Behavioral Modeling in Weight Loss Interventions

Designing systems with human agents is difficult because it often requires models that characterize agents' responses to changes in the system's states and inputs. An example of this scenario occurs when designing treatments for obesity. While weight loss interventions through increasing physical activity and modifying diet have found success in reducing individuals' weight, such programs are difficult to maintain over long periods of time due to lack of patient adherence. A promising approach to increase adherence is through the personalization of treatments to each patient. In this paper, we make a contribution towards treatment personalization by developing a framework for predictive modeling using utility functions that depend upon both time-varying system states and motivational states evolving according to some modeled process corresponding to qualitative social science models of behavior change. Computing the predictive model requires solving a bilevel program, which we reformulate as a mixed-integer linear program (MILP). This reformulation provides the first (to our knowledge) formulation for Bayesian inference that uses empirical histograms as prior distributions. We study the predictive ability of our framework using a data set from a weight loss intervention, and our predictive model is validated by comparison to standard machine learning approaches. We conclude by describing how our predictive model could be used for optimization, unlike standard machine learning approaches which cannot.

[1]  日本自動制御協会,et al.  システムと制御 = Systems and control , 1971 .

[2]  F. Glover IMPROVED LINEAR INTEGER PROGRAMMING FORMULATIONS OF NONLINEAR INTEGER PROBLEMS , 1975 .

[3]  I. Ajzen,et al.  Understanding Attitudes and Predicting Social Behavior , 1980 .

[4]  M. Becker,et al.  The Health Belief Model: A Decade Later , 1984, Health education quarterly.

[5]  M. Mifflin,et al.  A new predictive equation for resting energy expenditure in healthy individuals. , 1990, The American journal of clinical nutrition.

[6]  S. Wartman,et al.  When competent patients make irrational choices. , 1990, The New England journal of medicine.

[7]  K. Lorig,et al.  Four psychosocial theories and their application to patient education and clinical practice. , 1990, Arthritis care and research : the official journal of the Arthritis Health Professions Association.

[8]  D. Schoeller,et al.  Inaccuracies in self-reported intake identified by comparison with the doubly labelled water method. , 1990, Canadian journal of physiology and pharmacology.

[9]  F. H. Kanfer,et al.  Self-management methods. , 1991 .

[10]  Francisco E. Torres Linearization of mixed-integer products , 1991, Math. Program..

[11]  W. Wong,et al.  Profile Likelihood and Conditionally Parametric Models , 1992 .

[12]  .. W. V. Der,et al.  On Profile Likelihood , 2000 .

[13]  C. Metz,et al.  Maximum likelihood estimation of receiver operating characteristic (ROC) curves from continuously-distributed data. , 1998, Statistics in medicine.

[14]  Thomas A. Severini,et al.  On the relationship between Bayesian and non-Bayesian elimination of nuisance parameters , 1999 .

[15]  A. Bandura Social cognitive theory: an agentic perspective. , 1999, Annual review of psychology.

[16]  Leo Breiman,et al.  Statistical Modeling: The Two Cultures (with comments and a rejoinder by the author) , 2001 .

[17]  Ravindra K. Ahuja,et al.  Inverse Optimization , 2001, Oper. Res..

[18]  Stephan Dempe,et al.  Foundations of Bilevel Programming , 2002 .

[19]  S. Fowler,et al.  Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. , 2002 .

[20]  H. Mcdonald,et al.  Interventions to enhance patient adherence to medication prescriptions: scientific review. , 2002, JAMA.

[21]  James O. Hill,et al.  Obesity and the Environment: Where Do We Go from Here? , 2003, Science.

[22]  Ping Zhang,et al.  Costs associated with the primary prevention of type 2 diabetes mellitus in the diabetes prevention program. , 2003, Diabetes care.

[23]  Eric R. Ziegel,et al.  The Elements of Statistical Learning , 2003, Technometrics.

[24]  Clemens Heuberger,et al.  Inverse Combinatorial Optimization: A Survey on Problems, Methods, and Results , 2004, J. Comb. Optim..

[25]  J. Cawley An economic framework for understanding physical activity and eating behaviors. , 2004, American journal of preventive medicine.

[26]  Stephen E. Fienberg,et al.  Testing Statistical Hypotheses , 2005 .

[27]  Stephen P. Boyd,et al.  Convex Optimization , 2004, Algorithms and Theory of Computation Handbook.

