Research Appraisalother

Multimodal Sentiment and Emotion Analysis Framework for Personalized Health Coaching Messages: Proof-of-Concept Study

JMIR formative researchMd Zuki, Muhammad Aiman, Mohamad Ali, Nazlena, Chaw, Jun Kit21 Apr 2026DOI

Clinical Snapshot

35CEBM
Evidence: Weakother

PICO Framework

P — PopulationSynthetically generated health coaching messages using GPT-2
I — InterventionMultimodal sentiment and emotion analysis framework combining VADER, TextBlob, Text2Emotion, and NRCLex
C — ComparatorDifferent natural language processing tools (lexicon-based vs transformer-based approaches)
O — OutcomesAccuracy of sentiment analysis and emotion detection across different persuasive message types (reminder, reward, suggestion, praise)

Bottom Line

This proof-of-concept study presents a methodological framework for analyzing sentiment and emotion in health coaching messages using multiple natural language processing tools. While RoBERTa-sentiment demonstrated superior accuracy (88%) compared to lexicon-based approaches, the study's reliance on synthetically generated data significantly limits its clinical relevance. The authors appropriately acknowledge that findings require validation with real-world health coaching messages before clinical deployment. For Australian clinicians considering digital health coaching tools, this research provides useful technical insights but cannot inform clinical decision-making without further validation studies using authentic patient-provider communications. The framework may have utility for health informatics researchers developing communication analysis tools, but clinical implementation would require substantial additional evidence including patient outcome validation and cost-effectiveness analysis.

Evidence: Weak

Key Findings

  • P Value: Not reported

  • Effect Size: RoBERTa-sentiment achieved 88% accuracy vs VADER 69% and TextBlob 57%

  • Primary Outcome: Sentiment analysis accuracy comparison across different NLP tools

  • Nnt Or Sensitivity: Emotion detection showed 93.69% positive skew toward joy/happy labels; trust category precision 0.81-0.96

  • Confidence Interval: Not reported

Clinical Application

Technical framework appears feasible but implementation challenges not addressed No specific relevance to Australian healthcare systems, PBS, or TGA considerations discussed; would require local validation studies Limited applicability due to synthetic data; requires validation in real clinical populations receiving health coaching

Abstract

BACKGROUND: Text generation approaches in health care communication have evolved along 2 major paths. The first path involves generative adversarial networks, progressing from basic architectures to specialized variants like Text-to-Text Generative Adversarial Network (TT-GAN) and Time and Frequency Domain-Based Generative Adversarial Network (TF-GAN), which address challenges in discrete text generation through techniques such as Gumbel-Softmax and reinforcement learning. The second path emerges from transformer-based architectures, particularly Generative Pretrained Transformer-2 (GPT-2), which uses extensive pretraining and self-attention mechanisms to generate contextually appropriate text. GPT-2's transformer architecture enhances persuasive health communication by generating personalized messages using various strategies like task support, dialogue support, and social support for effective health interventions. OBJECTIVE: This study aimed to use GPT-2 as a generative method to construct persuasive text in a dataset and compare the performance of sentiment analysis and emotion detection analysis. METHODS: We combined sentiment analysis tools (VADER [Valence Aware Dictionary and Sentiment Reasoner] and TextBlob) with emotion detection methods (Text2Emotion and NRCLex [National Research Council Lexicon]) to analyze health coaching messages across different persuasive types: reminder, reward, suggestion, and praise. RESULTS: TextBlob and VADER achieved accuracies of 57% and 69%, respectively, while RoBERTa (robustly optimized BERT approach)-sentiment outperformed them with an accuracy of 88%. Emotion detection showed a high prevalence of "joy" and "happy" labels (93.69% positive skew). While transformers excel in accuracy, lexicon-based models like VADER offer a better performance-efficiency balance for real-time health communication systems. For emotion detection, all categories showed perfect accuracy (1.0), while trust showed mixed results, with precision, recall, and F1-score values ranging from 0.81 to 0.96. The emotion detection analysis revealed varying success rates across different emotions, with some categories, such as anger and neutral, showing reasonable performance and others, such as trust, showing mixed performance. CONCLUSIONS: This research contributes to understanding the emotional dynamics of persuasive health communication and highlights both the capabilities and limitations of current natural language processing tools in analyzing health-related persuasive messaging. This proof-of-concept study using synthetically generated data establishes a methodological framework for multimodal sentiment and emotion analysis. The findings require validation with real-world health coaching messages before clinical deployment.

References

  1. 1.Zuki, M. A., Ali, N. M., & Chaw, J. K. (2026). Multimodal sentiment and emotion analysis framework for personalized health coaching messages: Proof-of-concept study. JMIR Formative Research. https://doi.org/10.2196/79558
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