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Using generative AI and ontologies for motivating patients

Mor Peleg, University of Haifa, Israel

MEDSTAR Summit, Chennai, 2024

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Day 1, Part 2�Moitvation Chat

Mor Peleg, University of Haifa, Israel

Aneta Lisowska, Szymon Wilk, University of Poznan, Poland

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Holistic BCI personalisation

While in previous research we considered personalisation of schedule of delivery (ML-based) and message content tailoring(Rule-Based) separately in our recent work we explored utilisation of explainability methods for personalisation of all part of BCI in one end2end solution. See KR4H paper

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Telegram Bot and LLM

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To test this personalisation approach we built a telegram bot for meditation intervention.

The user information are:

goal (e.g. sleep improvement),
target activity style and dose (e.g. guided meditation lasting 5 minutes)
motivation and capability (at enrolment and then monitored twice weekly)
preferred activity time

External context: Day of the week, time of the day

We manipulate:

Selection of BCT technique (we use only subset of 40 bcts):

random selection
BCTs previously liked by user

Style of message:

unconstrained (anything generated by the GPT-3 model)
constrained (liked messages provided as examples in the prompt engineering)

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Can we use a LLM to generate motivational messages?

What behavioral theory can we use?

Susan Michie: Behavior Change Interventions

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BCT table

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BCT table

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Write a motivational message for walking 30 min to reduce stress

What are the two parts that are color coded?
Pick a number between 1 and 40
Read the definition of the Behavior Change Technique
Write a motivational message using that BCT

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How would you work with ChatGPT?

What does ChatGPT need to know to do this?
Try to ask it to generate a motivational message?
Can we do better? How?

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Provide ChatGPT with the background

Here is the basic info: BCT Description�1 1.2. Problem solving. Analyse, or prompt the person to analyse, factors influencing the behaviour and generate or select strategies that include overcoming barriers and/or increasing facilitators (includes ‘Relapse Prevention’ and ‘Coping Planning’)�2 1.4. Action planning Prompt detailed planning of performance of the behaviour (must include at least one of context, frequency, duration and intensity). Context may be environmental (physical or social) or internal (physical, emotional or cognitive) (includes ‘Implementation Intentions’)�3 1.5. Review behaviour goal(s) Review behaviour goal(s) jointly with the person and consider modifying goal(s) or behaviour change strategy in light of achievement. This may lead to re-setting the same goal, a small change in that goal or setting a new goal instead of (or in addition to) the first, or no change�4 1.6. Discrepancy between current behaviour and goal Draw attention to discrepancies between a person’s current behaviour (in terms of the form, frequency, duration, or intensity of that behaviour) and the person’s previously set outcome goals, behavioural goals or action plans (goes beyond self-monitoring of behaviour)�5 1.7. Review outcome goal(s) Review outcome goal(s) jointly with the person and consider modifying goal(s) in light of achievement. This may lead to re-setting the same goal, a small change in that goal or setting a new goal instead of, or in addition to the first�6 1.8. Behavioural contract Create a written specification of the behaviour to be performed, agreed on by the person, and witnessed by another�7 1.9. Commitment Ask the person to affirm or reaffirm statements indicating commitment to change the behaviour�8 3.2. Social support (practical) Advise on, arrange, or provide practical help (e.g. from friends, relatives, colleagues, buddies or staff) for performance of the behaviour�9 3.3. Social support (emotional) Advise on, arrange, or provide emotional social support (e.g. from friends, relatives, colleagues, buddies or staff) for performance of the behaviour�10 4.1. Instruction on how to perform behaviour Advise or agree on how to perform the behaviour (includes ‘Skills training’)�11 4.3. Re-attribution Elicit perceived causes of behaviour and suggest alternative explanations (e.g. external or internal and stable or unstable)�12 5.1. Information about health consequences Provide information (e.g. written, verbal, visual) about health consequences