Eric Hekler

Eric Hekler
University of California, San Diego | UCSD · Family Medicine and Public Health

PhD Clinical Health Psychology

About

165
Publications
32,461
Reads
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6,231
Citations
Additional affiliations
December 2017 - July 2018
University of California, San Diego
Position
  • Professor (Associate)
September 2011 - present
Arizona State University
Position
  • Professor (Assistant)

Publications

Publications (165)
Article
Background: Human activities have changed the environment so profoundly over the past two centuries that human-induced climate change is now posing serious health-related threats to current and future generations. Rapid action from all scientific fields, including behavioral medicine, is needed to contribute to both mitigation of, and adaption to,...
Article
Full-text available
As food intake patterns become less structured, different methods of dietary assessment may be required to capture frequently omitted snacks, smaller meals, and the time of day when they are consumed. Incorporating sensors that passively and objectively detect eating behavior may assist in capturing these eating occasions into dietary assessment me...
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The study of food consumption, diet, and related concepts is motivated by diverse goals, including understanding why food consumption impacts our health, and why we eat the foods we do. These varied motivations can make it challenging to define and measure consumption, as it can be specified across nearly infinite dimensions—from micronutrients to...
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Background Excess weight gain in young adulthood is associated with future weight gain and increased risk of chronic disease. Although multimodal, technology-based weight-loss interventions have the potential to promote weight loss among young adults, many interventions have limited personalization, and few have been deployed and evaluated for long...
Preprint
BACKGROUND Although it is widely recognized that physical activity is an important determinant of health there is considerable challenge in assessing this complex behavior. Tools for the objective assessment of the frequency, intensity, and duration of physical activity in adults and children have largely been developed for short-term use within re...
Article
Background: Although it is widely recognized that physical activity is an important determinant of health, assessing this complex behavior is a considerable challenge. Objective: The purpose of this systematic review and meta-analysis is to examine, quantify, and report the current state of evidence for the validity of energy expenditure, heart...
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Background and Aims Lapse risk when trying to stop or reduce harmful substance use is idiosyncratic, dynamic and multi-factorial. Just-in-time adaptive interventions (JITAIs) aim to deliver tailored support at moments of need or opportunity. We aimed to synthesise evidence on decision points, tailoring variables, intervention options, decision rule...
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Current research funding models for health psychologists tend to be biased toward support for large-scale ‘definitive’ behavioural trials. This approach emphasizes rigorous tests of one or more key questions, but, unintentionally, may lead to the funding of interventions that are based on myriad untested assumptions. We propose that future funding...
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This paper presents the Experiment in a Box (XB) framework to support interactive technology design for building health skills. The XB provides a suite of experiments—time-limited, loosely structured evaluations of health heuristics for a user-as-experimenter to select from and then test in order to determine that heuristic’s efficacy, and to explo...
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Despite the positive health effect of physical activity, one third of the world’s population is estimated to be insufficiently active. Prior research has mainly investigated physical activity on an aggregate level over short periods of time, e.g., during 3 to 7 days at baseline and a few months later, post-intervention. To develop effective interve...
Preprint
Full-text available
Background: Human activities have changed the biosphere so profoundly over the past two centuries that human-induced climate change is now posing serious health-related treats to the current and future generations. Rapid actions from all scientific fields are needed to contribute to both the mitigation and adaption to climate change. Purpose: This...
Article
Background Behavioral lifestyle intervention (BLI) is recommended as a first-line treatment for obesity. While BLI has been adapted for online delivery to improve potential for dissemination while reducing costs and barriers to access, weight losses are typically inferior to gold standard treatment delivered in-person. It is therefore important to...
Preprint
Full-text available
Despite the positive health effect of physical activity, one third of the world’s population is estimated to be insufficiently active. Prior research has mainly investigated physical activity on an aggregate level over short period of time, e.g., during 3 to 7 days at baseline and few-month later, post intervention. To develop effective interventio...
Article
Full-text available
Objective: Despite evidence that goal setting is valuable for physical activity promotion, recent studies highlighted a potential oversimplification in the application of this behavior change technique. While more difficult performance goals might trigger higher physical activity levels, higher performance goals might concurrently be more difficul...
