Design and Usability Evaluation of Mobile Voice-Added Food Reporting for Elderly People: Randomized Controlled Trial

“The error types were derived thematically for data analysis [34], which has been described in the subsection “Thematic Analysis.””

“To reduce system complexity, we applied a design heuristics approach for simplicity [31,32] to propose two alternatives.”

“Vogels [14] found that seniors actively adopted new technologies in their daily lives, and among these, mobile health apps offer many potential advantages including accessibility, scalability, and cost-effectiveness [15,16].”

“We developed our voice-added design based on a user-centered design model [30] through research, ideation, and implementation steps.”

“This error is related to the user selecting the correct answer from a list of one to five possible choices, and could be explained by issues related to multimodal interaction in hand-eye coordination and speech input [40].”

“Digital dietary intake tracking has substantial potential for improving related health or nutrition outcomes [13].”

“Following the study by Bree and Galagher [37], all analyses were conducted using a Microsoft Excel worksheet (Microsoft Inc).”

“…and physiological functioning that can increase the challenge involved in operating mobile apps, such as tapping buttons and scrolling down the screen [17], and such users often require app developers to provide enhanced interface usability to make operation faster and more accurate [16-21].”

“Previous research [25] has suggested that voice-enabled interfaces could potentially reduce barriers to use by elderly people having vision and motor disabilities.”

“Recent technological advancements, such as v oice and speech recognition [22,23], have added a new dimension to health app interface design for older adults [24].”

“Older people are at increased risk of malnutrition [1-3], which can increase a range of health risks [4,5].”

“Regular screening of dietary factors from food intake can help to identify individuals at risk of malnutrition [7,8].”

“Advances in digital technologies are creating new options for delivering health interventions to seniors [9,10], and powerful new software and hardware tools can support improved health maintenance through the collection, analysis, and interpretation of dietary intake data [11,12].”

“Advances in digital technologies are creating new options for delivering health interventions to seniors [9,10], and powerful new software and hardware tools can support improved health maintenance through the collection, analysis, and interpretation of dietary intake data [11,12].”

“To reduce system complexity, we applied a design heuristics approach for simplicity [31,32] to propose two alternatives.”

“Older people are at increased risk of malnutrition [1-3], which can increase a range of health risks [4,5].”

“Some previous studies [17,26] suggested that senior citizens find button tapping-based interfaces on smartphones to be challenging.”

“To prevent malnutrition in seniors, self-monitoring of food intake is a critical component of macronutrient intake assessment and calorie calculation [6].”

“Older people are at increased risk of malnutrition [1-3], which can increase a range of health risks [4,5].”

“Advances in digital technologies are creating new options for delivering health interventions to seniors [9,10], and powerful new software and hardware tools can support improved health maintenance through the collection, analysis, and interpretation of dietary intake data [11,12].”

“Recent technological advancements, such as v oice and speech recognition [22,23], have added a new dimension to health app interface design for older adults [24].”

“Regular screening of dietary factors from food intake can help to identify individuals at risk of malnutrition [7,8].”

“In addition, incorrect recognition results were found for food names such as “peanut,” “bacon,” and “salted duck egg,” possibly because seniors have greater difficulty articulating nasal vowels [38].”

“Recent technological advancements, such as v oice and speech recognition [22,23], have added a new dimension to health app interface design for older adults [24].”

“Effective interface development usually requires the active involvement of target end users throughout the development process [27].”

“This error may result from the app imposing cognitive overloading, as advanced age is associated with a decline in working memory [39].”

“Our previous study [28] also addressed this issue for older adults, and system usability performance could be improved through improvements to the visual layout, increase in font size, or further improvements to user interaction design.”

“Advances in digital technologies are creating new options for delivering health interventions to seniors [9,10], and powerful new software and hardware tools can support improved health maintenance through the collection, analysis, and interpretation of dietary intake data [11,12].”

“We previously provided a proof of concept for a combinatorial approach of dietary recording that accounts for a wide range of dish variations [28,29].”

“38 Nine studies suffered from other sources of bias, such as a small sample size, 34,46,48,52,54,58,69,71 a biased sample, 54,59,71,90 and a lack of base-line data.”

