Smart Speaker-Based Applications to Support Social Connectedness in Older Adult Residents in Affordable Housing: User-Centered Design Study

Clinical Snapshot

Key Findings

• P Value: Not applicable — qualitative design study

• Effect Size: Not applicable — qualitative design study; no quantitative effect size reported

• Primary Outcome: Development of seven prototype smart speaker application scenarios across four functional categories: Checking-In (peer and management safety verification with privacy controls), Social Companion (conversational AI-based companionship and emotional support), Community Involvement (virtual bulletin boards and activity coordination), and Wellness Check (system-initiated monitoring of activity and behavioural patterns with user-controlled interventions)

• Nnt Or Sensitivity: Not applicable — this is a participatory design study, not a diagnostic or therapeutic intervention trial; 153 participant-generated ideas were produced, with Health and Safety and Daily Assistance as the most frequent categories

• Confidence Interval: Not applicable — qualitative design study

Clinical Application

The prototype scenarios are conceptually feasible given the widespread availability of commercial smart speakers (e.g., Amazon Echo, Google Nest). However, real-world implementation will require attention to digital literacy support, reliable internet access in affordable housing settings, data privacy infrastructure, and integration with existing community and healthcare services. The study has not yet progressed to usability testing or clinical deployment. Social isolation and loneliness among older Australians living in social and community housing is a recognised public health concern, addressed in part through the RACGP's guidelines on preventive care for older people and the Australian Government's Aged Care Quality Standards. Smart speaker technology is not currently listed on the PBS or TGA-regulated as a therapeutic device, but falls within the scope of assistive technology under the Commonwealth Home Support Programme (CHSP) and My Aged Care frameworks. The findings are relevant to Australian aged care providers, Primary Health Networks (PHNs), and housing organisations seeking to integrate digital health tools into community-based care models. The emphasis on co-design with culturally and linguistically diverse (CALD) and low-income older adults aligns with the National Ageing and Aged Care Strategy's equity priorities. Implementation in Australia would require consideration of ATSI community needs, NDIS intersections for younger people with disabilities in social housing, and the Office of the Australian Information Commissioner's privacy frameworks governing health-adjacent data collection. Older adults (aged 65+) living alone in affordable or social housing, particularly those from low-income, minority, or educationally disadvantaged backgrounds who face heightened risks of social isolation, loneliness, and limited technology access

Abstract

BACKGROUND: Older adults in affordable housing face heightened risks of social isolation and loneliness due to limited social networks, transportation barriers, chronic conditions, and inadequate technology access. Smart speakers offer potential for enhancing social connectedness in this underserved population, yet technology interventions are rarely designed with meaningful input from older adults themselves. User-centered design (UCD) approaches can address this gap by engaging end users throughout the development process to ensure technology solutions align with their needs and living contexts. OBJECTIVE: This study aimed to engage older adults in affordable housing in an iterative UCD process to develop prototype scenarios for smart speaker-based applications that promote social connectedness while addressing safety, community-building, and wellness needs. METHODS: We conducted a 3-stage UCD study with 29 older adults (mean age 70, SD 6.8 years; 23/29, 79% African American; 20/29, 69% high school education or less) living alone in affordable housing between April 2021 and April 2022. Stage 1 included 5 focus groups (n=25) combining needs assessment discussions with rapid brainstorming activities. Stage 2 involved research team synthesis of focus group transcripts and brainstorming data to create a Design Strategies Map, development of initial prototype scenarios, 5 evaluation focus groups (n=18) to gather feedback, and iterative scenario refinement. Stage 3 comprised 4 validation focus groups (n=17) to assess refined scenarios and identify implementation recommendations. Participants included both smart speaker users (n=13) and nonusers (n=16). Data were analyzed using thematic analysis for needs assessment, content analysis for brainstorming ideas and feedback, and matrix analysis for systematic comparison across scenarios. RESULTS: Participants generated 153 ideas for smart speaker use, with Health and Safety and Daily Assistance being the most frequent categories. Analysis revealed that social connection needs were inseparable from safety concerns related to living alone. Through iterative co-design, we developed 7 prototype scenarios across 4 functional categories: Checking-In (peer and management safety verification with privacy controls), Social Companion (conversational artificial intelligence-based companionship and emotional support), Community Involvement (virtual bulletin boards and activity coordination), and Wellness Check (system-initiated monitoring of activity and behavioral patterns as health indicators with user-controlled interventions). Participants emphasized requirements for personalization, opt-in/opt-out controls, "Do-Not-Disturb" functionality, and safeguards preventing replacement of human connection. CONCLUSIONS: Older adults in affordable housing engaged in technology design and provided valuable insights that challenge assumptions about their needs and preferences. The prototype scenarios addressed the dual imperatives of social connection and safety while living alone, offering a foundation for developing technology-based applications tailored to underserved populations. Implementation should prioritize user control, privacy protection, and human-in-the-loop design ensuring that technology facilitates rather than replaces human connection and community programming, alongside consideration of user characteristics to build trust and ensure effective, sustained use of the intended technology platform.

References

1. 1.Chung, J., Mansion, N., Gendron, T., Wood, R. E., & Demiris, G. (2026). Smart speaker-based applications to support social connectedness in older adult residents in affordable housing: User-centered design study. JMIR Aging. https://pubmed.ncbi.nlm.nih.gov/42412625