of performing the behaviour�13 5.2. Salience of consequences Use methods specifically designed to emphasise the consequences of performing the behaviour with the aim of making them more memorable (goes beyond informing about consequences)�14 5.3. Information about social and environmental consequences Provide information (e.g. written, verbal, visual) about social and environmental consequences of performing the behaviour�15 5.6. Information about emotional consequences Provide information (e.g. written, verbal, visual) about emotional consequences of performing the behaviour�16 6.1. Demonstration of the behaviour Provide an observable sample of the performance of the behaviour, directly in person or indirectly e.g. via film, pictures, for the person to aspire to or imitate (includes ‘Modelling’).�17 6.2. Social comparison Draw attention to others’ performance to allow comparison with the person’s own performance�18 6.3. Information about others’ approval Provide information about what other people think about the behaviour. The information clarifies whether others will like, approve or disapprove of what the person is doing or will do�19 7.5. Remove aversive stimulus Advise or arrange for the removal of an aversive stimulus to facilitate behaviour change (includes ‘Escape learning’)�20 8.1. Behavioural practice/rehearsal Prompt practice or rehearsal of the performance of the behaviour one or more times in a context or at a time when the performance may not be necessary, in order to increase habit and skill�21 8.7. Graded tasks Set easy-to-perform tasks, making them increasingly difficult, but achievable, until behaviour is performed�22 9.2. Pros and cons Advise the person to identify and compare reasons for wanting (pros) and not wanting to (cons) change the behaviour (includes ‘Decisional balance’)�23 9.3. Comparative imagining of future outcomes Prompt or advise the imagining and comparing of future outcomes of changed versus unchanged behaviour�24 10.6. Non-specific incentive Inform that a reward will be delivered  if and only if there has been effort and/or progress in performing the behaviour (includes ‘Positive reinforcement’)�25 10.7. Self-incentive Plan to reward self in future if and only if there has been effort and/or progress in performing the behaviour�26 10.8. Incentive (outcome) Inform that  a reward will be delivered if and only if there has been effort and/or progress in achieving the behavioural outcome (includes ‘Positive reinforcement’)�27 11.2. Reduce negative emotions Advise on ways of reducing negative emotions to facilitate performance of the behaviour (includes ‘Stress Management’)�28 11.3. Conserving mental resources Advise on ways of minimising demands on mental resources to facilitate behaviour change�29 12.1. Restructuring the physical environment Change, or advise to change the physical environment in order to facilitate performance of the wanted behaviour or create barriers to the unwanted behaviour (other than prompts/cues, rewards and punishments)�30 12.2. Restructuring the social environment Change, or advise to change the social environment in order to facilitate performance of the wanted behaviour or create barriers to the unwanted behaviour (other than prompts/cues, rewards and punishments)�31 12.5. Adding objects to the environment Add objects to the environment in order to facilitate performance of the behaviour�32 13.1. Identification of self as role model Inform that one's own behaviour may be an example to others�33 13.2. Framing/reframing Suggest the deliberate adoption of a perspective or new perspective on behaviour (e.g. its purpose) in order to change cognitions or emotions about performing the behaviour (includes ‘Cognitive structuring’)�34 13.3. Incompatible beliefs Draw attention to discrepancies between current or past behaviour and self-image, in order to create discomfort (includes ‘Cognitive dissonance’)�35 13.4. Valued self-identify Advise the person to write or complete rating scales about a cherished value or personal strength as a means of affirming the person’s identity as part of a behaviour change strategy (includes ‘Self-affirmation’)�36 15.1. Verbal persuasion about capability Tell the person that they can successfully perform the wanted behaviour, arguing against self-doubts and asserting that they can and will succeed�37 15.2. Mental rehearsal of successful performance Advise to practise imagining performing the behaviour successfully in relevant contexts�38 15.3. Focus on past success Advise to think about or list previous successes in performing the behaviour (or parts of it)�39 15.4. Self-talk Prompt positive self-talk (aloud or silently) before and during the behaviour�40 16.2. Imaginary reward Advise to imagine performing the wanted behaviour in a real-life situation followed by imagining a pleasant consequence (includes ‘Covert conditioning’)