“…older adults rather than focusing on specific diseases, which contained a variety of solutions, including fall prevention [41, 42], fitness [43, 44], lifestyle modification [45, 46], medication adherence [47, 48], health monitoring [40, 49], nutrition [50, 51], and cognitive stimulation [52, 53].”

“[49] suggested voice only reporting requires significant less time and is less error prone compared to the voice button reporting.”

“…outcomes of respective assistive technology use, but rather focused on older adults ’ experiences with, motivation for, usability of, and acceptance of technology (Bozan and Gewald 2018; Justo et al. 2020; Liu et al. 2020; McMahon et al. 2014; Pettersson et al. 2019; Vermeulen et al. 2013).”

“In terms of efficiency, the application of touch screens [42] and voice input [75] can facilitate the use by the elderly and improve the use efficiency.”

“This tendency is reinforced, as noted by Mahmood et al [63] and Liu et al [64], by two recurring influences: (1) the way many voice interfaces are designed and promoted to mirror human conversational styles and (2) the inherent affordance of speech as an interaction modality, which can implicitly…”

“Popular usability instruments used are task performance logging [5], think-aloud [13][14], and the System Usability Scale (SUS) [15].”

“Other e-health applications used with older adults showed comparable SUS scores [32–34].”

“Portable devices included: Microcassette tape recorders (n = 2) [5], [23]; Personal Digital Assistants (n = 2) [4], [13]; Mobile phones (n = 2) [25], [29]; touchbased iPods (n= 2) [24], [30]; Tablet computers (n= 2) [16], [22]; and Smartphones (n = 5) [14], [15], [27], [28], [41].”

“…(2019) Found that enhancing the clarity of user expressions significantly improves the fluidity of voice interactions. system recognition accuracy Liu et al. (2020) Determined that the primary factor for the highest error rate in voice interactions is the speech system recognition accuracy.…”

“Previous usability studies of self-administered dietary assessment apps among older adults, include apps with voice-added reporting [23] or apps where health personnel can complete the reporting on behalf of the respondent [24].”

“This includes adequately adapted user interfaces [27], [38], big fonts, auditory feedback [39], [40], or additional input methods (i.e., voice input) which support their demands [26].”

“For instance, researchers have designed apps to help older adults manage specific health conditions (Botella et al., 2013; Mira et al., 2014), prevent falls (Hawley-Hague et al., 2020; Liu et al., 2020), and promote healthy eating habits (Hakobyan et al., 2016; Liu et al., 2020).”

“A study by the International Journal of Human-Computer Studies highlights that universal design principles, such as using clear and simple layouts, can significantly improve the usability of mobile applications for older adults (Y.-C. Liu et al., 2020).”

“The previous iteration included voice inputs to enhance meal reporting, using AI services, specifically Google AI, to transcribe speech into text [32].”

“It benefits from ease-of-use [10] and reduced time cost [11], [12], and does not require a high literacy level which is of particular interest to the LLMIC setting [12], [13].”

“Moreover, usage logs are unable to capture organic vocal reactions, interruptions, and overlapping speech during VA interactions.”

“The vast majority of technologies developed for older adults are mobile applications for smart-phones or tablets that support for example, the regular intake of medication [13, 14] or the self-monitoring of nutrition [15, 16].”

“…of VUI use (Nguyen et al., 2019; Poushneh, 2021); the exploration of the behavior, attitude, and experience of the elderly using VUIs (Kim, 2021; Liu et al., 2020; Pradhan et al., 2020) and the usability and user experience analysis of digital devices based on VUIs (Du et al., 2018; Guerino &…”

“…such as the use of computer vision and depth-sensing technologies for quantitative nutrient analysis, enabling 3D reconstruction of food portions (rather than relying on standard serving size assumptions) [38], as well as mobile voice-added apps for food intake reporting [39], are promising.”

“In addition, the cognitive load can be very high for older adults, as they have to keep several navigation steps in mind to make entries in the diary [12,13].”

“10 – 12 One study aimed to create an AI-powered assistant to provide caregivers of older adults with dementia a tool that can give instructions on cooking and nutritional advice for their residents.”