Artificial Intelligence Chatbot Behavior Change Model for Designing Artificial Intelligence Chatbots to Promote Physical Activity and a Healthy Diet: Viewpoint

Abstract

Background Chatbots empowered by artificial intelligence (AI) can increasingly engage in natural conversations and build relationships with users. Applying AI chatbots to lifestyle modification programs is one of the promising areas to develop cost-effective and feasible behavior interventions to promote physical activity and a healthy diet. Objective The purposes of this perspective paper are to present a brief literature review of chatbot use in promoting physical activity and a healthy diet, describe the AI chatbot behavior change model our research team developed based on extensive interdisciplinary research, and discuss ethical principles and considerations. Methods We conducted a preliminary search of studies reporting chatbots for improving physical activity and/or diet in four databases in July 2020. We summarized the characteristics of the chatbot studies and reviewed recent developments in human-AI communication research and innovations in natural language processing. Based on the identified gaps and opportunities, as well as our own clinical and research experience and findings, we propose an AI chatbot behavior change model. Results Our review found a lack of understanding around theoretical guidance and practical recommendations on designing AI chatbots for lifestyle modification programs. The proposed AI chatbot behavior change model consists of the following four components to provide such guidance: (1) designing chatbot characteristics and understanding user background; (2) building relational capacity; (3) building persuasive conversational capacity; and (4) evaluating mechanisms and outcomes. The rationale and evidence supporting the design and evaluation choices for this model are presented in this paper. Conclusions As AI chatbots become increasingly integrated into various digital communications, our proposed theoretical framework is the first step to conceptualize the scope of utilization in health behavior change domains and to synthesize all possible dimensions of chatbot features to inform intervention design and evaluation. There is a need for more interdisciplinary work to continue developing AI techniques to improve a chatbot’s relational and persuasive capacities to change physical activity and diet behaviors with strong ethical principles.

The Artificial Intelligence (AI)-Based Chatbot for Promoting Physical Activity and Healthy Diet: Protocol for a Systematic Review

“…In addition, this review may help to identify research gaps concerning the feasibility, acceptability, and effects of AI chatbots on changing lifestyle behaviors. Combined with the theoretical and ethical discussions presented in Zhang et al [7], our review will point out the blind spots and limitations in existing research and promising future directions for advancing chatbot-based interventions and programs.…”

“…self-report and/or objectively measure physical activity), and 5) safety and ethical assessment. Data extractions for domains from 2) to 5) will be guided by the AI-Chatbot Behavior Change Model [7]. If there is any missing data, we may contact study authors to obtain the data.…”

“…With the rapid rise of arti cial intelligence (AI) technologies in recent years, AI-based lifestyle interventions have offered new possibilities into developing innovative ways to support behavior change. One frontier regards recent advancements in voice and text recognition, natural language processing, and machine learning, which have led to the increasing incorporation of conversational agents, or AI-chatbots, into lifestyle modi cation programs [7,8]. AI-chatbots employ dialogue systems to enable both constrained and unconstrained natural language conversations with users.…”

“…The aims of this systematic review are to 1) describe characteristics, functions, and core conversational capacities of chatbot interventions; 2) investigate whether these chatbot interventions are effective on changing physical activity, diet, weight management behaviors, and other related health outcomes; and 3) identify knowledge gaps and limitations. We will also use the AI-Chatbot Behavior Change Model [7] as a guiding theoretical framework to examine the chatbot interventions' characteristics, theoretical mechanisms, quality and safety checks, and ethical considerations. The model is proposed for guiding the design and evaluation of chatbot-based lifestyle interventions and speci es four conceptual domains regarding (1) designing chatbot characteristics and understanding user backgrounds; 2) building chatbot's relational capacity; 3) building chatbot's persuasive conversational capacity; and 4) evaluating mechanisms and outcomes.…”

Machine Learning in Healthcare Communication

“…Vivibot is another chatbot developed to deliver positive psychology skills and influence a healthy lifestyle in young people after cancer treatment [67]. It is another chatbot that was introduced to promote physical activity and a healthy diet was [68].…”