Spring 2013

Advances in Measuring Behavior

PHTH 5228
Bouvé College of Health Sciences

Credit Hours:

  3 SH

Class Location:

  Ryder Hall 157

Class Time:

  5:00-7:30 PM Wednesdays

First Class:

  Jan 9, 2013
Last Class:    April 17, 2013

Final exam:



  Stephen Intille, Ph.D.


  450 West Village H

Office Hrs:          

  Tue 8:30-9:30, immediately after class, or arranged via email
Email:    ...@neu.edu

Catalog Description:

Offers a survey and project-oriented course examining current and emerging methods of measuring human behavior known to impact human health. Discusses some of the most common instruments used to measure everyday behaviors and considers how emerging technologies may change how these behaviors are measured in the future. Explores the measurement of behaviors such as the following: activities of daily living, dietary decision making, patterns-of-eating behavior, physical activity, sedentary behavior/posture, screen time, activity in the community, social-connectedness, stress and stressful events, affective state, medication adherence, use of alcohol and addictive substances, risky behaviors, and physiological states that can be measured using wearable devices in the field (e.g., heart rate and blood pressure). Prereq. Senior or graduate standing.

Levels: Graduate, Undergraduate
Type: Seminar


No course prerequisites. The tools necessary to develop the project will be made available and described in class, but students do need to be comfortable with basic use of computers and mobile phones and have an interest in using technology for advanced behavioral measurement. Students are not required to know how to program computers, and this course does not require programming expertise.

Course Objectives:

By the conclusion of this course, students will be able to:

Classroom Format: 

Most classes will consist of a short introductory overview lecture on measuring a particular human behavior followed by student presentations on instruments described in the readings. Some classes will be devoted to pilot testing of project ideas using low-fidelity (i.e. paper) prototyping and instruction on how to convert existing surveys to run on mobile phones (using off-the-shelf ecological momentary assessment software). Weekly readings consist of research articles.

For each topic area, students will (1) learn why measuring the behavior is important for public health, (2) read and discuss research papers on measuring these behaviors and the design, validation, and use of 2-3 surveys/instruments commonly used in recent research, (3) read and discuss 1-3 research papers measuring the same behavior using an emerging technology, and (4) explore how the measurement of the behavior might be improved in the future. Some classes may include guest visits by researchers in the Boston-area who have used or developed specific instruments. Coursework will consist of presentations on reading material, short assignments identifying and organizing research papers on measurement of particular behaviors, a paper assignment comparing and contrasting existing measures for a behavior and describing and critiquing a new technology to measure a particular behavior, and a project where students convert an existing paper-based measure to run on mobile phones using experience sampling and then conduct a small-scale feasibility test of the device.

Required and Optional Texts:

This course has a moderate but steady reading load with an average of 5-8 research papers per week. Readings will be available online. Those that are not will be distributed in class or available in a course reader.

Additional Materials: 

None required. Phones will be provided for testing the projects as needed.

Course Schedule/Outline:

For each topic, 4-6 recent research papers will be selected in consultation with experts on the particular behavior being discussed. Some papers will describe some of the most common surveys/technologies used to measure the behavior today, and others will describe prototypes of emerging technologies that may change how the behavior is measured in the future. Readings will be refined based upon the interests of students in the course.



Readings Due
(Beginning of class)

Assignments Due
(Beginning of class)

Wed 1/9/13

Introduction to the course; Why measure behavior?


Designing surveys/instruments and issues to consider

Wed 1/16/13
(or special day/time)

Emerging technologies (Electronic EMA, sensors, CS-EMA, CAT)

Booth, 1977, A short history of blood pressure measurement

Stone, Shiffman, et al., 2002, Patient non-compliance with paper diaries

Smyth and Stone, 2003, Ecological Momentary Assessment research in behavioral medicine

S. S. Intille, Technological innovations enabling automatic, context-sensitive ecological momentary assessment

Rappaport and Smith, 2010, Environment and disease risks

Kix, 2011, Something in the water

Chapter selection from Duhigg, The Power of Habit: Why We Do What We Do in Life and Business

