Investigating the Integration and the Long-Term Use of Smart Speakers in Older Adults' Daily Practices: Qualitative Study

BACKGROUND

As smart speakers become more popular, there have been an increasing number of studies on how they may benefit older adults or how older adults perceive them. Despite the increasing ownership rates of smart speakers among older adults, studies that examine their integration and the long-term use in older adults' daily practices are scarce.

OBJECTIVE

This study aims to uncover the integration of smart speakers into the daily practices of older adults over the long term, contributing to an in-depth understanding of maintained technology use among this demographic.

METHODS

To achieve these objectives, the study interviewed 20 older adults who had been using smart speakers for over 6 months. These semistructured interviews enabled participants to share their insights and experiences regarding the maintained use of smart speakers in the long term.

RESULTS

We identified 4 dimensions of the long-term use of smart speakers among older adults, including functional integration, spatial integration, cognitive integration, and semantic integration. For the functional integration of smart speakers, the study reported different types of use, including entertainment, information collection, medication reminders, companionship, environment modification, and emergency calls. For the spatial integration of smart speakers, the study showed older adults' agency in defining, changing, and reshaping daily practices through the spatial organization of smart speakers. For the cognitive integration of smart speakers, the findings showed the cognitive processes involved in adapting to and incorporating smart speakers into daily habits and routines. For the semantic integration of smart speakers, the findings revealed that older adults' enjoyable user experience and strong bonds with the device contributed to their acceptance of occasional functional errors. Finally, the study proposed several suggestions for designers and developers to better design smart speakers that promote maintainable use behaviors among older adults.

CONCLUSIONS

On the basis of the findings, this study highlighted the importance of understanding how older adults use smart speakers and the practices through which they integrate them into their daily routines. The findings suggest that smart speakers can provide significant benefits for older adults, including increased convenience and improved quality of life. However, to promote maintainable use behaviors, designers and developers should consider more about the technology use contexts and the specific needs and preferences of older adults when designing these devices.

User Perception of Smart Home Surveillance Among Adults Aged 50 Years and Older: Scoping Review

BACKGROUND

Smart home technology (SHT) can be useful for aging in place or health-related purposes. However, surveillance studies have highlighted ethical issues with SHTs, including user privacy, security, and autonomy.

OBJECTIVE

As digital technology is most often designed for younger adults, this review summarizes perceptions of SHTs among users aged 50 years and older to explore their understanding of privacy, the purpose of data collection, risks and benefits, and safety.

METHODS

Through an integrative review, we explored community-dwelling adults' (aged 50 years and older) perceptions of SHTs based on research questions under 4 nonmutually exclusive themes: privacy, the purpose of data collection, risk and benefits, and safety. We searched 1860 titles and abstracts from Ovid MEDLINE, Ovid Embase, Cochrane Database of Systematic Reviews, and Cochrane Central Register of Controlled Trials, Scopus, Web of Science Core Collection, and IEEE Xplore or IET Electronic Library, resulting in 15 included studies.

RESULTS

The 15 studies explored user perception of smart speakers, motion sensors, or home monitoring systems. A total of 13 (87%) studies discussed user privacy concerns regarding data collection and access. A total of 4 (27%) studies explored user knowledge of data collection purposes, 7 (47%) studies featured risk-related concerns such as data breaches and third-party misuse alongside benefits such as convenience, and 9 (60%) studies reported user enthusiasm about the potential for home safety.

CONCLUSIONS

Due to the growing size of aging populations and advances in technological capabilities, regulators and designers should focus on user concerns by supporting higher levels of agency regarding data collection, use, and disclosure and by bolstering organizational accountability. This way, relevant privacy regulation and SHT design can better support user safety while diminishing potential risks to privacy, security, autonomy, or discriminatory outcomes.

Remote Multi-Person Heart Rate Monitoring with Smart Speakers: Overcoming Separation Constraint

Heart rate is a key vital sign that can be used to understand an individual's health condition. Recently, remote sensing techniques, especially acoustic-based sensing, have received increasing attention for their ability to non-invasively detect heart rate via commercial mobile devices such as smartphones and smart speakers. However, due to signal interference, existing methods have primarily focused on monitoring a single user and required a large separation between them when monitoring multiple people. These limitations hinder many common use cases such as couples sharing the same bed or two or more people located in close proximity. In this paper, we present an approach that can minimize interference and thereby enable simultaneous heart rate monitoring of multiple individuals in close proximity using a commonly available smart speaker prototype. Our user study, conducted under various real-life scenarios, demonstrates the system's accuracy in sensing two users' heart rates when they are seated next to each other with a median error of 0.66 beats per minute (bpm). Moreover, the system can successfully monitor up to four people in close proximity.

