A system identification and control engineering approach for optimizing mHealth behavioral interventions based on social cognitive theory

Behavioral health problems such as physical inactivity are among the main causes of mortality around the world. Mobile and wireless health (mHealth) interventions offer the opportunity for applying control engineering concepts in behavioral change settings. Social Cognitive Theory (SCT) is among the most influential theories of health behavior and has been used as the conceptual basis of many behavioral interventions. This dissertation examines adaptive behavioral interventions for physical inactivity problems based on SCT using system identification and control engineering principles. First, a dynamical model of SCT using fluid analogies is developed. The model is used throughout the dissertation to evaluate system identification approaches and to develop control strategies based on Hybrid Model Predictive Control (HMPC). An initial system identification informative experiment is designed to obtain basic insights about the system. Based on the informative experimental results, a second optimized experiment is developed as the solution of a formal constrained optimization problem. The concept of Identification Test Monitoring (ITM) is developed for determining experimental duration and adjustments to the input signals in real time. ITM relies on deterministic signals, such as multisines, and uncertainty regions resulting from frequency domain transfer function estimation that is performed during experimental execution. ITM is motivated by practical considerations in behavioral interventions; however, a generalized approach is presented for broad-based multivariable application settings such as process control. Stopping criteria for the experimental test utilizing ITM are developed using both open-loop and robust control considerations.

A closed-loop intensively adaptive intervention for physical activity is proposed relying on a controller formulation based on HMPC. The discrete and logical features of HMPC naturally address the categorical nature of the intervention components that include behavioral goals and reward points. The intervention incorporates online controller reconfiguration to manage the transition between the behavioral initiation and maintenance training stages. Simulation results are presented to illustrate the performance of the system using a model for a hypothetical participant under realistic conditions that include uncertainty. The contributions of this dissertation can ultimately impact novel applications of cyberphysical system in medical applications.