System Identification of User Engagement in mHealth Behavioral Interventions

Abstract

Digital behavior change interventions (DBCIs) such as “just-in-time” adaptive interventions (JITAIs) have demonstrated efficacy for increasing physical activity behavior. However, the effectiveness of these interventions is heavily dependent upon user engagement. Despite the inherent dynamic nature of engagement, as it varies over time based on an individual’s changing environment, context, and psychological state, the current understanding of engagement primarily comes from static snapshots of the behavior. The availability of intensive longitudinal data from JITAIs provides a unique opportunity to build and test dynamic models of behavior change from a process systems lens, relying on prediction-error methods from system identification. However, data missingness is a significant practical consideration in this process. Therefore, in this work we address missingness using a Bayesian imputation approach, which we evaluate using data from the HeartSteps II JITAI. Ultimately, the methods presented support the discovery of key factors that impact engagement behavior over time and can play an important role in the development of large-scale personalized interventions.