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To use or not to use

Technology in general, and assistive technology in particular, is considered to be a promising opportunity to address the challenges of an aging population. Nevertheless, in health care, technology is not as widely used as could be expected. In this chapter, an overview is given of theories and models that help to understand this phenomenon. First, the design of (assistive) technologies will be addressed and the importance of human-centered design in the development of new assistive devices will be discussed. Also theories and models are addressed about technology acceptance in general. Specific attention will be given to technology acceptance in healthcare professionals, and the implementation of technology within healthcare organizations. The chapter will be based on the state of the art of scientific literature and will be illustrated with examples from our research in daily practice considering the different perspectives of involved stakeholders.

Implementation, Mechanisms of Effect and Context of an Integrated Care Intervention for Vulnerable Families in Central Sydney Australia

Introduction: In March 2014, the New South Wales (NSW) Government (Australia) announced the NSW Integrated Care Strategy. In response, a family-centred, population-based, integrated care initiative for vulnerable families and their children in Sydney, Australia was developed. The initiative was called Healthy Homes and Neighbourhoods. A realist translational social epidemiology programme of research and collaborative design is at the foundation of its evaluation. Theory and Method: The UK Medical Research Council (MRC) Framework for evaluating complex health interventions was adapted. This has four components, namely 1) development, 2) feasibility/piloting, 3) evaluation and 4) implementation. We adapted the Framework to include: critical realist, theory driven, and continuous improvement approaches. The modified Framework underpins this research and evaluation protocol for Healthy Homes and Neighbourhoods. Discussion: The NSW Health Monitoring and Evaluation Framework did not make provisions for assessment of the programme layers of context, or the effect of programme mechanism at each level. We therefore developed a multilevel approach that uses mixed-method research to examine not only outcomes, but also what is working for whom and why.

A lab of labs

Human-Centered AI for Dementia Care: Using Reinforcement Learning for Personalized Interventions Support in Eating and Drinking Scenarios

For people with early-dementia (PwD), it can be challenging to remember to eat and drink regularly and maintain a healthy independent living. Existing intelligent home technologies primarily focus on activity recognition but lack adaptive support. This research addresses this gap by developing an AI system inspired by the Just-in-Time Adaptive Intervention (JITAI) concept. It adapts to individual behaviors and provides personalized interventions within the home environment, reminding and encouraging PwD to manage their eating and drinking routines. Considering the cognitive impairment of PwD, we design a human-centered AI system based on healthcare theories and caregivers’ insights. It employs reinforcement learning (RL) techniques to deliver personalized interventions. To avoid overwhelming interaction with PwD, we develop an RL-based simulation protocol. This allows us to evaluate different RL algorithms in various simulation scenarios, not only finding the most effective and efficient approach but also validating the robustness of our system before implementation in real-world human experiments. The simulation experimental results demonstrate the promising potential of the adaptive RL for building a human-centered AI system with perceived expressions of empathy to improve dementia care. To further evaluate the system, we plan to conduct real-world user studies.

Development of eHOME, a Mobile Instrument for Reporting, Monitoring, and Consulting Drug-Related Problems in Home Care

Home care patients often use many medications and are prone to drug-related problems (DRPs). For the management of problems related to drug use, home care could add to the multidisciplinary expertise of general practitioners (GPs) and pharmacists. The home care observation of medication-related problems by home care employees (HOME)-instrument is paper-based and assists home care workers in reporting potential DRPs. To facilitate the multiprofessional consultation, a digital report of DRPs from the HOME-instrument and digital monitoring and consulting of DRPs between home care and general practices and pharmacies is desired. The objective of this study was to develop an electronic HOME system (eHOME), a mobile version of the HOME-instrument that includes a monitoring and a consulting system for primary care.

Human-centered evaluation of explainable AI applications

Explainable Artificial Intelligence (XAI) aims to provide insights into the inner workings and the outputs of AI systems. Recently, there’s been growing recognition that explainability is inherently human-centric, tied to how people perceive explanations. Despite this, there is no consensus in the research community on whether user evaluation is crucial in XAI, and if so, what exactly needs to be evaluated and how. This systematic literature review addresses this gap by providing a detailed overview of the current state of affairs in human-centered XAI evaluation. We reviewed 73 papers across various domains where XAI was evaluated with users. These studies assessed what makes an explanation “good” from a user’s perspective, i.e., what makes an explanation meaningful to a user of an AI system. We identified 30 components of meaningful explanations that were evaluated in the reviewed papers and categorized them into a taxonomy of human-centered XAI evaluation, based on: (a) the contextualized quality of the explanation, (b) the contribution of the explanation to human-AI interaction, and (c) the contribution of the explanation to human- AI performance. Our analysis also revealed a lack of standardization in the methodologies applied in XAI user studies, with only 19 of the 73 papers applying an evaluation framework used by at least one other study in the sample. These inconsistencies hinder cross-study comparisons and broader insights. Our findings contribute to understanding what makes explanations meaningful to users and how to measure this, guiding the XAI community toward a more unified approach in human-centered explainability.