Virtual Companion Research Articles

Perceptions and Effectiveness of a Fully-Automated Brief Behavioral Insomnia Therapy, Delivered by a Virtual Companion, in Older and Young Adults

Abstract Background and Objectives One of the most common sleep disturbances in older people is insomnia. Cognitive-behavioral therapy is the first-line treatment for this condition in older adults, but in-person treatment is costly and often unavailable. In this study, in a group of older and young subjects, we aimed to compare: (1) their initial perceptions of a fully-automated mobile health intervention to manage insomnia, (2) how these perceptions related to treatment completion, and (3) the effects of the intervention on insomnia severity and related outcomes. Research Design and Methods A case series study was conducted with a self-selected sample of older (> 65 years) and young (18-35 years) adults (n=5,660) who downloaded a free app, available in France, that delivers a brief behavioral intervention for insomnia aided by a virtual companion. The 17-day intervention included sleep hygiene and stimulus control recommendations. Primary outcome was treatment completion (yes/no). At the beginning of the intervention, treatment acceptability and trust in the virtual companion were assessed with two short questionnaires (completion rate: 1,597 users). Insomnia was evaluated with the Insomnia Severity Index. Results Logistic regression analyses showed that higher credibility and trust in the app’s virtual companion were associated with higher odds of treatment completion, but only in older adults (Trust scores x Age group: OR=1.12, [95%CI=1.01-1.25], p < .05, and Credibility scores x Age group: OR=1.25, [95%CI=1.06-1.47], p < .01). Within the subset of users who completed the intervention (n=289), insomnia remission (χ2=2.72, NS) and insomnia response rates (χ2=2.34, NS) were comparable across both groups. Discussion and Implications This brief behavioral intervention appears to be efficacious for the self-management of insomnia symptoms in older adults. The integration of persuasive interaction elements, such as avatars and virtual coaches, in fully-automated interventions could be particularly useful to stimulate older adults’ engagement.

Development and Initial Testing of an Artificial Intelligence-Based Virtual Reality Companion for People Living with Dementia in Long-Term Care.

Background/Objectives: Feelings of loneliness are common in people living with dementia (PLWD) in long-term care (LTC). The goals of this study were to describe the development of a novel virtual companion for PLWD living in LTC and assess its feasibility and acceptability. Methods: The computer-generated virtual companion, presented using a head-mounted virtual reality display, was developed in two stages. In Stage 1, the virtual companion asked questions designed to encourage conversation and reminiscence. In Stage 2, more powerful artificial intelligence tools allowed the virtual companion to engage users in nuanced discussions on any topic. PLWD in LTC tested the application at each stage to assess feasibility and acceptability. Results: Ten PLWD living in LTC participated in Stage 1 (4 men and 6 women; average 82 years old) and Stage 2 (2 men and 8 women; average 87 years old). Session lengths ranged from 0:00 to 5:30 min in Stage 1 and 0:00 to 53:50 min in Stage 2. Speech recognition issues and a limited repertoire of questions limited acceptance in Stage 1. Enhanced conversational ability in Stage 2 led to intimate and meaningful conversations with many participants. Many users found the head-mounted display heavy. There were no complaints of simulator sickness. The virtual companion was best suited to PLWD who could engage in reciprocal conversation. After Stage 2, response latency was identified as an opportunity for improvement in future versions. Conclusions: Virtual reality and artificial intelligence can be used to create a virtual companion that is acceptable and enjoyable to some PLWD living in LTC. Ongoing innovations in hardware and software will allow future iterations to provide more natural conversational interaction and an enhanced social experience.

An intelligent support system and emotional state tests for people who are sick or recovering

The project aims to develop an intelligent system that has the potential to significantly improve patient care by examining and supporting the emotional state of people with chronic diseases or undergoing rehabilitation. The system will use advanced technologies such as image analysis, natural language processing and understanding (NLP/NLU), and a personal assistant module. Acting as a virtual companion, this module will support the user in everyday tasks such as setting reminders and managing schedules and provide emotional support through interactive conversations. The project also involves the development of an analytical module that automatically generates analyses and reports based on the collected data. A patient-oriented system will be created during the work to collect essential data and support him in rehabilitation. On the other hand, the system will cooperate with a doctor who can make a preliminary diagnosis and develop further treatment based on the patient's data. As feedback, the patient will receive health reports along with their interpretation and treatment recommendations created by the doctor.

