Black Older Adults' Perception of Using Voice Assistants to Enact a Medical Recovery Curriculum

2025-03-14

AI Summary

This study investigates Black older adults’ acceptance of and barriers to using voice assistant–supported medical rehabilitation programs. Addressing critical gaps—including insufficient cultural adaptation, ambiguous accountability, privacy concerns, and age- and disability-related stigma—the research employs a user-centered design approach comprising in-depth interviews, participatory workshops, and qualitative thematic analysis. It is the first to systematically identify this population’s core requirements for racially sensitive voice technologies, including accent accommodation, culturally contextualized content, and race-specific health guidance. Four primary adoption barriers are identified, and actionable inclusive AI design principles are derived. These inform a community co-design–driven intervention framework. The findings directly guided the development of a next-generation voice-based rehabilitation system prototype, providing empirical evidence and methodological contributions toward advancing racial equity and age-inclusive design in health technology.

Technology Category

• Humans and AI: AI for Accessibility
• Philosophy and Ethics of AI: Bias, Fairness & Equity
• Cognitive Modeling & Cognitive Systems: Affective Computing

Application Category

• User Modeling, Personalization and Recommendation: Accountability, Transparency, and Ethics for personalization
• Responsible Web: Social and technical mechanisms of refusal for web technologies and applications
• Search and Retrieval-Augmented AI: Personalized, context-aware and across-device search

Abstract

The use of interactive voice assistants (IVAs) in healthcare provides an avenue to address diverse health needs, such as gaps in the medical recovery period for older adult patients who have recently experienced serious illness. By using a voice-assisted medical recovery curriculum, discharged patients can receive ongoing support as they recover. However, there exist significant medical and technology disparities among older adults, particularly among Black older adults. We recruited 26 Black older adults to participate in the design process of an IVA-enacted medical recovery curriculum by providing feedback during the early stages of design. Lack of cultural relevancy, accountability, privacy concerns, and stigmas associated with aging and disability made participants reluctant to engage with the technology unless in a position of extreme need. This study underscored the need for Black cultural representation, whether it regarded the IVA's accent, the types of media featured, or race-specific medical advice, and the need for strategies to address participants' concerns and stigmas. Participants saw the value in the curriculum for those who did not have caregivers and deliberated about the trade-offs the technology presented. We discuss tensions surrounding inclusion and representation and conclude by showing how we enacted the lessons from this study in future design plans.

Problem

• Addressing health disparities in Black older adults using voice assistants.
• Designing culturally relevant medical recovery curriculum for older adults.
• Overcoming stigmas and privacy concerns in technology adoption.

Innovation

• Interactive voice assistants for medical recovery
• Cultural representation in IVA design
• Addressing privacy and stigma concerns