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  1. Physical activity is a cornerstone of chronic conditions and one of the most critical factors in reducing the risks of cardiovascular diseases, the leading cause of death in the United States. App-based lifestyle interventions have been utilized to promote physical activity in people with or at risk for chronic conditions. However, these mHealth tools have remained largely static and do not adapt to the changing behavior of the user. In a step toward designing adaptive interventions, we propose BeWell24Plus, a framework for monitoring activity and user engagement and developing computational models for outcome prediction and intervention design. In particular, we focus on devising algorithms that combine data about physical activity and engagement with the app to predict future physical activity performance. Knowing in advance how active a person is going to be in the next day can help with designing adaptive interventions that help individuals achieve their physical activity goals. Our technique combines the recent history of a person's physical activity with app engagement metrics such as when, how often, and for how long the app was used to forecast the near future's activity. We formulate the problem of multimodal activity forecasting and propose an LSTM-based realization of our proposed model architecture, which estimates physical activity outcomes in advance by examining the history of app usage and physical activity of the user. We demonstrate the effectiveness of our forecasting approach using data collected with 58 prediabetic people in a 9-month user study. We show that our multimodal forecasting approach outperforms single-modality forecasting by 2.2$ to 11.1% in mean-absolute-error. 
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  2. Postprandial hyperglycemia (PPHG) is detrimental to health and increases risk of cardiovascular diseases, reduced eyesight, and life-threatening conditions like cancer. Detecting PPHG events before they occur can potentially help with providing early interventions. Prior research suggests that PPHG events can be predicted based on information about diet. However, such computational approaches (1) are data hungry requiring significant amounts of data for algorithm training; and (2) work as a black-box and lack interpretability, thus limiting the adoption of these technologies for use in clinical interventions. Motivated by these shortcomings, we propose, DietNudge 1 , a machine learning based framework that integrates multi-modal data about diet, insulin, and blood glucose to predict PPHG events before they occur. Using data from patients with diabetes, we demonstrate that our model can predict PPHG events with up to 90% classification accuracy and an average F1 score of 0.93. The proposed decision-tree-based approach also identifies modifiable factors that contribute to an impending PPHG event while providing personalized thresholds to prevent such events. Our results suggest that we can develop simple, yet effective, computational algorithms that can be used as preventative mechanisms for diabetes and obesity management. 
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  3. With rapid growth in unhealthy diet behaviors, implementing strategies that improve healthy eating is becoming increasingly important. One approach to improving diet behavior is to continuously monitor dietary intake (e.g., calorie intake) and provide educational, motivational, and dietary recommendation feedback. Although technologies based on wearable sensors, mobile applications, and light-weight cameras exist to gather diet-related information such as food type and eating time, there remains a gap in research on how to use such information to close the loop and provide feedback to the user to improve healthy diet. We address this knowledge gap by introducing a diet behavior change framework that generates real-time diet recommendations based on a user’s food intake and considering user’s deviation from the suggested diet routine. We formulate the problem of optimal diet recommendation as a sequential decision making problem and design a greedy algorithm that provides diet recommendations such that the amount of change in user’s dietary habits is minimized while ensuring that the user’s diet goal is achieved within a given time-frame. This novel approach is inspired by the Social Cognitive Theory, which emphasizes behavioral monitoring and small incremental goals as being important to behavior change. Our optimization algorithm integrates data from a user’s past dietary intake as well as the USDA nutrition dataset to identify optimal diet changes. We demonstrate the feasibility of our optimization algorithms for diet behavior change using real-data collected in two study cohorts with a combined N=10 healthy participants who recorded their diet for up to 21 days. 
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