||1R01CA247705-01 Interpret this number
||University Of California, San Francisco
||SCH: Changegradients: Promoting Adolescent Health Behavior Change with Clinically Integrated Sample-Efficient Policy Gradient Methods
Because the majority of adolescent health problems are amenable to behavioral intervention and most
adolescents visit a healthcare provider once a year, hea lth behavior change interventions linked to clinic-
based health information technologies hold significant promise for improving healthcare quality and
subsequent behavioral health outcomes for adolescents. Recognizing the potential to leverage advances in
machine learning and virtual narrative environments, the field of health behavior change is now well-
positioned to design health behavior change systems that extend the reach of clinicians to realize
significant impacts on behavior change for adolescent preventive health.
With a focus on risky behaviors and an emphasis on alcohol use, the project has two specific aims: (1)
design, develop, and iteratively refine a policy-based reinforcement learning behavior change system for
preventive adolescent health, and (2) investigate the impact of a clinically integrated sample-efficient policy
gradient-based behavior change system on adolescent behavior. The project w ill culminate w ith an
investigation of the behavioral effects of the CHANGEGRADIENTS system using adolescent patients recruited
from two outpatient primary care clinics within the UCSF Department of Pediatrics: Mt. Zion Pediatrics and
the Adolescent/Young Adult Clinic. It is hypothesized that adolescents who interact with CHANGEGRADIENTS
with reduce number of days of alcohol use, reduce binge drinking, and increase self-efficacy to engage in
healthy behavior a nd avoid risky substance use.
It is anticipated that CHANGEGRADIENTS will provide a testbed for a broad range of health behavior change
research and serve as the foundation for next-generation personalized preventive healthcare through
computationally-enabled behavior change that is designed to be tightly integrated into clinical practice
workflow. By taking advantage of the high degree of adaptive interactivity offered by its personalized
behavior change environment, CHANGEGRADIENTS holds significant potential for creating compelling
interactions that promote self-efficacy and engagement in healthy lifestyle behaviors to prevent cancer
through improving cancer-related behaviors and risk factors.
REL EVAN CE (Se e in stru cti ons):
The proposed research will develop and field test an innovative computationally-enabled personalized
behavior change model that will provide a testbed for a broad range of health behavior change research
and is designed to be integrated into clinical practice. With adaptive interactivity, CHANGEGRADIENTS holds
significant potential for creating compelling interactions that promote self-efficacy and engagement in
healthy lifestyle behaviors to prevent cancer through improving cancer-related behaviors and risk factors .
Fostering Engagement in Health Behavior Change: Iterative Development of an Interactive Narrative Environment to Enhance Adolescent Preventive Health Services.
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The Journal of adolescent health : official publication of the Society for Adolescent Medicine, 2020 08; 67(2S), p. S34-S44.
The COVID-19 Pandemic and Rapid Implementation of Adolescent and Young Adult Telemedicine: Challenges and Opportunities for Innovation.
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The Journal of adolescent health : official publication of the Society for Adolescent Medicine, 2020 08; 67(2), p. 164-171.