Preprint
UNSTRUCTURED Digital technologies offer unique opportunities for health research. For example, Twitter posts can support public health surveillance to identify outbreaks (e.g., influenza, COVID-19), and a wearable fitness tracker can provide real-time data collection to assess the effectiveness of a behavior change intervention. With these opportun...
Article
Digital technologies offer unique opportunities for health research. For example, Twitter posts can support public health surveillance to identify outbreaks (eg, influenza and COVID-19), and a wearable fitness tracker can provide real-time data collection to assess the effectiveness of a behavior change intervention. With these opportunities, it is...
Article
The Science of Behavior Change Network (SOBC) offers a pragmatic "experimental medicine" approach for advancing mechanisms of change regarding behavior. The key promise of the SOBC is to facilitate more effective knowledge accumulation about not only whether behavior change occurs in response to an intervention, but also how and why behavior change...
Article
Physical activity is dynamic, complex, and often regulated idiosyncratically. In this paper, we review how techniques used in control systems engineering are being applied to refine physical activity theory and interventions. We hypothesize that person-specific adaptive behavioral interventions grounded in system identification and model predictive...
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Background: Access to digital health technologies is contributing to a paradigm shift where sickcare may become authentic healthcare. Individuals can now access personal health data through wearable sensors, affordable lab screenings, genetic and genomic sequencing, and real-time health tracking apps. Personal health data access creates opportuniti...
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Although group-level evidence supports the use of behavioral interventions to enhance cognitive and emotional well-being, different interventions may be more acceptable or effective for different people. N-of-1 trials are single-patient crossover trials designed to estimate treatment effectiveness in a single patient. We designed a mobile health (m...
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Precision health initiatives aim to progressively move from traditional, group-level approaches to health diagnostics and treatments toward ones that are individualized, contextualized, and timely. This article aims to provide an overview of key methods and approaches that can help facilitate this transition in the health behavior change domain. Th...
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Background In 2015, Collins and Varmus articulated a vision for precision medicine emphasizing molecular characterization of illness to identify actionable biomarkers to support individualized treatment. Researchers have argued for a broader conceptualization, precision health. Precision health is an ambitious conceptualization of health, which inc...
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Digital health promises to increase intervention reach and effectiveness for a range of behavioral health outcomes. Behavioral scientists have a unique opportunity to infuse their expertise in all phases of a digital health intervention, from design to implementation. The aim of this study was to assess behavioral scientists’ interests and needs wi...
Preprint
Objective: Despite evidences that goal setting is valuable for physical activity promotion, recent research pointed out a risk of oversimplification in the application of this behavior change technique. While more difficult goals might trigger higher physical activity levels, higher goals might concurrently be more difficult to achieve, which could...
Article
Full-text available
This study examined the between-person associations of seven health behaviors in adults with obesity participating in a weight loss intervention, as well as the covariations between these behaviors within-individuals across the intervention. The present study included data from a 12-month weight loss trial (N = 278). Seven health behaviors (physica...
Preprint
The purpose of the proposed systematic-review and meta-analysis is to systematically examine, quantify and report the validity of energy expenditure, intensity, heart rate, and steps measured by combined-sensing Fitbits.
Preprint
Full-text available
Background and purpose: Precision health initiatives aim to progressively move from traditional, group-level approaches to health diagnostics and treatments toward ones that are individualized, contextualized and timely. This article aims to provide an overview of key methods and approaches that can help facilitate this transition in the health beh...
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The active involvement of citizen scientists in setting research agendas, partnering with academic investigators to conduct research, analyzing and disseminating results, and implementing learnings from research can improve both processes and outcomes. Adopting a citizen science approach to the practice of precision medicine in clinical care and re...
Conference Paper
Most health tech for daily health and wellbeing is focused on individuals. We know that, with even the best will in the world, trying to practice what we learn in our workplaces, if we are the lone person in our group with that practice, it can be very challenging to sustain that practice. WellComm2019's goal is to explore how we can design interac...
