DEVELOPMENT OF AN ANDROID BASED PERFORMANCE ASSESSMENT SYSTEM FOR MOTIVATIONAL INTERVIEWING TRAINING A thesis submitted in partial fulfillment of the requirements for the degree of Master of Science By SOWMYA PAPPU B.Tech, Andhra University, 2013 2017 Wright State University WRIGHT STATE UNIVERSITY GRADUATE SCHOOL May 3, 2017 I HEREBY RECOMMEND THAT THE THESIS PREPARED UNDER MY SUPERVISION BY Sowmya Pappu ENTITLED Development Of An Android Based Performance Assessment System For Motivational Interviewing Training BE ACCEPTED IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF Master of Science. Yong Pei, Ph.D. Thesis Director Mateen M. Rizki, Ph.D. Chair, Department of Computer Science Committee on Final Examination Yong Pei, Ph.D. Mateen M. Rizki, Ph.D. Dean A. Bricker, M.D. Paul Bender, Ph.D. Robert E. W. Fyffe, Ph.D. Vice President for Research and Dean of the Graduate School ABSTRACT Pappu, Sowmya. M.S. Department of Computer Science, Wright State University, 2017. Development of an Android Based Performance Assessment System for Motivational Interviewing Training Motivational Interviewing (MI) has been proved to be an effective Screening, Brief Intervention, and Referral to Treatment (SBIRT) technique. It is an evidence-based practice used to identify, reduce, and prevent problematic use, abuse, and dependence on alcohol and illicit drugs. It emphasizes on patient-centered counseling approach that can help resolve their ambivalence through a non-confrontational, goal-oriented style for eliciting behavior change from the patient, almost like patients talk themselves into change. This approach provokes less resistance and stimulates the progress of patients at their own pace towards deciding about planning, making and sustaining positive behavioral change. Thus, training medical professionals to provide supportive care and adapt MI techniques plays a major role in not only improving their skills but also has follow-on impacts for patients to a large extent. The training, such as workshops (Role-plays and videos), help professionals learn about MI to improve the quality and effectiveness of counseling and consultations with patients. In this thesis research, we have developed an android based performance assessment system to assist the MI training by providing objective assessment and instantaneous feedback to the trainee about his or her performance and progress through iii the training sessions. It also provides the trainers with evidence to develop individually customized training sessions to address the specific needs of each trainee in order to achieve improved outcome from the training. In our prototype design, we have explored the use of automatic speech recognition, grammar-based MI analysis in a mobile/cloud hybrid solution. Particularly, we have extended the Android’s voice command interface to support the automatic scripting of a long-time conversation. Furthermore, we have assembled a user-friendly system which only uses smartphone/tablet and can be easily used by professionals without hassle. Through our experimental studies, our system has demonstrated sufficient accuracy and robustness to distinct between a good and bad interview, and has potential to grow into an effective assessment tool for MI training and practice. iv TABLE OF CONTENTS Page CHAPTER 1 ....................................................................................................................... 1 1.1 Introduction ............................................................................................................... 1 1.2 History of motivational interviewing ........................................................................ 2 1.3 When is motivational interviewing used? ................................................................. 4 1.4 Principles of motivational interviewing .................................................................... 5 1.5 Stages of change ....................................................................................................... 6 1.6 What is the difference between a good and a bad interview? ................................... 7 1.6.1 An example of a good interview ........................................................................ 9 1.6.2 An example of a bad interview ........................................................................ 13 1.7 Why do we need to train doctors for motivational interviewing? .......................... 16 1.8 What is the need of developing an android application? ........................................ 17 CHAPTER 2 ..................................................................................................................... 19 2.1 What is Speech Recognition? ................................................................................. 19 2.2 How it works? ......................................................................................................... 19 2.3 Applications of Speech Recognition ....................................................................... 21 2.4 Difference between Speech Recognition and Voice Recognition .......................... 21 v TABLE OF CONTENTS (Continued) 2.5 Overview about the different Speech Recognition Systems ................................... 22 2.6 Limitations of Speech Recognition ......................................................................... 26 2.7 What is an Application Programming Interface (API)? ......................................... 26 2.7.1 Android Speech Recognition API .................................................................... 27 2.7.2 Google Cloud Speech API ............................................................................... 28 2.7.3 IBM Watson Speech Recognition API ............................................................ 28 CHAPTER 3 ..................................................................................................................... 30 3.1 About Android Lifecycle Methods ......................................................................... 30 3.2 About Android Studio ............................................................................................. 32 3.3 Android Speech Recognition API in detail ............................................................. 33 3.4 Improving the system design from a question to a lengthy conversation ............... 38 3.5 Design implemented for supporting Voice Recognition (Two-device design) ...... 41 3.6 Improving the efficiency of the System Design ..................................................... 44 CHAPTER 4 ..................................................................................................................... 49 4.1 Interview Analysis .................................................................................................. 49 CHAPTER 5 ..................................................................................................................... 55 Experimental results...................................................................................................... 55 vi TABLE OF CONTENTS (Continued) CHAPTER 6 ..................................................................................................................... 93 Conclusion .................................................................................................................... 93 Future works ................................................................................................................. 94 REFERENCES ................................................................................................................. 95 vii LIST OF FIGURES Page Figure 1: General Scenario at an interview ......................................................................... 2 Figure 2: William Richard Miller and Stephen Rollnick (Co-founders of MI) .................. 4 Figure 3: Different types of counselling issues ................................................................... 4 Figure 4: Different stages of change ................................................................................... 6 Figure 5: Example of a good interview............................................................................... 9 Figure 6: Example of a bad interview ............................................................................... 13 Figure 7: Scenario at workshops for training doctors for MI ........................................... 17 Figure 8: Feasibility in using mobile applications ............................................................ 18 Figure 9: Speech to text conversion .................................................................................. 19 Figure 10: Speech to text conversion process ................................................................... 20 Figure 11: Baidu Speech Recognition System.................................................................. 22 Figure 12: Hound Speech Recognition System ................................................................ 23 Figure 13: Siri Speech Recognition System ..................................................................... 23 Figure 14: Google Now Speech Recognition System....................................................... 24 Figure 15: wit.ai Speech Recognition System .................................................................. 24 Figure 16: Cortana Speech Recognition System .............................................................. 25 Figure 17: Alexa Speech Recognition System .................................................................