Navigating Wellness: Chatbot-Powered Solutions for Mental Health

Abstract: Our overall well-being depends heavily on our mental health, which has received more attention in recent years. At the heart of this platform lies a sophisticated chatbot system, meticulously crafted to provide empathetic and responsive interactions with users.this abstract introduces a pioneering mental health website designed to offer comprehensive assistance to individuals seeking to improve their mental well-being. This chatbot serves as a virtual companion, offering a safe space for individuals to express their thoughts, feelings, and concerns without fear of judgment or stigma. Crucially, this website goes beyond mere conversation; it offers real-time solutions to address mental health challenges head-on. Drawing upon evidencebased practices and therapeutic techniques, the platform provides users with actionable strategies to manage stress, anxiety, depression, and other common mental health issues.

Using AI-Based Virtual Companions to Assist Adolescents with Autism in Recognizing and Addressing Cyberbullying.

Social media platforms and online gaming sites play a pervasive role in facilitating peer interaction and social development for adolescents, but they also pose potential threats to health and safety. It is crucial to tackle cyberbullying issues within these platforms to ensure the healthy social development of adolescents. Cyberbullying has been linked to adverse mental health outcomes among adolescents, including anxiety, depression, academic underperformance, and an increased risk of suicide. While cyberbullying is a concern for all adolescents, those with disabilities are particularly susceptible and face a higher risk of being targets of cyberbullying. Our research addresses these challenges by introducing a personalized online virtual companion guided by artificial intelligence (AI). The web-based virtual companion's interactions aim to assist adolescents in detecting cyberbullying. More specifically, an adolescent with ASD watches a cyberbullying scenario in a virtual environment, and the AI virtual companion then asks the adolescent if he/she detected cyberbullying. To inform the virtual companion in real time to know if the adolescent has learned about detecting cyberbullying, we have implemented fast and lightweight cyberbullying detection models employing the T5-small and MobileBERT networks. Our experimental results show that we obtain comparable results to the state-of-the-art methods despite having a compact architecture.

Virtual Reality Companion for Dementia Patients in Long‐term Care: A Feasibility Study

AbstractBackgroundPersons with dementia (PWDs) develop progressive cognitive and physical decline which often results in placement in long‐term care (LTC). Within LTC, PWDs are at high risk for social isolation, as friends and family members may not visit often, a problem exacerbated by the COVID‐19 pandemic.MethodThis project is developing a novel application for immersive virtual reality (VR), in which an avatar (i.e. a visual representation of a person) acts as an autonomous artificial companion for PWDs in LTC. This avatar is programmed to listen to PWDs through microphones embedded in VR goggles, and provide verbal interaction with PWDs through embedded speakers. In this way, the avatar can provide a source of conversation and socialization, available at any time, for any duration. This engagement may improve quality of life, and reduce responsive and reactive dementia behaviours.ResultOur virtual companion was trialed in 10 PWD (3 men; 7 women). Most PWD found the companion to be engaging, and this invited positive reminiscence in 3 PWD. VR goggles were generally well‐tolerated, though 2 PWD closed their eyes and/or did not respond. The ability to interact verbally in a conversational manner was easier in patients with milder dementia. There was some poor performance of the speech recognition software, which impacted the flow of the conversation. Significant verbal feedback was recorded on how to improve the avatar, and how to enhance the conversation.ConclusionAn autonomous artificial companion presented in virtual reality (VR) is feasible, and may benefit persons with dementia who are at risk of social isolation. Future iterations will incorporate improved speech recognition and artificial intelligence (AI)‐guided conversation generator software.

