Randomized trial of two artificial intelligence coaching interventions to increase physical activity in cancer survivors

Ahmed Hassoon,Daniel Q Naiman,Lawrence J Appel,Josef Coresh,Yasmin Baig,Jennifer Schrack,Dina Lansey,Hadas Zeilberger,Seth S Martin,Vered Stearns,Hsin-Chieh Yeh,David D Celentano

doi:10.1038/s41746-021-00539-9

Abstract

Physical activity (PA) has numerous health benefits. Personalized coaching may increase adherence to PA recommendations, but it is challenging to deliver personalized coaching in a scalable manner. The objective of our study was to determine whether novel artificially intelligent (AI) coaching interventions increase PA among overweight or obese, physically inactive cancer survivors compared to a control arm that receives health information. We conducted a single-center, three-arm randomized trial with equal allocation to (1) voice-assisted AI coaching delivered by smart speaker (MyCoach), (2) autonomous AI coaching delivered by text message (SmartText), and (3) control. Data collection was automated via sensors and voice technology, effectively masking outcome ascertainment. The primary outcome was change in mean steps per day from baseline to the end of follow-up at 4 weeks. Of the 42 randomized participants, 91% were female, and 36% were Black; mean age was 62.1 years, and mean BMI was 32.9 kg/m2. The majority were breast cancer survivors (85.7%). At the end of 4 weeks follow-up, steps increased in the MyCoach arm by an average of 3618.2 steps/day; the net gain in this arm was significantly greater [net difference = 3568.9 steps/day (95% CI: 1483–5655), P value <0.001] compared to control arm, and [net difference = 2160.6 steps/day (95% CI: 11–4310), P value 0.049] compared to SmartText. In conclusion, AI-based voice-assisted coaching shows promise as a practical method of delivering scalable, individualized coaching to increase physical activity in sedentary cancer survivors. Additional research is needed to replicate these findings in a broader population of cancer survivors and to investigate the effects of these interventions in the general population.ClinicalTrials.gov Identifier: NCT03212079, July 11, 2017, https://clinicaltrials.gov/ct2/show/NCT03212079.

Highlights

Despite obesity’s well-documented association with poor health outcomes—including increased risk of cardiovascular disease (CVD), diabetes, and cancer incidence and recurrence— the prevalence of overweight and obesity has risen sharply over the past several decades[1]
The aim of our study was to determine whether novel artificially intelligent (AI) coaching interventions increase physical activities among overweight or obese, physically inactive cancer survivors compared to a control arm that receives health information
Our main finding was that AI-based, voice-assisted coaching delivered through a smart speaker (MyCoach) significantly increased physical activity in comparison to the control arm and the AI-based autonomous texting (SmartText)

Summary

Introduction

Despite obesity’s well-documented association with poor health outcomes—including increased risk of cardiovascular disease (CVD), diabetes, and cancer incidence and recurrence— the prevalence of overweight and obesity has risen sharply over the past several decades[1]. CVDs became one of the leading causes of death among cancer survivors[3]. Obesity among cancer survivors significantly reduces survivorship[4]. Increasing physical activities among cancer survivors significantly reduced all-cause mortality[5]. Behavioral approaches to reduce calorie intake and increase physical activity are essential features of weight loss interventions, which typically involve individualized, person-to-person coaching[6,7].

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Conclusion