Responses to survey email 

Common Data Elements Toolkits

Hamilton et al., 2011, The PhenX Toolkit: Get the Most From Your Measures

PhenX Demographic surveys

PhenX Anthrometric surveys

Skim: PhenX Toolkit

Skim: GEM

Skim: CDE

Wed 1/23/13

Introduction to paper prototyping

Rettig, 1994, Prototyping with Tiny Fingers

Clark, 2010, TapWorthy Chapter 3

Colborn, 2011, Simple and Usable Displace, Hide, Organize, and Remove Chapters

Experience sampling on phones: nuts and bolts

Hartung et al., 2010, Open Data Kit: Tools to Build Information Services for Developing Regions

Froehlich et al., 2007, MyExperience: A System for In Situ Tracing and Capturing of User Feedback on Mobile Phones

Hicks et al, 2010, AndWellness: an open mobile system for activity and experience sampling (ACM Digital Library)

Gerken et al., 2010, Pocket Bee

Websites to skim over:
MobXamp, MyExperience, ESP, Affect-Sampler, AndWellness, UrbanSensing, T2 Mood Tracker, invivodata, OpenDataKit, PRIMIExperience, CAESSA,

Mon 1/28/13    

Wed 1/30/13

In-class paper prototyping design exercise

Tierney, 2011, Do you Suffer from Decision Fatigue? (on blackboard)



Be prepared to develop a paper prototype for a survey

Wed 2/6/13

Measuring activities of daily living (ADLs, iADLs)  

Sikkes et al., 2011, A systematic review of Instrumental Activities of Daily Living scales in dementia: room for improvement

Boissy et al., 2007, The eSMAF: a software for the assessment and follow-up of functional autonomy in geriatrics (on blackboard)

Le et al., 2008, Health Smart Home for elders – A tool for automatic recognition of activities of daily living

Optional: Zingmond et al., 2011, Association of Claims-based Quality of Care Measures With Outcomes Among Community-dwelling Vulnerable Elders (NU Libraries Web of Knowledge and on blackboard)

Research assignment #1 due


Project planning discussion


Wed 2/13/13

Measuring diet

Thompson and Subar, Dietary Assessment Methodology (On Blackboard)

Boushey et al., Use of technology in children's assessment

Research Assignment #2 due


Measuring eating behaviors and decision making

Amft and Troster, 2008, Recognition of dietary activity events using on-body sensors (skim)

Van't Riet et al., The importance of habits in eating behaviour. An overview and recommendations for future research (On Blackboard)

Wed 2/20/13

Measuring physical activity/exercise

van Poppel et al., 2010, Physical Activity Questionnaires
for Adults: A Systematic Review of Measurement Properties (On Blackboard)

Ainsworth, 2008, How Do I Measure Physical Activity in my Patients? (On Blackboard)

Tudor-Locke et al., 2011, Pedometry Methods for Assessing Free-Living Adults (On Blackboard)


Research assignment #3 due



Measuring sedentary behavior/posture

Healy et al., 2011, Measurement of Adults’ Sedentary Time in Population-Based Studies (On Blackboard)

Kozey-Keadle et al., 2011, Validation of Wearable Monitors for Assessing Sedentary Behavior (On Blackboard)


Wed 2/27/13

Introduction to item response theory

Pilkonis et al., 2011, Item banks for measuring emotional distress from the Patient-Reported Outcomes Measurement Information System (PROMIS): Depression, anxiety, and anger

Baylor et al., 2011, An introduction to item response theory and rash models for speech-language pathologists


Measuring sleep

Buysse et al., 1898, The Pittsburgh Sleep Quality Index: A New Instrument for Psychiatric Practice and Research

Johns, 1991, A new method for measuring daytime sleepiness: The Epworth Sleepiness Scale

Van De Water et al, 2011, Objective measurements of sleep for non-laboratory settings as alternatives to polysomnography – a systematic review (On Blackboard)

Lockley et al., 1999, Comparison between subjective and actigraphic measurement of sleep and sleep rhythms (On Blackboard)