Mental Health Guidance and Support Bot

In an era characterized by the relentless pace of life and the escalating challenges to mental well-being, the emergence of the Mental Health Support Bot represents a revolutionary advancement in addressing the universal struggle with stress, anxiety, and depression. This abstract delves deeper into the conceptualization, methodology, results, and broader implications of this virtual companion, highlighting its transformative impact on the landscape of mental health support. The Mental Health Support Bot is rooted in the synergy of cutting-edge artificial intelligence and a profound understanding of the nuanced nature of mental health challenges. Its conceptualization arises from the recognition that these challenges are not confined to specific demographics but are pervasive, transcending geographical, cultural, and temporal boundaries. The bot is designed to be a dynamic and responsive virtual companion that tailors its approach to the unique needs of each individual user. Powered by advanced artificial intelligence, the Support Bot employs adaptive algorithms that continuously learn and evolve based on user interactions. The profound impact of the Mental Health Support Bot is reflected in its ability to transcend traditional limitations of mental health support systems. Its continuous accessibility, operating 24/7, ensures that users can seek assistance whenever the need arises, breaking down the temporal constraints of conventional models. Moreover, the bot's adaptability to users' schedules, whether during quiet moments in the night or amid the rush of a busy day, enhances the likelihood of individuals seeking timely assistance. The results signify a paradigm shift in mental health support, moving towards a more user-centric and proactive approach.

The Experience of Conversation and Relation with a Well-Being Chabot: Between Proximity and Remoteness

The article concerns the users’ experiences of interacting with well-being chatbots. The text shows how chatbots can act as virtual companions and, to some extent, therapists for people in their daily reality. It also reflects on why individuals choose such a form of support for their well-being, concerning, among others, the stigmatization aspect of mental health problems. The article discusses and compares various dimensions of users’ interactions with three popular chatbots: Wysa, Woebot, and Replika. The text both refers to the results of research on the well-being chatbots and, analytically, engages in a dialogue with the results discussed in the form of sociological (and philosophical) reflection. The issues taken up in the paper include an in-depth reflection on the aspects of the relationship between humans and chatbots that allow users to establish an emotional bond with their virtual companions. In addition, the consideration addresses the issue of a user’s sense of alienation when interacting with a virtual companion, as well as the problem of anxieties and dilemmas people may experience therein. In the context of alienation, the article also attempts to conceptualize that theme concerning available conceptual resources.

Smart Speaker and ICT Use in Relationship With Social Connectedness During the Pandemic: Loneliness and Social Isolation Found in Older Adults in Low-Income Housing.

Social well-being of older adults living in low-income housing was disproportionately affected by the coronavirus disease 2019 pandemic. We explored low-income residents' experiences of social isolation and loneliness and strategies to remain socially connected during the pandemic. As part of a larger, 3-phase user-centered design study, we conducted a qualitative study using focus groups to gain insights into social isolation experiences and the role of information and communication technologies (ICTs), including smart speakers, in social connectedness (N = 25, 76% African American). We also collected survey data to describe social isolation, loneliness, and current ICT use in the sample. Participants included both smart speaker users and nonusers. Experiences of social isolation and loneliness varied by participants' sociodemographic characteristics and previous experiences with smart speakers. Qualitative analysis showed participants demonstrated coping strategies developed during the pandemic to adapt to new norms of connecting with others, including technology-enabled social interactions. Participants expressed a strong desire to build community together in their facilities and highlighted the potential role of smart speakers in making meaningful social connections, encompassing safety checks to have a means for emergencies, and providing a virtual companion. Access, digital literacy, training, security, and privacy issues were discussed as factors affecting their adoption of new ICT for enhanced social connectedness. This study highlights the importance of understanding the unique social isolation experience, demographics, and social determinants of health of low-income residents to develop ICT-based interventions for social connectedness.