here is the basic info: BCT Description�1 1.2. Problem solving Analyse, or prompt the person to analyse, factors influencing the behaviour and generate or select strategies that include overcoming barriers and/or increasing facilitators (includes ‘Relapse Prevention’ and ‘Coping Planning’)�2 1.4. Action planning Prompt detailed planning of performance of the behaviour (must include at least one of context, frequency, duration and intensity). Context may be environmental (physical or social) or internal (physical, emotional or cognitive) (includes ‘Implementation Intentions’)�3 1.5. Review behaviour goal(s) Review behaviour goal(s) jointly with the person and consider modifying goal(s) or behaviour change strategy in light of achievement. This may lead to re-setting the same goal, a small change in that goal or setting a new goal instead of (or in addition to) the first, or no change�4 1.6. Discrepancy between current behaviour and goal Draw attention to discrepancies between a person’s current behaviour (in terms of the form, frequency, duration, or intensity of that behaviour) and the person’s previously set outcome goals, behavioural goals or action plans (goes beyond self-monitoring of behaviour)�5 1.7. Review outcome goal(s) Review outcome goal(s) jointly with the person and consider modifying goal(s) in light of achievement. This may lead to re-setting the same goal, a small change in that goal or setting a new goal instead of, or in addition to the first�6 1.8. Behavioural contract Create a written specification of the behaviour to be performed, agreed on by the person, and witnessed by another�7 1.9. Commitment Ask the person to affirm or reaffirm statements indicating commitment to change the behaviour�8 3.2. Social support (practical) Advise on, arrange, or provide practical help (e.g. from friends, relatives, colleagues, buddies or staff) for performance of the behaviour�9 3.3. Social support (emotional) Advise on, arrange, or provide emotional social support (e.g. from friends, relatives, colleagues, buddies or staff) for performance of the behaviour�10 4.1. Instruction on how to perform behaviour Advise or agree on how to perform the behaviour (includes ‘Skills training’)�11 4.3. Re-attribution Elicit perceived causes of behaviour and suggest alternative explanations (e.g. external or internal and stable or unstable)�12 5.1. Information about health consequences Provide information (e.g. written, verbal, visual) about health consequences of performing the behaviour�13 5.2. Salience of consequences Use methods specifically designed to emphasise the consequences of performing the behaviour with the aim of making them more memorable (goes beyond informing about consequences)�14 5.3. Information about social and environmental consequences Provide information (e.g. written, verbal, visual) about social and environmental consequences of performing the behaviour�15 5.6. Information about emotional consequences Provide information (e.g. written, verbal, visual) about emotional consequences of performing the behaviour�16 6.1. Demonstration of the behaviour Provide an observable sample of the performance of the behaviour, directly in person or indirectly e.g. via film, pictures, for the person to aspire to or imitate (includes ‘Modelling’).�17 6.2. Social comparison Draw attention to others’ performance to allow comparison with the person’s own performance�18 6.3. Information about others’ approval Provide information about what other people think about the behaviour. The information clarifies whether others will like, approve or disapprove of what the person is doing or will do�19 7.5. Remove aversive stimulus Advise or arrange for the removal of an aversive stimulus to facilitate behaviour change (includes ‘Escape learning’)�20 8.1. Behavioural practice/rehearsal Prompt practice or rehearsal of the performance of the behaviour one or more times in a context or at a time when the performance may not be necessary, in order to increase habit and skill�21 8.7. Graded tasks Set easy-to-perform tasks, making them increasingly difficult, but achievable, until behaviour is performed�22 9.2. Pros and cons Advise the person to identify and compare reasons for wanting (pros) and not wanting to (cons) change the behaviour (includes ‘Decisional balance’)�23 9.3. Comparative imagining of future outcomes Prompt or advise the imagining and comparing of future outcomes of changed versus unchanged behaviour�24 10.6. Non-specific incentive Inform that a reward will be delivered  if and only if there has been effort and/or progress in performing the behaviour (includes ‘Positive reinforcement’)�25 10.7. Self-incentive Plan to reward self in future if and only if there has been effort and/or progress in performing the behaviour�26 10.8. Incentive (outcome) Inform that  a reward will be delivered if and only if there has been effort and/or progress in achieving the behavioural outcome (includes ‘Positive reinforcement’)�27 11.2. Reduce negative emotions Advise on ways of reducing negative emotions to facilitate performance of the behaviour (includes ‘Stress Management’)�28 11.3. Conserving mental resources Advise on ways of minimising demands on mental resources to facilitate behaviour change�29 12.1. Restructuring the physical environment Change, or advise to change the physical environment in order to facilitate performance of the wanted behaviour or create barriers to the unwanted behaviour (other than prompts/cues, rewards and punishments)�30 12.2. Restructuring the social environment Change, or advise to change the social environment in order to facilitate performance of the wanted behaviour or create barriers to the unwanted behaviour (other than prompts/cues, rewards and punishments)�31 12.5. Adding objects to the environment Add objects to the environment in order to facilitate performance of the behaviour�32 13.1. Identification of self as role model Inform that one's own behaviour may be an example to others�33 13.2. Framing/reframing Suggest the deliberate adoption of a perspective or new perspective on behaviour (e.g. its purpose) in order to change cognitions or emotions about performing the behaviour (includes ‘Cognitive structuring’)�34 13.3. Incompatible beliefs Draw attention to discrepancies between current or past behaviour and self-image, in order to create discomfort (includes ‘Cognitive dissonance’)�35 13.4. Valued self-identify Advise the person to write or complete rating scales about a cherished value or personal strength as a means of affirming the person’s identity as part of a behaviour change strategy (includes ‘Self-affirmation’)�36 15.1. Verbal persuasion about capability Tell the person that they can successfully perform the wanted behaviour, arguing against self-doubts and asserting that they can and will succeed�37 15.2. Mental rehearsal of successful performance Advise to practise imagining performing the behaviour successfully in relevant contexts�38 15.3. Focus on past success Advise to think about or list previous successes in performing the behaviour (or parts of it)�39 15.4. Self-talk Prompt positive self-talk (aloud or silently) before and during the behaviour�40 16.2. Imaginary reward Advise to imagine performing the wanted behaviour in a real-life situation followed by imagining a pleasant consequence (includes ‘Covert conditioning’)

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Ask ChatGPT to generate a motivational message

Please use one of the BCTs to generate a motivational message for Sanga, who wants to meditate 20 minutes each day to improve her sleep. Let us know which BCT you used.

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Using openAI API as part of the Virtual Coach

The Virtual Coach can ask the ChatBot to compose message from BCTs liked by the user

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Challenges and Interesting Findings

Given a small number of individuals in our study and the information we capture, our behaviour prediction model is not doing a great job (too little variability)

Even Though LLM most of the times is able to take BCT and generate ‘novel content’ using LLM created few interesting ege case e.g.:

the version which uses previously likes messages as examples ignored explicitly provided information about current users activity length goals, considered the goals from previous message instead
bugs in message generation which are hard to foresee (see example screenshot on right )
in constrained generation, when including previously liked example messages, the content of new messages becomes repetitive (see screenshots on left)