A sensitive virtual assistant to support people in vulnerable positions in their access to care
For citizens with communication or cognitive impairments (e.g., people with low (health) literacy skills, intellectual disability (ID) or autism spectrum disorder (ASD), etc.) who live independently, it is challenging to find answers to their specific health needs and receive appropriate health care. In this project a consortium that consisted of the target group, social workers, scientists, social designer and a private partner with expertise in digital user experience and AI, designed a sensitive chatbot or ‘virtual assistant’ (SVA) that tailors the responses to individual needs of users may help in supporting them. To avoid a mismatch between the needs of people in vulnerable positions and the SVA, we conducted an ‘inclusive research and development project’. Our study investigates the added value of co-design and citizen science in technology development and the implementation process.
In many European societies, the demand for health and social care for people in vulnerable positions is increasing. Twenty percent of the Dutch population is considered vulnerable due to often invisible disabilities, such as autism, mild intellectual disabilities (MID), acquired brain injury, and/or mental health issues. The Netherlands has 1.1 million people with MID. At least one-third of this group struggles to fully participate in areas such as healthcare and welfare. There are three challenges in finding the right support for a specific question: 1) emotional challenge: due to shame, care seekers experience a barrier to approaching institutions; 2) cognitive challenge: articulating questions and answering counter-questions is often too demanding; and 3) the complex support infrastructure: knowledge, working methods, and organization differ per municipality and social district team. Social district team employees work in a demand-oriented manner. Self-management of citizens is central to this. As a result, there is a high risk that vulnerable care seekers will hit a wall, drop out prematurely, or receive help too late. This is a societal problem for care seekers and the involved institutions, such as mental health services. Consequently, care seekers receive care too late or the wrong care. Together with a lack of personal and growing societal care costs, it is warranted to look for innovative ways to better support people in vulnerable positions in their care. People in vulnerable positions often face challenges in the timely access to various forms of care they need, for example due an intellectual disability, autism spectrum disorder (ASD) or a mental disorder. This project examined the possibility of a virtual assistant to improve access to care for people in vulnerable positions. Innovative in this project was the study of whether and how a ‘sensitive’ virtual assistant can be developed, i.e., a virtual assistant that modifies to the different needs of the target group through adaptive and inclusive artificial intelligence technology. We developed a sensitive virtual assistant through a design thinking method, in which 1) the current and desired experiences of the target group regarding their care and support were mapped, and 2) the sensitive virtual assistant's ability to address these needs and adapt its functionalities to different users was explored. This was inclusive, the study took place in close collaboration with ‘citizen scientists’ who had a cognitive impairment such as intellectual disability or ASD. In this inclusive research trajectory, they ensured that the virtual assistant would fit the needs and lifeworld of the target population. This project has generated theoretical, methodological and technological contributions to the field of chatbot research, citizen science, inclusive research and public health.
The project used a citizen science approach, meaning that the SVA’s target group was closely involved during the entire project – from the grant application, throughout the research and development cycle to the dissemination of our findings and implementation of our end product. The citizen scientists are people with low (health) literacy skills, ASD or mild ID and act as consultants and co-researchers, enabling the SVA to take into account the challenges underlying the complexity of different living situations. We co-design the SVA following Design Thinking Method and conduct interviews, focus groups and user experience tests.
Deliverables and results
- A (working) AI sketch design of a sensitive virtual assistant with room for clarification
- Relevant knowledge about the wishes, needs, and perceptions of vulnerable care recipients, their network, and care professionals regarding their care and support questions
- Interest profiles translated into a framework, digital onboarding, and persona for the Sensitive Virtual Assistant
- Relevant knowledge about the wishes, needs, and perceptions of different variants of a virtual assistant
- Process evaluation of the collaboration with citizen scientists
- Various scientific articles (4) and presentations at scientific conferences (5)
- Follow-up assignments for the next phases: o Substantive approval for further testing and implementation in the organization of MEE Vivenz o Practical testing in four municipalities as part of strengthening Independent Client Support, and additionally, the request of two other MEE organizations to participate in these practical tests. o Follow-up project in collaboration with the Arnhem and Nijmegen University of Applied Sciences with the aim of further developing the sketch design in practice with everything that entails. The first preparatory subsidy for a larger Raak/Sia application has been received.
- Invitation to present at the Health Valley conference
- Invitation to a workshop at a Twente AI conference
- Invitation to give a presentation at a Catalan exchange
- Invitation to give a presentation at the Department of Communication and Cognition at Tilburg University
- Invitation to present the results at a citizen science day organized by the Arnhem and Nijmegen University of Applied Sciences and Radboudumc for vulnerable care recipients
- Serious interest from municipalities in Twente for the implementation of the Sensitive Virtual Assistant within their organizations.
Communication:
- Four newsletters, two of which are in plain language.
- Own website: www.sensitievevirtueleassistent.nl
- Three podcasts, see website
- Interview with the platform Sociale Versnellers
- Multiple LinkedIn posts by the project partners that have received a lot of exposure. For example, the latest post from the project leader received 3,351 impressions, of which 1,694 were unique views, there were 80 interactions, 13 comments, and 8 reposts.
- Presentations on the results to the members of the sounding board and steering group
- Video with final results in plain language for participants in focus and test groups