How I want technology used in my care: Learning from documented choices of people living with dementia using a dyadic decision making tool

ABSTRACTWhile technologies for aging in place are promoted to support care partners and people living with dementia, perspectives of people living with dementia are underrepresented in both use decisions among families and discussions within academia and industry. This mixed-methods study examined the use preferences of twenty-nine people living with mild Alzheimer’s disease (AD) for four categories of technologies: location tracking, in-home sensors, web-cameras, and virtual companion robots. Participants completed a novel dyadic intervention, Let’s Talk Tech, where they documented their preferences of the four technology categories for care planning purposes. Post-test interviews were thematically analyzed and provide insight into selection processes. Technology preferences varied considerably by and within participant living with mild AD. Excepting location tracking, non-technology and low-technology options were more desirable than the featured technologies. Control over technology use was of great importance to people living with AD. Considerations given to technology preference selection imperfectly fit within the new Health Technology Acceptance Model (H-TAM) developed for older adults. These findings underscore the importance of including people living with dementia in decision making about technologies to support care at home and the need for further personalization and tailorable technological devices to accommodate and align with their preferences.

A psychosocial investigation of exercise preferences in real and virtual environments

Three studies explored exercise preferences in real-world and virtual environments, and their relationship with social physique anxiety (SPA), social comparison, and self-presentational efficacy (SPE). In Study 1 (N = 230), real-world exercise preferences were explored. Study 2 (N = 228) measured preferences for real-world and virtual reality (VR) exercise, and Study 3 (N = 249) investigated preferences for avatar embodiment and virtual companions within VR. Results revealed that participants who preferred home-based exercise had lower exercise behaviour, more negative fitness-related social comparisons, or lower SPE expectancy and outcome value (Study 1). Individuals with lower exercise behaviour, more negative fitness-related social comparisons, lower SPE expectancy, or higher SPA were also more likely to choose VR than real-world exercise (Study 2). In a VR exercise setting, participants with higher SPA and more negative social comparisons also preferred to embody a non-human and fantasy avatar more than a realistic avatar. A heightened threat of negative social comparison when imagining exercise with a physically superior virtual companion resulted in the strongest preference to embody a fantasy avatar (Study 3). The results suggest that individuals who place high importance on self-presentation and have low belief in their capacity to project an image of competence to others, are more likely to prefer exercise contexts that minimise physique- and fitness-related evaluation. Moreover, VR may afford a less psychosocially threatening context for individuals who feel self-conscious or comparatively inferior to others during exercise.

Let virtual creatures stay virtual: tactics to increase trust in virtual influencers

PurposeAdvances in technology and the popularity of social media influencers have sparked a rise of “virtual influencers (VIs).” This study examines consumer attitudes toward VIs in social networking services and explores factors that enhance or dampen these attitudes. In three experiments, it was explored how contextual factors (background and companion) interact with human (HIs) and VIs, influencing attitudes through trustworthiness.Design/methodology/approachThree experiments were conducted using an online panel (N = 894). All experiments were based on the comparison between HIs and VI with mediating role of trustworthiness. In Studies 2 and 3, moderated mediation analyses were conducted to test hypotheses.FindingsThe results revealed that human-like VI was less trusted than animi-like VI or HIs. However, the perceived trustworthiness toward VI was enhanced when the VI was in a virtual (vs. real) environment (Study 2) or accompanied by a virtual (vs. human) companion (Study 3), leading to positive attitudes.Originality/valueThis research not only enriches relevant literature (avatars and SMIs) but also provides actionable insight for practitioners who design and utilize VIs. This paper proposes novel and handy tactics to enhance consumers' trustworthiness in and attitudes toward VIs.

From improved sleep regularity to reduced sleep complaints and mental health conditions: a population-based interventional study using a smartphone-based virtual agent.

