Objectives: Emotional eating is recognized as a potential contributor to weight gain. Emotional eaters often hide their problems because of feelings of shame about their behavior, making it challenging to provide them with the necessary support. The introduction of a virtual coach might offer a potential solution in assisting them. To find out whether emotional eaters are receptive to online personalized coaching, we presented emotional eaters with two essential proto-typical problem situations for emotional eaters: “experiencing cravings” and “after giving in to cravings,” and asked them whether they preferred one of the three coaching strategies presented: Validating, Focus-on-Change and Dialectical.Methods: An experimental vignette study (2 × 3 design) was carried out. The vignettes featured two distinct personas, each representing one of the two common problem scenarios experienced by emotional eaters, along with three distinct coaching strategies for each scenario. To identify potential predictors for recognition of problem situations, questionnaires on emotional eating (DEBQ), personality traits (Big-5), well-being (PANAS), and BMI were administrated.Results: A total of 62% of the respondents identified themselves with “after giving in to cravings” and 47% with “experiencing cravings.” BMI, emotional eating and emotional stability appeared to be predictors in recognizing both the problem situations. In “experiencing cravings,” the participating women preferred Dialectical and the Validation coaching strategies. In the “after giving in to cravings” condition, they revealed a preference for the Dialectical and the Focus-on-Change coaching strategies.Conclusion: Using vignettes allowed a less threatening way of bringing up sensitive topics for emotional eaters. The personas representing the problem situations were reasonably well recognized. To further enhance this recognition, it is important for the design and content of the personas to be even more closely related to the typical problem scenarios of emotional eaters, rather than focusing on physical characteristics or social backgrounds. This way, users may be less distracted by these factors. With the knowledge gained about the predictors that may influence recognition of the problem situations, design for coaching can be more customized. The participants represented individuals with high emotional eating levels, enhancing external validity.
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Self-management is widely seen as a viable contribution to sustainable health care as it allows to promote physical and mental well-being. A promising approach to promoting a healthy lifestyle is the deployment of personalized virtual coaches, especially in combination with the latest developments in the fields of Data Science and Artificial Intelligence. This paper presents a framework for a virtual coaching system, as well as a use case in which parts of this framework are applied. The virtual coach in the use case aims to encourage customer contact center employees to protect their mental health. This article outlines one part of the use-case in particular, viz. how to promote employee autonomy and supervisor support by, inter alia, monitoring employees’ levels of emotional exhaustion. Current systems focus on providing users with insight in their health status or behavior, the authors developed the functional architecture for a system that can be implemented for different goals and generates personalized, real-time advice based on the combination of user preferences, motivational success and predicted user behavior.
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Obesity has become a major societal problem worldwide [1][2]. The main reason for severe overweight is excessive intake of energy, in relation to the individual needs of a human body. Obesity is associated with poor eating habits and/or a sedentary lifestyle. A significant part of the obese population (40%) belongs to a vulnerable target group of emotional eaters, who overeat due to negative emotions [3]. There is a need for self-management support and personalized coaching to enhance emotional eaters in recognising and self-regulating their emotions.Over the last years, coaching systems have been developed for behavior change support, healthy lifestyle, and physical activity support [4]-[9]. Existing virtual coach applications lack systematic evaluation of coaching strategies and usually function as (tele-)monitoring systems. They are limited to giving general feedback to the user on achieved goals and/or accomplished (online) assignments.Dialectical Behavior Therapy (DBT) focuses on getting more control over one’s ownemotions by reinforcing skills in mindfulness, emotion regulation, and stress tolerance [10]. Emotion regulation is about recognizing and acknowledging emotions and accepting the fact that they come and go. The behavior change strategies within DBT are based on validation and dialectics [11]. Dialectics changes the users’ attitude and behavior by creating incongruence between an attitude and behavior since stimuli or the given information contradict with each other.The ultimate goal of the virtual coach is to raise awareness of emotional eaters on their own emotions, and to enhance a positive change of attitude towards accepting the negative emotions they experience. This should result in a decrease of overeating and giving in to binges. We believe that the integration of the dialectical behavior change strategies and persuasive features from the Persuasive System Design Model by Kukkonen and Harjumaa [12] will enhance the personalization of the virtual coach for this vulnerable group. We aim at developing a personalized virtual coach ‘Denk je zèlf!’ (Dutch for ‘Develop a wise mind and counsel yourself’) providing support for self-regulation of emotions for young obese emotional eaters. This poster presents an eCoaching model and a research study protocol aiming at the validation of persuasive coaching strategies based on behavior change techniques using dialectical strategies. Based on the context (e.g., location), emotional state of the user, and natural language processing, the virtual coach application enables tailoring of the real-time feedback to the individual user. Virtual coach application communicates with the user over a chat timeline and provides personal feedback.The research protocol decribes the two weeks field study on validating persuasive coaching strategies for emotional eaters. Participants (N=30), recruited via a Dutch franchise organization of dietitian nutritionists, specialized in treating emotional eating behaviors, will voluntarily participate in this research study. Participants will be presented with short dialogues (existing questions and answers) and will be asked to select the preferred coaching strategy (validating or a dialectical), according to their (current) emotions. To trigger a certain emotion (e.g., the affect that fits best with the chosen coaching strategy), a set of pictures will be shown to the user that evoke respectively sadness, anger, fear, and disgust [13].Participants will be asked to fill out the demographics data ((nick) name, age, gender, weight, length, place of residence) and three questionnaires: • Dutch Eating Behavior Questionnaire (DEBQ) [14],• Five Factor Personality Inventory (FFPI) [15], • Quality of Life Index Questionnaire [16].This research study aims at answering the following research questions: “Which coaching strategies do users with a specific type of emotional eating behavior benefit most from while consulting their personalized virtual coach?; “Which coaching strategies are optimal for which emotions?” and “Which coaching approach do users prefer in which context, e.g. time of the day, before/after a craving?”
