An Individualized, Data-Driven Digital Approach for Precision Behavior Change

Chronic disease now affects approximately half of the US population, causes 7 in 10 deaths, and accounts for roughly 80% of US health care expenditure. Because the root causes of chronic diseases are largely behavioral, effective therapies require frequent, individualized interventions that extend beyond the hospital and clinic to reach patients in their day-to-day lives. However, a mismatch currently exists between what the health care system is equipped to provide and the interventions necessary to effectively address the chronic disease burden. To remedy this health crisis, we present an individualized, data-driven digital approach for chronic disease management and prevention through precision behavior change. The rapid growth of information, biological, and communication technologies makes this an opportune time to develop digital tools that deliver precision interventions for health behavior change to address the chronic disease crisis. Building on this rapid growth, we propose a framework that includes the precise targeting of risk-producing behaviors using real-time sensing technology, machine learning data analysis to identify the most effective intervention, and delivery of that intervention with health-reinforcing feedback to provide real-time, individualized support to empower sustainable health behavior change.

[1]  A. Dey,et al.  Mobile phone sensors and supervised machine learning to identify alcohol use events in young adults: Implications for just-in-time adaptive interventions. , 2017, Addictive behaviors.

[2]  Suchi Saria,et al.  A Bayesian Nonparametic Approach for Estimating Individualized Treatment-Response Curves , 2016, ArXiv.

[3]  Misha Pavel,et al.  Advancing the Science of mHealth , 2012, Journal of health communication.

[4]  François Laviolette,et al.  Domain-Adversarial Training of Neural Networks , 2015, J. Mach. Learn. Res..

[5]  Interventions for Increasing Physical Activity: From "Ingenious Toys" to mHealth. , 2016, Journal of the American College of Cardiology.

[6]  Stephen D. Anton,et al.  Long-Term Adherence to Health Behavior Change , 2013, American journal of lifestyle medicine.

[7]  Daphne Zohar,et al.  Digital medicine's march on chronic disease , 2016, Nature Biotechnology.

[8]  Ambuj Tewari,et al.  Microrandomized trials: An experimental design for developing just-in-time adaptive interventions. , 2015, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[9]  John C. Earls,et al.  A wellness study of 108 individuals using personal, dense, dynamic data clouds , 2017, Nature Biotechnology.

[10]  Eric J Topol,et al.  Individualized Medicine from Prewomb to Tomb , 2014, Cell.

[11]  S. Murphy,et al.  Assessing Time-Varying Causal Effect Moderation in Mobile Health , 2016, Journal of the American Statistical Association.

[12]  Eric J. Topol,et al.  The emerging field of mobile health , 2015, Science Translational Medicine.

[13]  Tanzeem Choudhury,et al.  Automated Personalized Feedback for Physical Activity and Dietary Behavior Change With Mobile Phones: A Randomized Controlled Trial on Adults , 2015, JMIR mHealth and uHealth.

[14]  S. Steinhubl,et al.  High-Definition Medicine , 2017, Cell.

[15]  Daniel E. Rivera,et al.  Agile science: creating useful products for behavior change in the real world , 2016, Translational behavioral medicine.

[16]  Inbal Nahum-Shani,et al.  Randomised trials for the Fitbit generation , 2015, Significance.

[17]  Eric J Topol,et al.  Can mobile health technologies transform health care? , 2013, JAMA.

[18]  Suchi Saria,et al.  Integrative Analysis using Coupled Latent Variable Models for Individualizing Prognoses , 2016, J. Mach. Learn. Res..

[19]  Wendy Nilsen,et al.  Dynamic Models of Behavior for Just-in-Time Adaptive Interventions , 2014, IEEE Pervasive Computing.

[20]  Nicholas J Schork,et al.  Clickotine, A Personalized Smartphone App for Smoking Cessation: Initial Evaluation , 2017, JMIR mHealth and uHealth.

[21]  Ambuj Tewari,et al.  Micro-randomized trials & mHealth , 2015, 1504.00238.

[22]  L. Hood,et al.  P4 medicine: how systems medicine will transform the healthcare sector and society. , 2013, Personalized medicine.

[23]  Ambuj Tewari,et al.  Microrandomized trials: An experimental design for developing just-in-time adaptive interventions. , 2015, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[24]  Euan A Ashley,et al.  The precision medicine initiative: a new national effort. , 2015, JAMA.

[25]  Suchi Saria,et al.  Using Smartphones and Machine Learning to Quantify Parkinson Disease Severity: The Mobile Parkinson Disease Score , 2018, JAMA neurology.

[26]  Suchi Saria,et al.  Learning Treatment-Response Models from Multivariate Longitudinal Data , 2017, UAI.

[27]  Aaron J Fisher,et al.  A Bayesian hierarchical model for prediction of latent health states from multiple data sources with application to active surveillance of prostate cancer , 2015, Biometrics.