Drs. April Idalski Carcone, PhD, MSW and Elizabeth Towner with their collaborator, Dr. Alex Kotov, WSU College of Engineering, Department of Computer Science, were awarded a two-year grant from the National Institute of Nursing Research to develop a neural conversational agent to deliver Motivational Interviewing counseling aimed at weight reduction. Drs. Carcone and Towner will serve as co-investigators on this study led by Dr. Kotov, along with Drs. Sylvie Naar (Florida State University) and Kathryn Brogan Hartlieb (Parker University) as consultants.

Recent estimates suggest that one-third of U.S. adults are overweight or obese making obesity one of the most important public health problems in the United States. One effective treatment for reducing weight is Motivational Interviewing. Motivational Interviewing is a client-centered approach to counseling people about changing their behavior with a strong empirical support for encouraging people to make weight-related behavior changes. However, access to Motivational Interviewing counselors is limited in certain geographical areas, subject to long wait times, can be costly, and people seeking treatment are sometimes stigmatized. Recent advances in artificial intelligence (AI) have opened the door to many areas of health care previously thought to be the exclusive province of human experts, such as counseling. This project will test the feasibility and usability of a neural conversational agent for weight loss counseling. This research will build on recent advances in AI technology, including transformers, supervised policy learning and adversarial training, to develop and validate NAOMI (Neural Agent for Obesity Motivational Interviewing), an AI agent programmed to conduct Motivational Interviewing counseling focused on weight loss through a patient’s mobile device (smartphone or tablet). NAOMI is based on a novel neural architecture, which consists of neural networks that can be independently and collectively trained to learn to strategically use communication behaviors during different stages of a counseling session based on the Motivational Interviewing framework.

Dr. Carcone is a behavioral health researcher whose work leverages mixed methods approaches to developing and testing interventions to improve the health and well-being of children and young adults living with chronic illnesses, including obesity, diabetes, asthma, and HIV. Dr. Carcone is also a member of the Motivational Interviewing Network of Trainers (MINT) with specific expertise in the process of Motivational Interviewing counseling. She and Dr. Kotov have collaborated on several prior Motivational Interviewing research studies that have examined the process of Motivational Interviewing clinical conversations during weight loss treatment sessions and developed computer algorithms to annotate (assign behavioral codes) these conversations. This collaborative work forms the basis of the newly funded project. On the current project, Dr. Carcone will leverage her Motivational Interviewing expertise in the development of NAOMI and will help facilitate the qualitative interviews with patients to assess the feasibility and usability of the agent for weight loss conversations.

Dr. Towner is a pediatric health psychologist with expertise in the treatment of obesity and the development of weight loss interventions. Dr. Towner is also the Research Director for MetroNet, a family medicine practice research network. She will support this research as an expert in obesity and weight loss intervention and by assisting with the recruitment of patients from MetroNet-affiliated practices. These patients will interact with NAOMI and provide feedback on their treatment experiences with NAOMI. 

Award number: 1R21NR020388-01A1