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There is a growing number of eHealth interventionsaiming at enhancing lifestyle to address obesity. However, theexisting interventions do not take the emotional aspects ofobesity into account. Forty percent of the overweightpopulation is an emotional eater. Emotional eaters gain weightbecause of poor emotion regulation, not just due to bad eatinghabits. We aim at developing a personalized virtual coach‘Denk je zèlf!’ providing support for self-regulation ofemotions for young obese emotional eaters. This paperpresents an eCoaching model and a research study protocolaiming at the validation of persuasive coaching strategies basedon behavior change techniques. Ultimately, we aim atdesigning a personalized eCoaching framework, allowing us tooptimally translate successful behavior change mechanismsand techniques, such as dialectical strategies, into personalizedpersuasive coaching strategies.
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The shift toward prevention and self-management in health hinges upon a massive realization of behavior change, which involves the use of virtual coaches. Increasing availability of data from mobile devices and techniques for real time analysis provide new opportunities for personalizing virtual coaches. We propose an architecture that takes advantage of those developments. We identify the required knowledge and methods to develop a flexible ecosystem for rapid prototyping of personalized virtual coaches.
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Background: Around 13% of the world’s population suffers from obesity. More than 40% of people with obesity display emotional eating behaviour (eating in response to negative emotions or distress). It is an alternate to moreeffective coping strategies for negative emotions. Our study explored the opportunities for helping adults with emotional overeating using a virtual coach, aiming to identify preferences for tailored coaching strategies applicable in a personal virtual coach environment. Three different coaching strategies were tested: a validating, a focus-on-change, and a dialectical one – the latter being a synthesis of the first two strategies. Methods: A qualitative study used vignettes reflecting the two most relevant situations for people with emotional eating: 1. experiencing negative emotions, with ensuing food cravings; and 2. after losing control to emotional eating, with ensuing feelings of low self-esteem. Applied design: 2 situations × 3 coaching strategies. Participants: 71 adult women (Mage 44.4/years, range 19–70, SD = 12.86) with high scores on the DEBQ-emotional eating scale (Memo 3.65, range 1.69–4.92, SD = .69) with mean BMI 30.1 (range 18–46, SD = 6.53). They were recruited via dieticians’ practices, were randomly assigned to the conditions and asked how they would face and react to thepresented coaching strategies. Data were transcribed and a thematic analysis was conducted. Results: Qualitative results showed that participants valued both the validating coaching strategy and the focus-onchange strategy, but indicated that a combination of validation and focus-on-change provides both mental supportand practical advice. Data showed that participants differed in their level of awareness of the role that emotions play in their overeating and the need for emotion-regulation skills. Conclusion: The design of the virtual coach should be based on dialectical coaching strategies as preferred by participants with emotional eating behaviour. It should be tailored to the different stages of awareness of their emotions and individual emotion-regulation skills.
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Human Digital Twins are an emerging type of Digital Twin used in healthcare to provide personalized support. Following this trend, we intend to elevate our virtual fitness coach, a coaching platform using wearable data on physical activity, to the level of a personalized Human Digital Twin. Preliminary investigations revealed a significant difference in performance, as measured by prediction accuracy and F1-score, between the optimal choice of machine learning algorithms for generalized and personalized processing of the available data. Based on these findings, this survey aims to establish the state of the art in the selection and application of machine learning algorithms in Human Digital Twin applications in healthcare. The survey reveals that, unlike general machine learning applications, there is a limited body of literature on optimization and the application of meta-learning in personalized Human Digital Twin solutions. As a conclusion, we provide direction for further research, formulated in the following research question: how can the optimization of human data feature engineering and personalized model selection be achieved in Human Digital Twins and can techniques such as meta-learning be of use in this context?
