Leading a sedentary lifestyle may cause numerous health problems. Therefore, passive lifestyle changes should be given priority to avoid severe long-term damage. Automatic health coaching system may help people manage a healthy lifestyle with continuous health state monitoring and personalized recommendation generation with machine learning (ML). This study proposes a semantic ontology model to annotate the ML-prediction outcomes and personal preferences to conceptualize personalized recommendation generation with a hybrid approach. We use a transfer learning approach to improve ML model training and its performance, and an incremental learning approach to handle daily growing data and fit them into the ML models. Furthermore, we propose a personalized activity recommendation algorithm for a healthy lifestyle by combining transfer learning, incremental learning, the proposed semantic ontology model, and personal preference data. For the overall experiment, we use public and private activity datasets collected from healthy adults (n = 33 for public datasets; n = 16 for private datasets). The standard ML algorithms have been used to investigate the possibility of classifying daily physical activity levels into the following activity classes: sedentary (0), low active (1), active (2), highly active (3), and rigorous active (4). The daily step count, low physical activity, medium physical activity, and vigorous physical activity serve as input for the classification models. We first use publicly available Fitbit datasets to build the initial classification models. Subsequently, we re-use the pre-trained ML classifiers on the real-time MOX2-5 dataset using transfer learning. We test several standard algorithms and select the best-performing model with optimized configuration for our use case by empirical testing. We find that DecisionTreeClassifier with a criterion "entropy” outperforms other ML classifiers with a mean accuracy score of 97.50% (F1 = 97.00, precision = 97.00, recall = 98.00, MCC = 96.78) and 96.10% (F1 = 96.00, precision = 96.00, recall = 96.00, MCC = 96.10) in Fitbit and MOX2-5 datasets, respectively. Using transfer learning, the DecisionTreeClassifier with a criterion "entropy" outperforms other classifiers with a mean accuracy score of 97.99% (F1 = 98.00, precision = 98.00, recall = 98.00, MCC = 96.79). Therefore, the transfer learning approach improves the machine learning model performance by ≈ 1.98% for defined datasets and settings on MOX2-5 datasets. The Hermit reasoner outperforms other reasoners with an average reasoning time of 1.1–2.1 s, under defined settings in our proposed ontology model. Our proposed algorithm for personalized recommendations conceptualizes a direction to combine the classification results and personal preferences in an ontology for activity eCoaching. The proposed method of combining machine learning technology with semantic rules is an invaluable asset in personalized recommendation generation. Moreover, the semantic rules in the knowledge base and SPARQL (SPARQL Protocol and RDF Query Language) query processing in the query engine helps to understand the logic behind the personalized recommendation generation.
Background Regular physical activity (PA), healthy habits, and an appropriate diet are recommended guidelines to maintain a healthy lifestyle. A healthy lifestyle can help to avoid chronic diseases and long-term illnesses. A monitoring and automatic personalized lifestyle recommendation system (i.e., automatic electronic coach or eCoach) with considering clinical and ethical guidelines, individual health status, condition, and preferences may successfully help participants to follow recommendations to maintain a healthy lifestyle. As a prerequisite for the prototype design of such a helpful eCoach system, it is essential to involve the end-users and subject-matter experts throughout the iterative design process. Methods We used an iterative user-centered design (UCD) approach to understend context of use and to collect qualitative data to develop a roadmap for self-management with eCoaching. We involved researchers, non-technical and technical, health professionals, subject-matter experts, and potential end-users in design process. We designed and developed the eCoach prototype in two stages, adopting different phases of the iterative design process. In design workshop 1, we focused on identifying end-users, understanding the user’s context, specifying user requirements, designing and developing an initial low-fidelity eCoach prototype. In design workshop 2, we focused on maturing the low-fidelity solution design and development for the visualization of continuous and discrete data, artificial intelligence (AI)-based interval forecasting, personalized recommendations, and activity goals. Results The iterative design process helped to develop a working prototype of eCoach system that meets end-user’s requirements and expectations towards an effective recommendation visualization, considering diversity in culture, quality of life, and human values. The design provides an early version of the solution, consisting of wearable technology, a mobile app following the “Google Material Design” guidelines, and web content for self-monitoring, goal setting, and lifestyle recommendations in an engaging manner between the eCoach app and end-users. Conclusions The adopted iterative design process brings in a design focus on the user and their needs at each phase. Throughout the design process, users have been involved at the heart of the design to create a working research prototype to improve the fit between technology, end-user, and researchers. Furthermore, we performed a technological readiness study of ProHealth eCoach against standard levels set by European Union (EU).