Using Smart Displays to Implement an eHealth System for Older Adults With Multiple Chronic Conditions: Protocol for a Randomized Controlled Trial

Background

Voice-controlled smart speakers and displays have a unique but unproven potential for delivering eHealth interventions. Many laptop- and smartphone-based interventions have been shown to improve multiple outcomes, but voice-controlled platforms have not been tested in large-scale rigorous trials. Older adults with multiple chronic health conditions, who need tools to help with their daily management, may be especially good candidates for interventions on voice-controlled devices because these patients often have physical limitations, such as tremors or vision problems, that make the use of laptops and smartphones challenging.

Objective

The aim of this study is to assess whether participants using an evidence-based intervention (ElderTree) on a smart display will experience decreased pain interference and improved quality of life and related measures in comparison with participants using ElderTree on a laptop and control participants who are given no device or access to ElderTree.

Methods

A total of 291 adults aged ≥60 years with chronic pain and ≥3 additional chronic conditions will be recruited from primary care clinics and community organizations and randomized 1:1:1 to ElderTree access on a smart display along with their usual care, ElderTree access on a touch screen laptop along with usual care, or usual care alone. All patients will be followed for 8 months. The primary outcomes are differences between groups in measures of pain interference and psychosocial quality of life. The secondary outcomes are between-group differences in system use at 8 months, physical quality of life, pain intensity, hospital readmissions, communication with medical providers, health distress, well-being, loneliness, and irritability. We will also examine mediators and moderators of the effects of ElderTree on both platforms. At baseline, 4 months, and 8 months, patients will complete written surveys comprising validated scales selected for good psychometric properties with similar populations. ElderTree use data will be collected continuously in system logs. We will use linear mixed-effects models to evaluate outcomes over time, with treatment condition and time acting as between-participant factors. Separate analyses will be conducted for each outcome.

Results

Recruitment began in August 2021 and will run through April 2023. The intervention period will end in December 2023. The findings will be disseminated via peer-reviewed publications.

Conclusions

To our knowledge, this is the first study with a large sample and long time frame to examine whether a voice-controlled smart device can perform as well as or better than a laptop in implementing a health intervention for older patients with multiple chronic health conditions. As patients with multiple conditions are such a large cohort, the implications for cost as well as patient well-being are significant. Making the best use of current and developing technologies is a critical part of this effort.

Trial Registration

ClinicalTrials.gov NCT04798196; https://clinicaltrials.gov/ct2/show/NCT04798196

International Registered Report Identifier (IRRID)

PRR1-10.2196/37522

Smart speaker devices can improve speech intelligibility in adults with intellectual disability

BACKGROUND

Successful communication is vital to quality of life. One group commonly facing speech and communication difficulties is individuals with intellectual disability (ID). A novel route to encourage clear speech is offered by mainstream smart speakers (e.g., Amazon Alexa and Google Home). Smart speakers offer four factors important for learning: reward immediacy, spaced practice, autonomy/intrinsic motivation and reduced social barriers. Yet the potential of smart speakers to improve speech intelligibility has not been explored before.

AIMS

To determine whether providing individuals with intellectual disabilities with smart speaker devices improved ratings of speech intelligibility for (1) phrases related to device use and (2) unrelated words via a semi-randomized controlled trial.

METHODS & PROCEDURES

In a semi-randomized controlled trial, an intervention group of adults with ID (N = 21) received smart speakers, while a control group (N = 22) did not. Before and after about 12 weeks, participants were recorded saying smart speaker-related phrases and unrelated words. Naïve participants then rated the intelligibility of the speech recordings.

OUTCOMES & RESULTS

The group that received smart speakers made significantly larger intelligibility gains than the control group. Although the effect size was modest, this difference was found for both smart speaker-related phrases and unrelated words.

CONCLUSIONS & IMPLICATIONS

While the mechanism of action remains to be determined, the presence of smart speakers in the home had a demonstrable impact on ratings of speech intelligibility, and could provide cost-effective inclusive support for speech and communication improvement, improving the quality of life of vulnerable populations. What this paper adds What is already known on the subject Speech intelligibility is a key obstacle for social relationships and quality of life across several vulnerable populations (children with speech difficulties, older adults with dementia, individuals with ID). Anecdotal reports suggest mainstream smart speakers (e.g., Amazon Alexa, Google Home), could improve speech intelligibility. What this paper adds to existing knowledge We used a semi-randomized controlled trial to show that using a smart speaker for about 12 weeks could improve ratings of speech intelligibility in adults with ID for both smart speaker-related phrases and unrelated words. What are the potential or actual clinical implications of this work? These initial findings suggest that smart speaker technology could be a novel, and inclusive, route to improving speech intelligibility in vulnerable populations.