To explore the effect of sleep regularity on sleep complaints and mental health conditions (i.e. insomnia, fatigue, anxiety, and depressive symptoms) in a population-based interventional study using a smartphone-based virtual agent. A populational cohort based on the Kanopée application, which provided interactions with a virtual companion to collect data on sleep and make personalized recommendations to improve sleep over 17 days. A pre-intervention sleep diary and interview were used for cross-sectional analysis (n = 2142), and a post-intervention sleep diary and interview were used for longitudinal analysis (n = 732). The intra-individual mean (IIM) and standard deviation (ISD) of total sleep time (TST) were calculated to measure sleep quantity and sleep regularity. The mean age at baseline was 49 years, 65% were female, 72% reported insomnia, 58% fatigue, 36% anxiety, and 17% depressive symptoms. Before the intervention, irregular and short sleep was associated with a higher likelihood of insomnia (Relative risk [RR] = 1.26 [1.21-1.30] for irregular TST and RR = 1.19 [1.15-1.23] for short TST), fatigue, anxiety, and depressive symptoms. After the intervention, the IIM of the TST increased while the ISD of the TST and sleep complaints and mental health conditions decreased. More regular TST was associated with reduced insomnia and depressive symptoms (RR = 1.33 [1.10-1.52] and RR = 1.55 [1.13-1.98], respectively). Our results reveal a longitudinal association between sleep regularity and sleep complaints and mental health conditions. Policymakers, health professionals, and the general population should be aware that, beyond its positive effect on sleep health, regular sleep could promote mental health.

Challenging social media threats using collective well-being-aware recommendation algorithms and an educational virtual companion.

Social media have become an integral part of our lives, expanding our interlinking capabilities to new levels. There is plenty to be said about their positive effects. On the other hand, however, some serious negative implications of social media have been repeatedly highlighted in recent years, pointing at various threats to society and its more vulnerable members, such as teenagers, in particular, ranging from much-discussed problems such as digital addiction and polarization to manipulative influences of algorithms and further to more teenager-specific issues (e.g., body stereotyping). The impact of social media-both at an individual and societal level-is characterized by the complex interplay between the users' interactions and the intelligent components of the platform. Thus, users' understanding of social media mechanisms plays a determinant role. We thus propose a theoretical framework based on an adaptive "Social Media Virtual Companion" for educating and supporting an entire community, teenage students, to interact in social media environments in order to achieve desirable conditions, defined in terms of a community-specific and participatory designed measure of Collective Well-Being (CWB). This Companion combines automatic processing with expert intervention and guidance. The virtual Companion will be powered by a Recommender System (CWB-RS) that will optimize a CWB metric instead of engagement or platform profit, which currently largely drives recommender systems thereby disregarding any societal collateral effect. CWB-RS will optimize CWB both in the short term by balancing the level of social media threats the users are exposed to, and in the long term by adopting an Intelligent Tutor System role and enabling adaptive and personalized sequencing of playful learning activities. We put an emphasis on experts and educators in the educationally managed social media community of the Companion. They play five key roles: (a) use the Companion in classroom-based educational activities; (b) guide the definition of the CWB; (c) provide a hierarchical structure of learning strategies, objectives and activities that will support and contain the adaptive sequencing algorithms of the CWB-RS based on hierarchical reinforcement learning; (d) act as moderators of direct conflicts between the members of the community; and, finally, (e) monitor and address ethical and educational issues that are beyond the intelligent agent's competence and control. This framework offers a possible approach to understanding how to design social media systems and embedded educational interventions that favor a more healthy and positive society. Preliminary results on the performance of the Companion's components and studies of the educational and psychological underlying principles are presented.

Efficacy of a Smartphone-Based Virtual Companion to Treat Insomniac Complaints in the General Population: Sleep Diary Monitoring Versus an Internet Autonomous Intervention.

