Establishing an Artificially Intelligent Framework for Improving Therapeutic Alliance with Obese African American Youth and Caregivers through Multimodal Monitoring of Empathetic Accuracy and Interper

建立人工智能框架，通过共情准确性和 Interper 的多模式监测来改善肥胖非裔美国青年和护理人员的治疗联盟

• 批准号: 10595321
• 负责人: PHILLIPPE Belton CUNNINGHAM
• 金额: $ 59.74万
• 依托单位: MEDICAL UNIVERSITY OF SOUTH CAROLINA
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-26 至 2027-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10595321
• 关键词: Accounting; Address; Adolescent; Affect; African American; African American population; Age; Agreement; American; Applied Research; Artificial Intelligence; Basic Science; Behavior; Behavior Therapy; Caregivers; Classification; Client; Clinical; Clinical Skills; Clinical Trials; Community Health Aides; Competence; Cultural Backgrounds; Data; Deterioration; Development; Diabetes Mellitus; Dropout; Effectiveness; Elements; Emotional Bonds; Empathy; Ensure; Ethnic group; Evidence based treatment; Family; Feedback; Future; Galvanic Skin Response; Gender; Geographic Locations; Goals; Health; Health Promotion; Health behavior change; Heart Rate; Influentials; Interpersonal Relations; Intervention Trial; Laboratories; Link; Maintenance; Measures; Mediating; Methodology; Minority Groups; Modeling; Monitor; Natural Language Processing; Not Hispanic or Latino; Obesity; Outcome; Patient Self-Report; Personality; Physiological; Physiology; Population; Process; Process Assessment; Provider; Psychotherapy; Public Health; Race; Religion; Research; Research Design; Role; Rupture; Science; Scientist; Services; Sex Orientation; Signal Transduction; Therapeutic; Time; Time Series Analysis; Training; Treatment outcome; Voice; Wireless Technology; Work; Youth; analytical tool; base; behavior change; biopsychosocial; clinical encounter; clinical translation; cultural values; design; ethnic minority; ethnic minority population; heart rate variability; improved; innovation; machine learning model; minority children; multimodal data; multimodality; obesity treatment; practice setting; premature; primary caregiver; programs; racial and ethnic; randomized trial; recruit; repaired; response; skills; therapeutic development; therapy outcome; wearable device; wearable sensor technology

PROJECT SUMMARY/ABSTRACT. Obesity is a significant public health concern among all racial/ethnic groups, ages, gender, and geographic areas, but some groups are more disproportionately affected than others. Ethnic minority adolescents, especially AAs, are disproportionately likely to be obese relative to non-Hispanic White adolescents. The proposed study is designed to improve a comprehensive multicomponent family- based behavioral intervention (FIT Families) delivered by Community Health Workers (CHWs; therapists) for African American (AA) adolescents with obesity (AAAO). This application expands a program of research that has followed the Obesity Related Behavioral Intervention Trials (ORBIT) for developing behavioral treatments, by capitalizing on our recent work using innovative machine-learning (ML) models to thoroughly examine within-session therapy processes, specifically the role of CHW empathy in the development and maintenance of the therapeutic alliance (TA) while treating AAAO and their primary caregivers. TA is considered an essential element of therapy. The TA is composed of three features: 1. Emotional bond between therapist and client; 2. Agreement between the client and therapist on the goals of treatment; and 3. Agreement on the tasks of therapy. TA is a dynamic, bidirectional, and synergistic element of therapy with implications across differences in race, age, and gender of the client and therapist. Therapist empathy is critical in establishing and maintaining a strong TA, with outcomes mediated by the therapeutic alliance. Empathy accounts for more variance in therapy outcome than specific interventions and consistently predicts client change. Unfortunately, analysis of crucial facilitative interpersonal skills such as therapist empathy is technically challenging as the intent of another's behavior is nuanced, contextual (e.g., therapists and client differ in personality, background, cultural values, etc.), and interactive (bidirectional and synergistic); and can be expressed in multiple ways (voice tone, physiology]). To better understand empathy, especially in a cross-race context, requires empirical approaches and analytical tools that can discern empathetic behaviors in actual clinical encounters that produce behavior change. We will operationalize empathy through two measures that are each associated with empathy and treatment outcomes: 1) Empathic accuracy, defined as the CHW's accurate understanding of the client's state; and 2) Interpersonal physiological synchrony (IPS), defined as the correlation between therapist and client IPS over time (i.e., heart rate [HR], HR variability, galvanic skin response, voice features). This study uses these two empathy measures to understand the relationship between empathy, therapeutic alliance, and treatment outcomes. Further, the study will explore how empathy effects change based on the race and gender concordance/discordance of therapist-client dyads. Toward future clinical translation, the audio and physiological data collected will be used to build a M-L classification model for differing degrees of empathy. This model could then be used to provide real-time feedback for therapists training to improve their empathic responses.

项目摘要/摘要。肥胖是所有种族/种族的重要公共卫生关注 群体，年龄，性别和地理区域，但有些群体比其他群体更受影响。相对于非西班牙裔白人青少年，少数族裔青少年，尤其是AA的青少年，可能是肥胖的。拟议的研究旨在改善社区卫生工作者（CHWS；治疗师）为非裔美国人（AA）青少年提供的全面多组分家庭行为干预（适合家庭）。该应用程序扩展了一项研究计划，该计划遵循与肥胖相关的行为干预试验（Orbit）进行行为治疗，通过利用我们最近使用创新的机器学习（ML）模型来彻底检查课程内治疗过程的工作，特别是CHW促进性在治疗联盟的发展和维持中的作用（TAAAAO），尤其是CHW移情在治疗中的发展和维护，尤其是chw促进症的作用。 TA被认为是治疗的基本要素。 TA由三个特征组成：1。治疗师和客户之间的情感联系； 2。就治疗目标就客户与治疗师之间的协议；和3。就治疗任务达成协议。 TA是治疗的动态，双向和协同元素，在客户和治疗师的种族，年龄和性别差异之间具有影响。治疗师的同理心对于建立和维持强大的TA至关重要，其结果是由治疗联盟介导的。同理心解释了治疗结果的差异，而不是特定的干预措施，并始终如一地预测客户的变化。不幸的是，由于他人行为的意图是细微的，上下文的（例如，治疗师和客户的个性，背景，文化价值等）和互动性（双向和协调性），对关键的促进人际技能（例如治疗师同理心）在技术上在技术上具有挑战性的分析在技术上是具有挑战性的；并且可以通过多种方式（语音，生理学）表达）。为了更好地理解同理心，尤其是在跨越环境中，需要经验方法和分析工具，这些工具可以辨别出产生行为变化的实际临床遭遇中的同情行为。我们将通过两种与同理心和治疗结果相关的措施来实现同理心：1）移情精度，定义为CHW对客户状态的准确理解； 2）人际生理同步（IPS），定义为随着时间的流逝，治疗师和客户IP之间的相关性（即心率[HR]，人力资源变异性，电力皮肤反应，语音特征）。这项研究采用了这两种移情措施来了解同理心，治疗联盟和治疗结果之间的关系。此外，该研究将根据治疗师 - 客户 - 客户二元组的种族和性别一致性/不一致的同情影响如何变化。为了将来的临床翻译，收集的音频和生理数据将用于建立一个M-L分类模型，以不同程度的移情程度。然后，该模型可用于为治疗师培训提供实时反馈，以改善他们的移情反应。