[28]  Lora E Burke,et al.  Adherence to a behavioral weight loss treatment program enhances weight loss and improvements in biomarkers , 2009, Patient preference and adherence.

[29]  David M Nathan,et al.  10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study. , 2009, Lancet.

[30]  Pinar Keskinocak,et al.  OR Practice - Catch-Up Scheduling for Childhood Vaccination , 2009, Oper. Res..

[31]  F. Ovalle 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study , 2010 .

[32]  Stephen P. Boyd,et al.  Imputing a convex objective function , 2011, 2011 IEEE International Symposium on Intelligent Control.

[33]  Yoshimi Fukuoka,et al.  The mPED randomized controlled clinical trial: applying mobile persuasive technologies to increase physical activity in sedentary women protocol , 2011, BMC public health.

[34]  Ida Sim,et al.  Making Sense of Mobile Health Data: An Open Architecture to Improve Individual- and Population-Level Health , 2012, Journal of medical Internet research.

[35]  Turgay Ayer,et al.  OR Forum - A POMDP Approach to Personalize Mammography Screening Decisions , 2012, Oper. Res..

[36]  Huan Liu,et al.  Steptacular: An incentive mechanism for promoting wellness , 2012, 2012 Fourth International Conference on Communication Systems and Networks (COMSNETS 2012).

[37]  Katherine M Flegal,et al.  Prevalence of obesity and trends in the distribution of body mass index among US adults, 1999-2010. , 2012, JAMA.

[38]  Donna Spruijt-Metz,et al.  Current mHealth technologies for physical activity assessment and promotion. , 2013, American journal of preventive medicine.

[39]  David B. Dunson,et al.  Bayesian data analysis, third edition , 2013 .

[40]  Brian T. Denton,et al.  Using Electronic Health Records to Monitor and Improve Adherence to Medication , 2013 .

[41]  Lora E Burke,et al.  Mobile applications for weight management: theory-based content analysis. , 2013, American journal of preventive medicine.

[42]  Sarang Deo,et al.  Improving Health Outcomes Through Better Capacity Allocation in a Community-Based Chronic Care Model , 2013, Oper. Res..

[43]  Devin Mann,et al.  Evidence-based strategies in weight-loss mobile apps. , 2013, American journal of preventive medicine.

[44]  Yoshimi Fukuoka,et al.  Digital Technology Ownership, Usage, and Factors Predicting Downloading Health Apps Among Caucasian, Filipino, Korean, and Latino Americans: The Digital Link to Health Survey , 2014, JMIR mHealth and uHealth.

[45]  Chih-Ping Chou,et al.  Technology-facilitated depression care management among predominantly Latino diabetes patients within a public safety net care system: comparative effectiveness trial design. , 2014, Contemporary clinical trials.

[46]  Juan Pablo Vielma,et al.  Mixed Integer Linear Programming Formulation Techniques , 2015, SIAM Rev..

[47]  G. Flores Mateo,et al.  Mobile Phone Apps to Promote Weight Loss and Increase Physical Activity: A Systematic Review and Meta-Analysis , 2015, Journal of medical Internet research.

[48]  Mariel S. Lavieri,et al.  Dynamic Forecasting and Control Algorithms of Glaucoma Progression for Clinician Decision Support , 2015, Oper. Res..

[49]  Kevin L. Joiner,et al.  A Novel Diabetes Prevention Intervention Using a Mobile App: A Randomized Controlled Trial With Overweight Adults at Risk. , 2015, American journal of preventive medicine.

[50]  Vishal Gupta,et al.  Data-driven estimation in equilibrium using inverse optimization , 2013, Mathematical Programming.

[51]  R. Blankstein,et al.  Abstract 146: Drivers of Healthcare Costs Among Adults With Obesity in United States: 2012 Medical Expenditure Panel Survey , 2016, Circulation: Cardiovascular Quality and Outcomes.

[52]  Anil Aswani,et al.  Behavioral analytics for myopic agents , 2017, Eur. J. Oper. Res..

[53]  Margaret L. Brandeau,et al.  Dynamic Learning of Patient Response Types: An Application to Treating Chronic Diseases , 2017, Manag. Sci..

[54]  Zuo-Jun Max Shen,et al.  Inverse Optimization with Noisy Data , 2015, Oper. Res..