Smart Speaker Recommendations: Impact of Gender Congruence and Amount of Information on Users' Engagement and Choice

The relevance of smart speakers is steadily increasing, allowing users perform several daily tasks. From a commercial perspective, smart speakers also provide recommendations of products and services that may influence the consumer decision-making process. However, previous studies have mainly focused on the adoption of smart speakers, but there is a lack of proper guidelines that help design the way these devices should offer their consumption recommendations. Based on a stimulus-organism-response approach, we analyze how two features of smart speakers' recommendations (the gender congruence between the customer and the speaker, and the length of the message) influence on the effectiveness of such recommendations (i.e., visiting intentions) through its impact on user engagement and attitude. Data was collected from a sample of undergrad students in Spain using an experiment design that focused on a restaurant recommendation, and analyzed using partial least squares. On the one hand, our results suggests that gender congruence generates user engagement with the smart speaker. On the other hand, message length is positively related to attitudes towards the restaurant, at a declining rate. In addition, while better attitudes lead to higher visiting intentions, the influence of engagement on visiting intentions is partially mediated via attitudes. Thus, our findings contribute to understand the antecedents of users' engagement with smart speakers, as well as its impact on the customers' willingness to follow smart speakers' recommendations, constituting a base to analyze the impact of artificial intelligence solutions aimed to smooth the transitions of a customer through the stages of purchase process.

Smart-speaker technology and intellectual disabilities: agency and wellbeing

PURPOSE

Mainstream intelligent personal assistants (IPAs, e.g., Amazon Echo and Google Home) offer an unprecedented opportunity to enhance agency and wellbeing among vulnerable groups across health and social care. However, unintended consequences and barriers to use are possible.

MATERIALS AND METHODS

We conducted a mixed-methods semi-randomized controlled trial among individuals with intellectual disability (ID), providing IPAs to an intervention group (N = 22), but not a control group (N = 22). Semi-structured interviews on device use and daily life were conducted with individuals with ID. Observation surveys were also collected from support staff. Key themes were identified using thematic analysis. We also collected quantitative agency and wellbeing data. A separate group of 40 individuals who had already received IPAs were additionally assessed, as well as their support staff.

RESULTS

Four themes were identified: (1) social value, (2) entertainment, (3) perceived agency, (4) challenges, perseverance, training/support needs. Opinions regarding IPAs were overwhelmingly positive. Most individuals qualitatively reported improved sense of agency and IPAs enabled many individuals to access features associated with wellbeing, but there was no significant change in the quantitative measure. Some individuals experienced challenges related to pronouncing and remembering IPA phrases; however, perseverance was common.

CONCLUSIONS

This study increases our understanding of the ways smart speakers can be used to enhance life quality among individuals with ID, and the nature of barriers faced. In conclusion, IPAs are cost-effective complementary support for vulnerable populations, but additional training is required to realize all potential benefits.Implications for rehabilitationIndividuals with intellectual disability (ID) in supported living are able to use mainstream smart-speakers to access features associated with supporting wellbeing and social communication.They also reported that smart speakers made them feel better able to do things for themselves.A number of individuals with ID and their support staff identified a need for training and support to get the most out of smart speakers in future.

Alexa, What classes do I have today? The use of Artificial Intelligence via Smart Speakers in Education

Looking back to the rumours from the early 2000’s, when the world of technology bloomed together with the curiosity towards what was next to come, by 2020, robots should have assisted and supported almost every task from our daily life. While this may seem as a Sci-Fi movie scenario, it is partially a tangible reality, that we quickly got used to, thanks to the introduction of smart speakers.

As the world changes, so does the future of our students. In this respects, the evolution of the technology comes up with specific environments for educational purpose. Building smart learning environments supported by e-learning platforms is an important area of research in education domain within our days. The evolution of these smart learning environments is justified by some events (Covid19) that force students to learn remotely.

The paper proposes a software application component using Alexa smart speaker, that integrates different services (Amazon Web Services, Microsoft Services) for a proper virtual environment platform, for both students and teachers. It addresses the main concerns of the current educational system, and provides a smart solution through the use of Artificial Intelligence based tools. The proposed approach not only achieves unifying data and knowledge-share mechanisms in a remotely mode, but it brings also a good learning experience, increasing the effectiveness and the efficiency of the learning process.

A comparison of text versus audio for information comprehension with future uses for smart speakers

Objective

Audio is increasingly used to access information on the Internet through virtual assistants and smart speakers. Our objective is to evaluate the distribution of health information through audio.

Materials and Methods

We conducted 2 studies to compare comprehension after reading or listening to information using a new corpus containing short text snippets from Cochrane (N = 50) and Wikipedia (N = 50). In study 1, the snippets were first presented as audio or text followed by a multiple-choice question. Then, the same information was presented as text and the question was repeated in addition to questions about perceived difficulty, severity and the likelihood of encountering the disease. In study 2, the first multiple-choice question was replaced with a free recall question.

Results

Study 1 showed that information comprehension is very similar in both presentation modes (53% accuracy for text and 55% for audio). Study 2 showed that information retention is higher with text, but similar comprehension. Both studies show improvement in performance with repeated information presentation.

Discussion

Audio presentation of information is effective and the format novel. Performance was slightly lower with audio when asked to repeat information, but comparable to text for answering questions. Additional studies are needed with different types of information and presentation combinations.

Conclusion

The use of audio to provide health information is a promising field and will become increasingly important with the popularity of smart speakers and virtual assistants, particularly for consumers who do not use computers, for example minority groups, or those with limited sight or motor control.