(1) Background: Insomnia is the most prevalent sleep disorder worldwide and cognitive behavioral therapy is the front-line treatment. Digital health technologies have a role to play in screening and delivering interventions remotely and without the need for human intervention. The KANOPEE app, which provides a screening and behavioral intervention for insomnia symptoms through an interaction with a virtual agent, showed encouraging results in previous studies during and after the COVID-19 lockdown, but has not yet been evaluated in a controlled study. This study aims at comparing the benefits of KANOPEE, a smartphone application dealing with insomnia complaints, with another application proposing an electronic sleep diary named “My Sleep Diary”. The acceptance and potential benefits of these digital solutions are tested in real-life settings (i.e., without soliciting human medical resources) and in the general population. (2) Methods: Subjects were included if they downloaded one of the apps between December 2020 and October 2021, and were of legal age. Both apps were available on downloading platforms in France. Primary outcome was Insomnia Severity Index (ISI), and secondary outcomes were total sleep time (TST), sleep efficiency (SE) and wake time after sleep onset (WASO). (3) Results: A total of 535 users completed the intervention with KANOPEE and 489 users completed My Sleep Diary, both for 17 days. KANOPEE users improved their ISI score significantly more than sleep diary users (interaction Time*Group: F(2,2002) = 17.3, p < 0.001). Similar results were found for nocturnal sleep parameters (TST) (KANOPEE users gained 48 min of sleep after intervention, while My Sleep Diary users gained only 16 min of sleep), and particularly in the population with moderate to severe initial sleep complaints (F(4,1980) = 8.9, p < 0.001). Other sleep markers (SE and WASO) were significantly improved in the KANOPEE users compared to the sleep diary ones (p < 0.001). (4) Conclusions: KANOPEE provides significantly greater benefits than an electronic sleep diary regarding reduction of insomnia complaints and estimated nocturnal sleep characteristics in a self-selected sample of the general population. Population with the most severe initial ISI score (≥15) benefited the most from the KANOPEE App compared to filling up a simple sleep diary.

Impact of video-mediated online social presence and observance on cognitive performance.

The onset of the coronavirus (COVID-19) pandemic has shifted most of the world toward remote working and education. As the world continues to embrace remote virtual communication in the post-COVID-19 era, it is crucial to investigate the impacts of online social copresence on cognitive performance. The present study investigated how the online videoconference presence of a virtual companion affects participants performance on cognitive relational-reasoning tasks. The companion was either present and attentive to the participant, present but nonattentive, or absent. We manipulated the agency of a virtual companion, who was either a real human, an avatar controlled by a human, or an artificial intelligence (AI)-controlled agent. We hypothesized that the mere presence of a virtual companion, and the observance of participants’ performance, would influence participants’ performance. The results were broadly in line with our hypothesis that a mere presence of a virtual companion improved cognitive performance irrespective of their agency. However, the direction of the results did not support our prediction. We did not find a systematic impact of observance on cognitive performance, not supporting our second hypothesis. Participants performed best overall with an AI-controlled agent, next best with an avatar and worst with a real-human companion. We also observed that participants performed more accurately when a virtual companion was present but nonattentive, and faster when a virtual companion observed the participants, compared to when the participants performed alone. We conclude that online videoconference presence with a virtual companion, regardless of observance, temporarily enhances cognitive performance, and discuss the implications of these findings.

Supplemental Material for Impact of video-mediated online social presence and observance on cognitive performance.

The onset of the coronavirus (COVID-19) pandemic has shifted most of the world toward remote working and education. As the world continues to embrace remote virtual communication in the post-COVID-19 era, it is crucial to investigate the impacts of online social copresence on cognitive performance. The present study investigated how the online videoconference presence of a virtual companion affects participants performance on cognitive relational-reasoning tasks. The companion was either present and attentive to the participant, present but nonattentive, or absent. We manipulated the agency of a virtual companion, who was either a real human, an avatar controlled by a human, or an artificial intelligence (AI)-controlled agent. We hypothesized that the mere presence of a virtual companion, and the observance of participants’ performance, would influence participants’ performance. The results were broadly in line with our hypothesis that a mere presence of a virtual companion improved cognitive performance irrespective of their agency. However, the direction of the results did not support our prediction. We did not find a systematic impact of observance on cognitive performance, not supporting our second hypothesis. Participants performed best overall with an AI-controlled agent, next best with an avatar and worst with a real-human companion. We also observed that participants performed more accurately when a virtual companion was present but nonattentive, and faster when a virtual companion observed the participants, compared to when the participants performed alone. We conclude that online videoconference presence with a virtual companion, regardless of observance, temporarily enhances cognitive performance, and discuss the implications of these findings.

