate-vigorous intensity physical activity (p = .11). The [Active Women over 50 Online] program demonstrated acceptability and feasibility among the target population, and effectiveness in some domains in the short term. Results warrant further testing in a full-scale RCT.

Reflections of Health Coaching Narratives

This narrative focuses on a health coach collaborating with a physical therapist and working with the emotional needs of physical therapy patients, but anyone looking to improve health can use the strategies presented. Integrative health coaching incorporates vision and values into a person's goal-setting process. Health coaches provide resources such as journal writing to assist the healing journeys of patients as well as strategies for healthy people who want to make wellness behavior changes.

Sustained positive behaviour change of wounded, injured and sick UK military following an adaptive adventure sports and health coaching recovery course

IntroductionA rising trend has occurred in the physical and mental health challenges faced by recovering UK service personnel. To support these individuals, bespoke inclusive multiactivity and adventurous training courses (MAC) have been developed. This study investigated the MAC’s influence on participants’ ability to sustain day-to-day changes that facilitate positive mental health and psychological need satisfaction.MethodsThe 146 UK service personnel who participated in this study attended a five-day MAC 12 months ago. To investigate how the supportive experience influenced participants’ lives, quantitative and qualitative data were collected via an online survey. Open-ended questioning and abductive analysis were conducted to understand mechanisms, influential aspects of the course and positive behaviour change.ResultsPositive behaviour changes were reported by 74% of the respondents. These changes align with positive psychological well-being (98%). Impactful elements of the course experienced by participants mostly aligned with the three basic psychological needs of autonomy (34%), competence (36%) and relatedness (61%).ConclusionsRecovery support programmes that encompass health coaching adventurous activities, such as the MAC, can initiate long-term positive behaviour change for recovering military personnel. In this specific context, the concurrence of the self-determination theory concepts that underpin the course delivery and participant outcomes is a powerful endorsement of implementation fidelity.

New Insights in Oral Health and Diets

The aim of this Special Issue is to bring the most updated information on the innovative field of oral and general health coaching and nutritional education strategies for better oral and general health [...]

Memory Problems During COVID in Low-Income Older Adults

Prevention, with widespread lifestyle risk reduction at the community-level, is considered an effective method to decrease Alzheimer’s disease (AD). Diverse low-income older adults in Virginia managing either diabetes/cardiovascular symptoms, were offered weekly lifestyle telephone-health coaching for 12-weeks, providing education, motivations, self-efficacy, and referral services for AD lifestyle risk. Participants provided positive anecdotal feedback and the need for continued health coaching during COVID-19. Thirty participants (predominantly African American/Black female) consented for continued health coaching during the pandemic with 47% reporting memory problems. Findings indicated poorer health status associated with reporting memory problems for poor physical health days, poor mental health days, total mental/physical health poor days, sad days, worried days, tired days, feelings of emptiness, feelings of rejection, feelings of failure, little interest/pleasure, and feeling down. This preliminary work creates the impetus for future large-scale AD prevention investigations to improve the lives of AD-risk, low-income, diverse older adults reporting memory problems.

Promoting Self-Care in Caregivers of Older Adults Living With Chronic Illness: The iCare4Me Study

Informal caregivers provide a substantial amount of social support to older adults which can be stressful and lead to poor self-care. When stressed, caregivers of persons living with chronic illness are less vigilant and less motivated to engage in self-care behaviors that are important for maintaining their own physical and emotional health. Support interventions can encourage self-care by helping caregivers to focus on values, solve problems, and transform their goals into action. In this symposium, we will discuss the iCareMe study, a randomized controlled trial (RCT) (NCT03988621) that tests a virtual support intervention which utilizes health coaching to increase self-care behaviors in caregivers of older adults living with chronic illnesses, such as heart failure and dementia. The first session will discuss the translation of self-care theory to the basis for the “Virtual Caregiver Coach for You” (ViCCY) intervention and will provide an overview of the iCare4Me randomized control trial designed for caregivers of persons living with advanced heart failure. The second session will describe the adaptation of the iCare4Me RCT to caregivers of persons living with dementia. The third session will highlight findings from a qualitative descriptive study examining the characteristics of effective health coaching used in these two RCTs. Finally, the last session will share findings from a cross-sectional analysis examining moderators of self-care in heart failure caregivers. Together, these presentations will illustrate the unique and innovative approach that iCare4Me has taken to improve self-care in caregivers of older adults living with chronic illness.