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. 2025 Jul 23:1-30.
doi: 10.1080/17483107.2025.2530195. Online ahead of print.

Enabling by voice: an exploratory study on how interactive smart agents (ISAs) can change the design of environmental control (EC) equipment and service

Umber Shamim  1 , Alan Woodcock  2 , Ajoy Nair  2 , Gabriella Spinelli  1
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Enabling by voice: an exploratory study on how interactive smart agents (ISAs) can change the design of environmental control (EC) equipment and service

Umber Shamim et al. Disabil Rehabil Assist Technol. .
Free article

Abstract

Aim: Well-designed assistive devices improve the quality of life of individuals with severe and permanent impairments and reduce the burden on their caregivers. This study investigated whether interactive smart agents (ISAs) are effective in supporting individuals who are affected by neurological conditions causing severe mobility issues, and the factors aiding ISAs' adoption.

Materials and methods: The North Thames Regional Environmental Control Equipment Services (NTRECES) supported this study by recruiting service users (people with severe mobility impairments due to neurological ailments) in the study. Health Research Authority approval was obtained (255096). NTRECES prescribes medical-grade environmental control (EC) devices, unlike smart speakers (ISAs). Research on ISA adoption by NTRECES users could support prescribing ISAs as assistive EC devices in the future. Through secondary research and exploratory primary data, this user-centred study developed an initial technology adoption model, subsequently revised in light of the insights from a multi-point qualitative primary research.

Conclusion: This research uncovered that novelty, ease of voice interaction and its entertainment value play a key role in the adoption decision. Willingness to overlook reliability, privacy and security attributes was identified, providing that the service users had back-up devices for security and privacy critical tasks. The originality of this work consists in the development of a technology adoption model tailored to consider the characteristics of service users with severe physical disabilities and the attributes of ISAs technology. The research contributes to the discussion on contextual factors and technology design features that may improve the inclusivity of ISAs and their use as medical devices.

Keywords: Assistive technologies; interactive smart agents; technology adoption; user-centred design.

Plain language summary

This manuscript represents original research conducted in the field of design focusing on User Centred Design in Assistive Technology. We believe that our findings significantly contribute to the understanding of Human Behaviour and Assistive Technology Adoption, which aligns closely with the scope and interests of your esteemed journal.Interactive smart agents (ISAs) like Alexa can be integrated with assistive technologies to support individuals with disabilities. For example, ISA devices can help those with mobility impairments control their environment or access information hands-free.Our study employs qualitative methods to investigate adoption of voice based smart agents as assistive technology devices. Through rigorous thematic analysis, we have proposed a new assistive technology adoption model based on theory of planned behaviour (TPB).The new model provides valuable insights for designers and manufacturers to tailor ISA devices to better meet the needs of users with severe mobility impairments. This can result in the improvement in their quality of life, less reliance on caregivers and increased independence. In addition to that, new venues of employability and entertainment can also be explored.The key constructs influencing behavioural intention include Attitude, perceived behavioural controls (PBCs), subjective norms (SNs) and a novel addition, voice Interaction experience. Various factors such as voluntariness, openness to innovation, disposable income, disability, familiarity with technology, technical support, trust in advice, among others, influence these constructs. The modified model integrates emerging themes from data analysis, including the addition of disability as a factor and modifications to existing factors like income. The research extends TPB by including voice interaction experience as a significant factor in behavioural intention. Additional factors affecting users’ attitude, perceived controls, norms, and voice interaction experience are identified and incorporated into the model, enhancing its comprehensiveness. Certain factors previously identified in technology adoption theories may not hold the same influence in this context, while others remain consistent or are adapted to suit the specific needs of users with severe mobility impairments.We believe that these contributions are particularly relevant and valuable to the readership of “Disability and Rehabilitation: Assistive Technology”.

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