{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:54:31Z","timestamp":1760147671149,"version":"build-2065373602"},"reference-count":129,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2023,2,16]],"date-time":"2023-02-16T00:00:00Z","timestamp":1676505600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Boston Roybal Center for Active Lifestyle Interventions (RALI Boston), sponsored by the National Institutes on Aging","award":["P30 AG048785"],"award-info":[{"award-number":["P30 AG048785"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Sensors"],"abstract":"<jats:p>Supervised personal training is most effective in improving the health effects of exercise in older adults. Yet, low frequency (60 min, 1\u20133 sessions\/week) of trainer contact limits influence on behavior change outside sessions. Strategies to extend the effect of trainer contact outside of supervision and that integrate meaningful and intelligent two-way communication to provide complex and interactive problem solving may motivate older adults to \u201cmove more and sit less\u201d and sustain positive behaviors to further improve health. This paper describes the experimental protocol of a 16-week pilot RCT (N = 46) that tests the impact of supplementing supervised exercise (i.e., control) with a technology-based behavior-aware text-based virtual \u201cCompanion\u201d that integrates a human-in-the-loop approach with wirelessly transmitted sensor-based activity measurement to deliver behavior change strategies using socially engaging, contextually salient, and tailored text message conversations in near-real-time. Primary outcomes are total-daily and patterns of habitual physical behaviors after 16 and 24 weeks. Exploratory analyses aim to understand Companion\u2019s longitudinal behavior effects, its user engagement and relationship to behavior, and changes in cardiometabolic and cognitive outcomes. Our findings may allow the development of a more scalable hybrid AI Companion to impact the ever-growing public health epidemic of sedentariness contributing to poor health outcomes, reduced quality of life, and early death.<\/jats:p>","DOI":"10.3390\/s23042221","type":"journal-article","created":{"date-parts":[[2023,2,16]],"date-time":"2023-02-16T04:01:52Z","timestamp":1676520112000},"page":"2221","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Companion: A Pilot Randomized Clinical Trial to Test an Integrated Two-Way Communication and Near-Real-Time Sensing System for Detecting and Modifying Daily Inactivity among Adults &gt;60 Years\u2014Design and Protocol"],"prefix":"10.3390","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1719-9955","authenticated-orcid":false,"given":"Diego","family":"Arguello","sequence":"first","affiliation":[{"name":"Bouv\u00e9 College of Health Sciences, Northeastern University, Boston, MA 02115, USA"}]},{"given":"Ethan","family":"Rogers","sequence":"additional","affiliation":[{"name":"Bouv\u00e9 College of Health Sciences, Northeastern University, Boston, MA 02115, USA"}]},{"given":"Grant H.","family":"Denmark","sequence":"additional","affiliation":[{"name":"Philadelphia College of Osteopathic Medicine, Philadelphia, PA 19131, USA"}]},{"given":"James","family":"Lena","sequence":"additional","affiliation":[{"name":"Manning College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA 02125, USA"}]},{"given":"Troy","family":"Goodro","sequence":"additional","affiliation":[{"name":"Manning College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA 02125, USA"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3404-4656","authenticated-orcid":false,"given":"Quinn","family":"Anderson-Song","sequence":"additional","affiliation":[{"name":"Bouv\u00e9 College of Health Sciences, Northeastern University, Boston, MA 02115, USA"}]},{"given":"Gregory","family":"Cloutier","sequence":"additional","affiliation":[{"name":"Bouv\u00e9 College of Health Sciences, Northeastern University, Boston, MA 02115, USA"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3722-5612","authenticated-orcid":false,"given":"Charles H.","family":"Hillman","sequence":"additional","affiliation":[{"name":"Bouv\u00e9 College of Health Sciences, Northeastern University, Boston, MA 02115, USA"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5870-2724","authenticated-orcid":false,"given":"Arthur F.","family":"Kramer","sequence":"additional","affiliation":[{"name":"College of Science, Northeastern University, Boston, MA 02115, USA"},{"name":"Beckman Institute, University of Illinois, Urbana, IL 61801, USA"}]},{"given":"Carmen","family":"Castaneda-Sceppa","sequence":"additional","affiliation":[{"name":"Bouv\u00e9 College of Health Sciences, Northeastern University, Boston, MA 02115, USA"}]},{"given":"Dinesh","family":"John","sequence":"additional","affiliation":[{"name":"Bouv\u00e9 College of Health Sciences, Northeastern University, Boston, MA 02115, USA"}]}],"member":"1968","published-online":{"date-parts":[[2023,2,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1016\/j.socscimed.2016.04.006","article-title":"The acceptability of physical activity interventions to older adults: A systematic review and meta-synthesis","volume":"158","author":"Powell","year":"2016","journal-title":"Soc. 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