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One of the main causes of numerous health problemsis a lack of physical activity. To promote a more active lifestyle,the Hanze University started a health promotion program. Participants were motivated to reach their daily goal of physical activityby means of an activity tracker in combination with two-weeklycoaching sessions. Employing the data of the experiment, weinvestigated the manners in which the predictability of physicalactivity of a participant during the day can be improved. Thecollected step count data was used to construct personalisedmachine learning models, by taking into account the differencebetween physical activities during weekdays on the one handand weekends on the other hand. The training of algorithmsper participant in combination with the time-slices weekdays,weekend and the whole week improves the accuracy of theprediction model. The performance of the models improveseven further when the individualised time-sliced models arecombined. More contextual data, like free time and workinghours, might even extend the accuracy. The use of personalisedprediction models, based on machine learning and time slices,could become an addition in preventive personalized eHealthsystems and mobile activity monitoring. For instance, this canconstitute as a viable addition to a virtual coaching system to helpthe participants to reach their daily goal. As the individualisedmodels allow for predictions of the progression of the physicalactivity during the day, they enable the virtual coaching systemto intervene at the appropriate moment in time.
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Seven college lecturers and two senior support staff were interviewed during 2021 about their experiences teaching in hybrid virtual classrooms (HVC). These technology-rich learning environments allow teachers to simultaneously teach students who are in class (on campus) and students who are joining remotely (online). There were two reasons for this choice: first, ongoing experimentation from innovative teaching staff who were already using this format before the COVID-19 pandemic; secondly, as a possible solution to restrictions on classroom size imposed by the pandemic. Challenges lecturers faced include adjusting teaching practice and lesson delivery to serve students in the class and those online equally; engaging and linking the different student groups in structured and natural interactions; overcoming technical challenges regarding audio and visual equipment; suitably configuring teaching spaces and having sufficient pedagogical and technical support to manage this complex process. A set of practical suggestions is provided. Lecturers should make reasoned choices when teaching in this format since it requires continued experimentation and practice to enhance the teaching and learning opportunities. When external factors such as classroom size restrictions are the driving force, the specific type of synchronous learning activities should be carefully considered. The structure and approach to lessons needs to be rethought to optimise the affordances of the hybrid virtual and connected classroom. The complexity of using these formats, and the additional time needed to do it properly, should not be underestimated. These findings are consistent with previous literature on this subject. An ongoing dialogue with faculty, support staff and especially students should be an integral part of any further implementation in this format.
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Background Emotional eating is a complex problem fostering obesity and resulting from maladaptive emotionregulation. Traditional behavioural weight loss interventions have shown insignificant effect. They can be improvedby targeting the specific needs of individuals with emotional eating.Objective The current study explored a tailored online approach with the aim to positively influence affect (positiveand negative) and emotion regulation by applying one of three exercises: body scan, opposite action, and positivereappraisal.Design An embedded mixed‑method design (questionnaire data (t0, t1, t2) and perceived usefulness of exercisesin t2) was used to evaluate the effects of a two‑week online quasi‑experimental pilot study.Subjects/setting In total, 80 participants with self‑reported emotional eating difficulties (DEBQ‑E; Memo = 3.48,SD = .64, range 1.62–4.92) finished baseline measurements; 15 completed the intervention. The study sample was pre‑dominantly female (95%), from 18 till 66 (Mage = 38,0 ± SD = 14.25).Results Participants reported that the exercises helped them to pay attention to their physical sensations, and to see positive aspects in negative matters. The exercises were considered difficult by the participants, with too littleexplanation, and dull, due to minor variation. The observed changes revealed small, and moreover, not significant improvements of the three exercises on positive and negative affect and overall emotion dysregulation. Although the quantitative results did not reach significance, the qualitative data highlighted which aspects of the tailored exer‑cises may have contributed to mood and emotion regulation outcomes. A notable observation in the present studyis the substantial dropout rate, with the number of participants decreasing from 80 at baseline (T0) to 15 at the post‑intervention stage (T2).Conclusions Future studies should identify tailored online exercises in emotion regulation skills in more detailand explore the contexts in which they are most effective in a personalized virtual coach virtual coach to be devel‑oped for individuals with emotional eating. Given the high dropout rate, more emphasis should be given to a properpresentation of the exercises, as well as more explanation of their usefulness and how to perform them.
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