How I Achieved Better Sleep

McCrae et al., 2005, Sleep Complaints, Subjective and Objective Sleep Patterns, Health, Psychological Adjustment, and Daytime Functioning in Community-Dwelling Older Adults (On Blackboard)

Wed 3/6/13

Spring Break - No Class

Wed 3/13/13

Measuring screen time (TV, computer, video games) and exposure to media

Bryant et al., 2006, Measurement of television viewing in children and adolescents: a systematic review (On Blackboard)

Potter, 2008, The Importance of Considering Exposure States When Designing Survey Research Studies (On Blackboard)

Info on the Portable People Meter: Article1 and Article2

Evans and Wobbrock, 2011, Input Observer: Measuring Text Entry and Pointing Performance from Naturalistic Everyday Computer Use

Optional: Steeves et al., 2012, A Review of Different Behavior Modification Strategies Designed to Reduce Sedentary Screen Behaviors in Children (On Blackboard)

Optional: Jennes and Pierson, 2011, Audience Measurement and Digitalisation: Digital TV and Internet (On Blackboard)

Paper comparing and contrasting existing measures for a behavior and describing and critiquing a new technology to measure a particular behavior (Deadline extended to Sat 3/16 by end of Day)

Measuring activity in the community (i.e. use transportation, context) ; Measuring social-connectedness/social-interaction/isolation


Eagle et al, 2009, Inferring friendship network structure by using mobile phone data

Wed 3/20/13

Measuring risky behaviors (i.e., driving, home safety)


Naito et al., 2010, A Browsing and Retrieval System for Driving Data (Blackboard)


Project idea

Updates on project progress


Wed 3/27/13

Measuring stress, stressful events, and stress management; Measuring affective state

Measuring use of alcohol and addictive substances

Wilhelm and Grossman, 2010, Emotions beyond the laboratory: Theoretical fundaments, study design, and analytic strategies for advanced ambulatory assessment (Blackboard)

Optional: Goodwin, Velicer, and Intille, 2008, Telemetric monitoring in the behavior sciences (Blackboard)

Optional: Killingsworth and Gilbert, 2010, A Wandering Mind is an Unhappy Mind (Blackboard)

Optional: Cranford et al., 2006, A Procedure for Evaluating Sensitivity to Within-Person Change: Can Mood Measures in Diary Studies Detect Change Reliably?


Measuring physiological state (HR, blood pressure, GSR)

Wed 4/3/13 Measuring medication adherence

Farmer, 1999, Methods for Measuring and Monitoring Medication Regimen Adherence in Clinical Trials and Clinical Practice (Blackboard)


Wed 4/10/13 Project presentations
(Note: depending on the number of people in the course, it may be necessary to slightly extend the length of the final class)
None Final presentation due

Wed 4/17/13

No class


Final project design and and paper revision due

Course subject content is tentative and may change during the semester.  Students will be notified of such changes.

Grading Procedures and Criteria:

Prior experience suggests that work in this course will generally fall into one of four categories:

Course work falling into these categories correspond roughly to A, B, C, and D grades. The final grade for the course will be computed by weighting the results from each assignment according to the following formula:  

Research assignments
Students will identify a health-related behavior or state and develop an annotated bibliography tracing the the history of measurment of the behavior and identifying the major methods of measurement used today and potentially used in the future. The assignments will be evaluated based on thoroughness of the research and organization of the information acquired.

Class presentations 
Students will makepresentations on the behavior measurement methods or technology described in the readings. Students will be provided with a template for the presentations using a variation of the Pecha Kucha format, which keeps presentations concise (6.5 minutes). Students will be expected to have practiced the presentation in advance. Presentations will be graded on adherence to the format and overall presentation clarity, as well as demonstration by the student of a thorough understanding of the topic being discussed and ability to launch a class discussion about the material. In a small class, students will present most classes. Presentations will be less frequent if more students enroll.

