CALLM: Understanding Cancer Survivors' Emotions and Intervention Opportunities via Mobile Diaries and Context-Aware Language Models

Abstract

Cancer survivors face unique emotional challenges that impact their quality of life. Mobile diary entries provide a promising method for tracking emotional states, improving self-awareness, and promoting well-being outcome. This paper aims to, through mobile diaries, understand cancer survivors' emotional states and key variables related to just-in-time intervention opportunities, including the desire to regulate emotions and the availability to engage in interventions. Although emotion analysis tools show potential for recognizing emotions from text, current methods lack the contextual understanding necessary to interpret brief mobile diary narratives. Our analysis of diary entries from cancer survivors (N=407) reveals systematic relationships between described contexts and emotional states, with administrative and health-related contexts associated with negative affect and regulation needs, while leisure activities promote positive emotions. We propose CALLM, a Context-Aware framework leveraging Large Language Models (LLMs) with Retrieval-Augmented Generation (RAG) to analyze these brief entries by integrating retrieved peer experiences and personal diary history. CALLM demonstrates strong performance with balanced accuracies reaching 72.96% for positive affect, 73.29% for negative affect, 73.72% for emotion regulation desire, and 60.09% for intervention availability, outperforming language model baselines. Post-hoc analysis reveals that model confidence strongly predicts accuracy, with longer diary entries generally enhancing performance, and brief personalization periods yielding meaningful improvements. Our findings demonstrate how contextual information in mobile diaries can be effectively leveraged to understand emotional experiences, predict key states, and identify optimal intervention moments for personalized just-in-time support.