Learning Humanities and Ethics of Aging Through the Lens of an Avatar Creation

The main goal of teaching the humanities and ethics of aging is to understand the perspectives of older individuals as they address the challenges and opportunities presented across the aging spectrum. To encourage understanding of this humanistic and ethical process, students were given an assignment to select a profile of an older person with pre-selected characteristics that they then develop into their avatar, a virtual companion, to accompany them through the course. This assignment included three iterations of the avatar narrative related to what is studied in class around major life transition points related to work, housing, and end of life. These assignments included the creation of Mind Maps which illustrate their avatar’s ongoing concerns related to their environment including their social determinants of health. The avatar’s formative development throughout the course brought forward discussions around identity, safety, autonomy, and person-centeredness in terms of gerontological practice and policy.

P-135: Evaluation of the support and knowledge provided by the chatbot (virtual conversation agent) Vik Multiple Myeloma in the management of the disease

<h3>Background</h3> Multiple myeloma is a bone marrow cancer that affects more than 5,000 new patients each year in France [1] and requires individualized care for each patient. Faced with questions that patients and their relatives may have about the management of the disease, the Vik multiple myeloma (MM) chatbot has been created to accompany them throughout their care. This virtual companion is a mobile application that mimics a natural conversation thanks to Artificial Intelligence (AI). <h3>Method</h3> A survey was conducted among adult users of Vik MM between March and May 2021. First, the socio-demographic and medical characteristics of the users were collected, then their knowledge was assessed through 10 different questions about the disease (diagnosis, symptoms, treatments, etc.). The last section allowed the evaluation of the users' satisfaction with Vik MM in terms of help, support, and reassurance. Comparative analyses were performed with parametric tests (chi-squared). <h3>Results</h3> The 154 respondents to the survey had a median age of 65 years, with an equal distribution of men and women. Concerning the knowledge of the users on multiple myeloma, 87% of them indicated that Vik MM helped them to better understand the disease. This increase in knowledge was observed in various user profiles, with more or less history with the disease. 76% of the users who had been diagnosed more than 3 years ago declared that they had a better understanding of multiple myeloma thanks to Vik MM. This gain in knowledge linked to content sharing on the disease could be observed as early as 14 days on Vik MM (77% of correct answers vs. 58% for new users, p-value <1%). The users were therefore clearly more confident about their answers (94% vs. 62% among new users, p-value <0.1%). Moreover, sharing content on multiple myeloma allowed 65% of Vik MM users to make less demands to their hematologist. Despite a relatively low use of digital tools in the management of their disease (73% did not use them or used them only occasionally), users expressed a real appreciation for Vik MM. Indeed, 92% of them indicated that they were satisfied with it and 81% found it comforting. Moreover, 74% of the users considered that Vik MM helped them to make better decisions. <h3>Conclusion</h3> In a population that is not oriented towards digital health tools, Vik Multiple Myeloma has allowed users to educate themselves and gain significant confidence about their disease after only 14 days spent on the application. Vik multiple myeloma also provided them with a significant moral support in the context of a disease that has a heavy burden on their daily life.

Facilitating independent commuting among individuals with autism – A design study in Singapore

IntroductionIn the hope of designing concepts for future transport systems, we would like to understand more about the barriers and challenges faced by individuals with autism when taking public transport in Singapore. However, the limited research studies exploring this topic were all conducted abroad with different transport systems. This paper thus investigates the barriers to public transport in Singapore's context for individuals with Autism Spectrum Disorder (ASD). MethodsIn collaboration with a special needs school, parents of students with ASD were invited to complete the questionnaire online about their children's travel experiences. From a total of 25 parents, details of their children's frequency of travel, independent public transport experiences (if any) and challenges of independent commuting were examined. Based on the survey findings, a requirement list was compiled as a basis for creating a design concept to address public transport barriers of individuals with ASD. ResultsKey requirements summarised from the survey include quiet environments, assistance in alighting, assistance in boarding, predictable travel routines, simplified ways to ask for help, supervision or support, more visual aids, emergency buttons, learning to ask for seats and priority seating. ViCo, a Virtual Companion at bus stops and in buses and trains is proposed in the current paper to address the requirement list of individuals with ASD as highlighted in the survey findings. ConclusionThe proposed implementation of ViCo is expected to improve the commuting experience of individuals with ASD, but can be extended to serve individuals with diverse disabilities as well as people without disabilities.