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Background Smartphone apps might enable interventions to increase physical activity, but few randomised trials testing this hypothesis have been done. The MyHeart Counts Cardiovascular Health Study is a longitudinal smartphone-based study with the aim of elucidating the determinants of cardiovascular health. We aimed to investigate the effect of fo...
Preprint
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Full text here: https://osf.io/preprints/sportrxiv/7mcdw This study aims at examine the between-person associations of seven health behaviors in adults with obesity participating in a weight loss intervention; and to compare how these behaviors covary within-individuals across the intervention. The present study included data from a 12-month inter...
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Objective: This pilot study tested a course-based intervention to help people with multiple sclerosis (MS) match their daily activity to symptom severity ("sweet spot") using wearable activity trackers. Methods: This two-phase study recruited online research network members reporting MS and who were utilizing Fitbit One™ activity trackers. In th...
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Background: There is great interest in and excitement about the concept of personalized or precision medicine and, in particular, advancing this vision via various 'big data' efforts. While these methods are necessary, they are insufficient to achieve the full personalized medicine promise. A rigorous, complementary 'small data' paradigm that can...
Conference Paper
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As the DIS community increasingly seeks to address social impact issues, it becomes important to examine the assumptions behind our methods to increase the likelihood of positive effects and reduce negative unintended consequences. The purpose of this workshop is to engage the design community in exploring, defining, and, if deemed valuable, advanc...
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Over the last century, the social and behavioral sciences have accumulated a vast storehouse of knowledge with the potential to transform society and all its constituents. Unfortunately, this knowledge has accumulated in a form (e.g., journal articles) that makes it extremely difficult to search, categorize, analyze and integrate across studies due...
Conference Paper
Self-tracking can help people understand their medical condition and the factors that influence their symptoms. However, it is unclear how tracking technologies should be tailored to help people cope with the progression of a degenerative disease. To understand how smartphone apps and other tracking technologies can support people in coping with an...
Conference Paper
A significant number of young Americans are vulnerable to excess weight gain, especially during the college years. While technology-based weight loss interventions have the potential to be very engaging, short-term approaches showed limited success. In our work we aim to better understand the impact of long-term, multimodal, technology-based weight...
Conference Paper
Inbodied design is an emerging area in HCI that focuses on using knowledge of the body's internal systems and processes to better inform em-bodied and circum-bodied design spaces. The current challenge in developing an inbodied approach to HCI research/design is domain expertise: accessing sufficient and appropriate information about how the body i...
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Since its earliest days, the field of behavioral medicine has leveraged technology to increase the reach and effectiveness of its interventions. Here, we highlight key areas of opportunity and recommend next steps to further advance intervention development, evaluation, and commercialization with a focus on three technologies: mobile applications (...
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System identification approaches have been used to design an experiment, generate data, and estimate dynamical system models for Just Walk, a behavioral intervention intended to increase physical activity in sedentary adults. The estimated models serve a number of important purposes, such as understanding the factors that influence behavior and as...
Article
Mobile health technologies are contributing to the increasing relevance of control engineering principles in understanding and improving health behaviors, such as physical activity. Social cognitive theory (SCT), one of the most influential theories of health behavior, has been used as the conceptual basis for behavioral interventions for smoking c...
Article
Background HeartSteps is an mHealth intervention that encourages regular walking via activity suggestions tailored to the individuals’ current context. Purpose We conducted a micro-randomized trial (MRT) to evaluate the efficacy of HeartSteps’ activity suggestions to optimize the intervention. Methods We conducted a 6-week MRT with 44 adults. Con...
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Transition arenas that do not converge with policy windows to achieve structural or institutional change often fail to achieve their stated transformative goals. For their part, policy windows often lead to only incremental change. On their own, transition management and the multiple streams approach seem inadequate to the challenges facing cities....
Chapter
Control systems engineering is a diverse field that examines how system variables can be adjusted over time to improve targeted outcomes. In recent years, control engineering approaches have shown significant appeal in the optimization phase of the multiphase optimization strategy (MOST). Control engineering can provide the basis for modeling inten...
Article
Background: Adaptive behavioral interventions are individualized interventions that vary support based on a person's evolving needs. Digital technologies enable these adaptive interventions to function at scale. Adaptive interventions show great promise for producing better results compared with static interventions related to health outcomes. Our...