Heterogeneity is a problem in storing and exchanging data in a digital health information system (HIS) following semantic and structural integrity. The existing literature shows different methods to overcome this problem. Fast healthcare interoperable resources (FHIR) as a structural standard may explain other information models, (e.g., personal, physiological, and behavioral data from heterogeneous sources, such as activity sensors, questionnaires, and interviews) with semantic vocabularies, (e.g., Systematized Nomenclature of Medicine—Clinical Terms (SNOMED-CT)) to connect personal health data to an electronic health record (EHR). We design and develop an intuitive health coaching (eCoach) smartphone application to prove the concept. We combine HL7 FHIR and SNOMED-CT vocabularies to exchange personal health data in JavaScript object notion (JSON). This study explores and analyzes our attempt to design and implement a structurally and logically compatible tethered personal health record (PHR) that allows bidirectional communication with an EHR. Our eCoach prototype implements most PHR-S FM functions as an interoperability quality standard. Its end-to-end (E2E) data are protected with a TSD (Services for Sensitive Data) security mechanism. We achieve 0% data loss and 0% unreliable performances during data transfer between PHR and EHR. Furthermore, this experimental study shows the effectiveness of FHIR modular resources toward flexible management of data components in the PHR (eCoach) prototype.
Background Regular physical activity (PA), healthy habits, and a healthy diet are recommended guidelines to maintain a healthy lifestyle. A healthy lifestyle can help to avoid chronic diseases and long-term illnesses. A monitoring and automatic personalized lifestyle recommendation system (i.e., automatic electronic coach or eCoach) with considering clinical and ethical guidelines, individual health status, condition, and preferences may successfully help participants to follow recommendations to maintain a healthy lifestyle. As a prerequisite for the prototype design of such a helpful eCoach system, it is essential to involve the end-users and subject-matter experts throughout the iterative design process. Methods We used an iterative user-centered design (UCD) approach with a dialogue-labs method to collect qualitative data from different users (i.e., researchers, non-technical and technical, health professionals, subject-matter experts, and potential end-users) to develop a roadmap for self-management with eCoaching. We designed and developed the eCoach prototype in two stages, adopting different phases of the UCD approach and co-design events. In UCD workshop 1, we focused on identifying end-users, understanding the user’s context, specifying user requirements, designing and developing an initial low-fidelity eCoach prototype. In UCD workshop 2, we focused on maturing the low-fidelity solution design and development for the visualization of continuous and discrete data, artificial intelligence (AI)-based interval forecasting, personalized recommendations, and activity goals. Results The UCD approach helped to develop a working prototype of eCoach system that meets end-user's requirements and expectations towards an effective recommendation visualization, considering diversity in culture, quality of life, and human values. The design provides an early version of the solution, consisting of wearable technology, a mobile app, and web content for self-monitoring, goal setting, and lifestyle recommendations in an engaging manner between the eCoach app and end-users. Conclusions The adopted UCD approach brings in a design focus on the user and their needs at each phase. Throughout the design process, users have been involved at the heart of the design to create a working research prototype to improve the fit between technology, end-user, and researchers. Furthermore, we performed a technological readiness study of ProHealth eCoach against standard levels set by European Union (EU). Trial Registration: Not Applicable.
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