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Therefore, developing cost-effective and feasible lifestyle interventions is urgently needed to reduce the prevalence. Nearly 80% of American adults do not meet the guidelines for both aerobic and muscle-strengthening activities, and the prevalence of overweight or obesity reached 71.6% in 2016. The United States is one of the countries experiencing a rapid rise in these risks. The prevalence of physical inactivity and an unhealthy diet varies considerably within and across countries. NCDs account for seven out of 10 deaths worldwide and pose a substantial economic burden. Physical inactivity and an unhealthy diet continue to be some of the leading risk factors for noncommunicable diseases (NCDs), such as cardiovascular disease, diabetes, and obesity, and death worldwide. There is a need for more interdisciplinary work to continue developing AI techniques to improve a chatbot’s relational and persuasive capacities to change physical activity and diet behaviors with strong ethical principles. The rationale and evidence supporting the design and evaluation choices for this model are presented in this paper.Ĭonclusions: As AI chatbots become increasingly integrated into various digital communications, our proposed theoretical framework is the first step to conceptualize the scope of utilization in health behavior change domains and to synthesize all possible dimensions of chatbot features to inform intervention design and evaluation. The proposed AI chatbot behavior change model consists of the following four components to provide such guidance: (1) designing chatbot characteristics and understanding user background (2) building relational capacity (3) building persuasive conversational capacity and (4) evaluating mechanisms and outcomes. Results: Our review found a lack of understanding around theoretical guidance and practical recommendations on designing AI chatbots for lifestyle modification programs. Based on the identified gaps and opportunities, as well as our own clinical and research experience and findings, we propose an AI chatbot behavior change model. We summarized the characteristics of the chatbot studies and reviewed recent developments in human-AI communication research and innovations in natural language processing. Methods: We conducted a preliminary search of studies reporting chatbots for improving physical activity and/or diet in four databases in July 2020. Objective: The purposes of this perspective paper are to present a brief literature review of chatbot use in promoting physical activity and a healthy diet, describe the AI chatbot behavior change model our research team developed based on extensive interdisciplinary research, and discuss ethical principles and considerations. Applying AI chatbots to lifestyle modification programs is one of the promising areas to develop cost-effective and feasible behavior interventions to promote physical activity and a healthy diet.
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