Virtual Assistant as a Companion for Stroke Survivors post Discharge: Thematic Analysis Highlights Expectations of Human Performance Pose a Key Barrier to Engagement.

INTRODUCTION

Health-related information and support is scarcely available to stroke survivors following discharge from the hospital, largely due to limited access to health professionals. Digital tools like virtual assistants (VAs) can address some of these needs on demand in a home environment, and there already is evidence of their effective deployment in health contexts. However, to maximise how individuals engage with such technological tools, it is integral that their design be grounded in the needs and associated expectations of the target user population.

METHODS

We conducted workshops where stroke survivors roleplayed as VAs and users and provided feedback on their expectations of a stroke-specific VA. In our one-to-one interviews with stroke survivors, we simulated VA interactions with two functions: administering PROMs and asking questions. Then, in testing sessions, stroke survivors, family, and caregivers completed PROMs both using the VA and with a human, before sharing their thoughts about the VA.

RESULTS

Our thematic analysis yielded four themes with semantic and latent codes. Aligned with past research, we observed an unmet need for on-demand information and support following discharge. Participants expected the VA to provide on-demand information not typically available through healthcare interactions. Participants perceived the VA as human or as a personable animate object, and these anthropomorphic expectations represented the most challenging-to-address barrier to engaging with the VA.

CONCLUSION

These qualitative findings validate that common expectations of digital tools in general adult populations also apply to stroke survivors, highlighting the importance of participatory design. Accounting for ethical and risk considerations, we propose future directions for the development of safe and useful conversational agents that can serve as companions post discharge.