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Active assistance technology for health-related behavior change: an interdisciplinary review.

Kennedy, Catriona M.; Powell, John; Payne, Thomas H.; Ainsworth, John; Boyd, Alan; Buchan, Iain


John Powell

Thomas H. Payne

John Ainsworth

Alan Boyd

Iain Buchan


Information technology can help individuals to change their health behaviors. This is due to its potential for dynamic and unbiased information processing enabling users to monitor their own progress and be informed about risks and opportunities specific to evolving contexts and motivations. However, in many behavior change interventions, information technology is underused by treating it as a passive medium focused on efficient transmission of information and a positive user experience. To conduct an interdisciplinary literature review to determine the extent to which the active technological capabilities of dynamic and adaptive information processing are being applied in behavior change interventions and to identify their role in these interventions. We defined key categories of active technology such as semantic information processing, pattern recognition, and adaptation. We conducted the literature search using keywords derived from the categories and included studies that indicated a significant role for an active technology in health-related behavior change. In the data extraction, we looked specifically for the following technology roles: (1) dynamic adaptive tailoring of messages depending on context, (2) interactive education, (3) support for client self-monitoring of behavior change progress, and (4) novel ways in which interventions are grounded in behavior change theories using active technology. The search returned 228 potentially relevant articles, of which 41 satisfied the inclusion criteria. We found that significant research was focused on dialog systems, embodied conversational agents, and activity recognition. The most covered health topic was physical activity. The majority of the studies were early-stage research. Only 6 were randomized controlled trials, of which 4 were positive for behavior change and 5 were positive for acceptability. Empathy and relational behavior were significant research themes in dialog systems for behavior change, with many pilot studies showing a preference for those features. We found few studies that focused on interactive education (3 studies) and self-monitoring (2 studies). Some recent research is emerging in dynamic tailoring (15 studies) and theoretically grounded ontologies for automated semantic processing (4 studies). The potential capabilities and risks of active assistance technologies are not being fully explored in most current behavior change research. Designers of health behavior interventions need to consider the relevant informatics methods and algorithms more fully. There is also a need to analyze the possibilities that can result from interaction between different technology components. This requires deep interdisciplinary collaboration, for example, between health psychology, computer science, health informatics, cognitive science, and educational methodology.


KENNEDY, C.M., POWELL, J., PAYNE, T.H., AINSWORTH, J., BOYD, A. and BUCHAN, I. 2012. Active assistance technology for health-related behavior change: an interdisciplinary review. Journal of medical internet research [online], 14(3), e80. Available from:

Journal Article Type Article
Acceptance Date May 15, 2012
Online Publication Date Jun 14, 2012
Publication Date Jun 30, 2012
Deposit Date Dec 4, 2023
Publicly Available Date Dec 4, 2023
Journal Journal of medical internet research
Print ISSN 1438-8871
Electronic ISSN 1438-8871
Publisher JMIR Publications
Peer Reviewed Peer Reviewed
Volume 14
Issue 3
Article Number e80
Keywords Behavior change; Consumer Health informatics; Health communication; Health promotion; Personalization
Public URL


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