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Adaptive interventions are an emerging class of behavioral interventions that allow for individualized tailoring of intervention components over time to a person’s evolving needs. The purpose of this study was to evaluate an adaptive step goal + reward intervention, grounded in Social Cognitive Theory delivered via a smartphone application (Just Wa...
Article
Background: Control systems engineering methods, particularly, system identification (system ID), offer an idiographic (i.e., person-specific) approach to develop dynamic models of physical activity (PA) that can be used to personalize interventions in a systematic, scalable way. The purpose of this work is to: 1) apply system ID to develop indivi...
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Background: Consumption of fruits and vegetables (F/V) among elementary school-aged children remains inadequate, especially among low-income children. The US Department of Agriculture's Fresh Fruit and Vegetable Program (FFVP) provides F/V as snacks to children during the school day, outside of school meals. School-based initiatives are successful...
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Background: Although current technological advancements have allowed for objective measurements of sedentary behavior via accelerometers, these devices do not provide the contextual information needed to identify targets for behavioral interventions and generate public health guidelines to reduce sedentary behavior. Thus, self-reports still remain...
Chapter
Control systems engineering is a broad-based field that examines how system variables can be adjusted over time to improve important process outcomes. In recent years, control engineering approaches have been proposed as the basis for modeling and optimizing personalized, timevarying interventions in behavioral health. This chapter describes how co...
Chapter
Cyber-physical systems, with their focus on creating closed-loop systems, have transformed a wide range of areas (e.g., flight systems, industrial plants, robotics, etc.). However, even after a century of health research we still lack dynamic computational models of human health and its interactions with the environment, let alone a full closed-loo...
Article
This paper presents the design of system identification experiments for physical activity behavioral interventions, utilizing a control-relevant identification test monitoring approach. The goal is to find, in real-time, the shortest possible experiment with sufficient information for identification meeting robust performance conditions. The proced...
Conference Paper
A system identification approach is used estimate linear time-invariant models from the data of physical activity gathered in the Just Walk intervention conducted by the Designing Health Lab and the Control Systems Laboratory at Arizona State University A class of identification algorithms proposed elsewhere by one of the authors, denoted as MoliZo...
Article
This book will give you a practical overview of several methods and approaches for designing mobile technologies and conducting mobile user research, including how to understand behavior and evaluate how such technologies are being (or may be) used out in the world. Each chapter includes case studies from our own work and highlights advantages, lim...
Conference Paper
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Over the last ten years, HCI researchers have introduced a range of novel ways to support health behavior change, from glanceable displays to sophisticated game dynamics. Yet, this research has not had as much impact as its originality warrants. A key reason for this is that common forms of evaluation used in HCI make it difficult to effectively ac...
Conference Paper
Desirable outcomes such as health are tightly linked to behaviors, thus inspiring research on technologies that support people in changing those behaviors. Many behavior-change technologies are designed by HCI experts but this approach can make it difficult to personalize support to each user's unique goals and needs. This paper reports on the iter...
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A central goal of behavioral medicine is the creation of evidence-based interventions for promoting behavior change. Scientific knowledge about behavior change could be more effectively accumulated using “ontologies.” In information science, an ontology is a systematic method for articulating a “controlled vocabulary” of agreed-upon terms and their...
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As more behavioral health interventions move from traditional to digital platforms, the application of evidence-based theories and techniques may be doubly advantageous. First, it can expedite digital health intervention development, improving efficacy, and increasing reach. Second, moving behavioral health interventions to digital platforms presen...
Article
To the Editor Clinical trials can contribute knowledge about both efficacy and mechanisms of action. Efficacy concerns whether the intervention is “better” than a control, such as standard of care; mechanisms concern how the intervention produces desired outcomes—its hypothesized causal pathways. For pharmacotherapies, after years of bench research...
Chapter
The BehaviorSim Modeling Tool, a behavioral-scientist-facing software for development of Computational Human Behavior Models (CHBMs), has been developed in an effort to close the gap between Just-in-Time Adaptive Intervention researchers and dynamical systems modeling. We present a summary of our iterative methodology for creating the BehaviorSim M...