Class reading quizzes and engagement
At the start of some classes a small 5-10 question quiz will be given. Students who have done the reading will find the questions easy. All students are expected to have completed all assigned readings prior to each class. Actively engaging in verbal exchanges of ideas and concepts will be a major component of learning in this course. This will be stimulated by readings and class presentations and discussions. Therefore everyone will be expected to actively and positively listen to others and to communicate their ideas during class. Some students are less comfortable speaking in class than others, but open discussion of ideas and even disagreement is essential.  Therefore, all students are expected to read course materials prior to class and will be called upon at times even if they do not raise their hands. Participation does not result from talking a lot, but as a result of critical thinking and articulation of ideas.

Compare/contrast and comparision to a new measurement technology paper
Students will write an 8 page paper (CHI format) comparing and contrasting two or more of the most common methods of measuring one particular behavior, and then describe an emerging technology for measurement of the behavior that may change how the behavior is measured in the future. The paper should include references to relevant scientific literature and a description of the pros/cons of the new technology relevant to the older methods, where the paper teaches the reader how the new technology works. The paper should discuss how both the old and new methods have (or will or could be) validated. The paper will be evaluated on how well the project shows that the student has mastered and can creatively apply the topics in the course, as well as clarity, grammar, spelling, attention to detail, and overall organization.

Final project design, presentation, and revised final paper
To gain experience using an emerging behavioral measurement technology, students will develop the questions/script for an ecological momentary assessment (EMA) behavioral measurement technology and gain some experience field testing the feasibility of such technology. Students will be taught how to develop new surveys that can be run on mobile phones using existing EMA software. This does not require programming ability, but does require attention to detail and careful iterative testing and refinement. Students will then gather feedback on the feasibility of the new instrument they have created by running it on themselves and, possibly, their classmates. This exercise will provide students with practical experiences that they may find useful in the future as behavioral assessment moves increasingly toward use of mobile devices. Students will revise their paper, adding an appendix that describes the EMA design's strengths and limitations and the student's experience testing. At the end of the term students will present their EMA design in class. Students will be provided with a template for the presentations and will be expected to have practiced the presentation in advance. Presentations will be graded on adherence to the format and overall presentation clarity, as well as demonstration by the student of a thorough understanding of the topic being discussed.

Note: Students with technical backgrounds, such as MS Health Informatics students, will have the option of developing a more advanced behavioral measurement system in lieu of the course paper requirement.  

Classroom Policies:

Students are expected to demonstrate qualities of academic integrity: a commitment, even in the face of adversity, to five fundamental values:  honesty, trust, fairness, respect and responsibility.  
University policy dictates that students must seek the instructor’s permission to tape record class lectures.  I will always allow the use of tape recorders to support your learning.

To facilitate discussion and learning, electronic devices must be turned off in class, including laptops, tablets, and phones. Slides shown in class will be available on the course website after each class. 

Despite the dinner time meeting time of our class, students should not eat in class out of respect for others.

Writing/Presentation Policies:

Assignments that involve writing and presentation will be judged on clarity of presentation as well as content. Students who are having difficulty with writing will be referred to the Northeastern University Writing Center.

Late Policy:

Prior to an assignment due date, a student may request an extension for extenuating circumstances.  It is the discretion of the instructor to permit late assignments.  Unexcused late assignments will be subject to a reduction of one half letter grade for every two days late.

Academic Honesty:

All students are expected and encouraged to discuss the topics raised by this course with each other. Ideas incorporated from an outside source or another student must be documented appropriately in write-ups or presentations.  Students must abide by the NU Code of Student Conduct and Academic Integrity Policy. Acts of academic dishonesty will be referred to the Office of Student Conduct and Conflict Resolution.

Academic honesty is fundamental to the learning process. As a reminder,  

Any student found cheating on an assignment will receive a zero on that assignment.  A second offense will result in a failing grade for the entire course.


Students who have a disability are encouraged to seek accommodations though the University Disability Resource Center and to speak privately with the instructor about needs for accommodations and strategies to support success. This information will be kept confidential.

Course Evaluations and Trace:

The instructor will distribute optional mid-term and final course evaluations, to be returned anonymously. Responses to the questions help to improve this course during the current semester and for future students.

All students are also strongly encouraged to use the TRACE (Teacher Rating and Course Evaluation) system near the end of the course to evaluate this course. An reminder about TRACE should arrive via email about two weeks before the end of the course.