Creating a virtual coach for Active and Healthy Ageing : Challenges, obstacles and opportunities, an interview from Gerard Cornet.

Gerard Cornet, gerontologist, Vice president of the University Institute of Gerontology Yves Ménin in France, and member of e-VITA ethical board, gives his thoughts about virtual coaching for Active and Healthy Ageing.

Why is it important to create a virtual coach focusing on Active and Healthy Ageing for e-VITA?

Adults, younger and older ones, have already their own ideas and expectations about their well-being and their perception of active and healthy ageing at home. Their opinion on the matter is as diverse as older people are heterogenous. Older people come in different shapes, status, health conditions, family composition, education, cultural background and living environment.

In practice, the interpretation of active and healthy ageing by older adults greatly differs from the one of researchers and service. That is why, e-VITA ambitions and methodology are of the greatest relevance to create a virtual coach adapted to the real needs of such a heterogenous group.

Why e-VITA interesting from a cultural perspective?

e-VITA will not only use its methodology by placing the older adult as at the center of a collaborative design but will provide personalized adapted solutions for older adults both living in Europe and Japan.  Exchange of research findings and experimentation between Japan and Europe, with two different cultures and traditions, with a demographic profile that differs, as well as the relationships with digital technologies and robotics and with a different care system for older adults, these are all challenges to tackle for a personalized coach in the context of a life expectancy growing in both part of the world. 

Among other project on virtual coaching, what will be the keys for success for the development of the e-VITA coach?

The well-meaning ambitions of e-Vita researchers and partners is to go beyond the state of the art; Indeed, in the domain of technology support for Active and Healthy Ageing in a smart living environment, e-VITA should take in account the lessons provided by many virtual coaching projects, obstacles to avoid going further from formal acceptance of the virtual coach to sustainable adoption by older adult to finally reach the growing markets and businesses.

It was found out that the main factor for a successful sustainable adoption by active older adults was the individual assessment of the disrupting benefits compared with costs and efforts for the acquisition and adaptation of the virtual coach.

It is therefore a question of finding a model where the reward for changing behavior is far greater than the effort and cost.  Rewards could be to value a participation thanks to a scale of points, organizes exchanges between participants which provokes emulation. We could think about reward form welfare or financial institutions as well.

This would create a culturally appropriate club business model that is more likely to find large markets. Our end-users are not willing to pay large contributions for organizations that they don’t perceive as impactful in their life. But they could pay contributions to go to clubs, or to play online (e.g. bridge).

Of course we should respect ethical requirements going beyond those of the GDPR, on consent and data security and the presence of selected and chosen advertisements, the contractual freedom to leave the application, a good balance between the intelligent emotional language of the virtual dialogue, the control of follow-up and the freedom of decision

As a member of the Ethical Board of the project, what do you think of the preventive approach of e-VITA?

The actual context of the population ageing requires conceptually new prevention, care, and smart living solutions. But prevention is not a matter of fact. Indeed, prevention is directly linked with the risk assessment of a medical disease made by each individual and older person. Improvement for a more preventive behavior may come from two main factors: (i) potential diseases are still not medically diagnosed (ii) adopting this new preventive behavior ask too much efforts in the daily life of older adults.

How can we tackle this challenge to involve and engage older adult to use this digital and preventive solution?      

Emotional and financial rewards value are complementary keys for sustainable improvements. Indeed, rewarding benefits resulting with smart gaming may provide more effects than boring lessons. Rewards with financial benefits are also to be considered if allowed by ethical rules in insurance contracts.

It may also provide exchange of good practices examples among  older persons and their carers.

e.g. Take the example of an older person who likes to play bridge in his/her club. This action is providing memory training and physical efforts to go there. It is also creating social relationship and wish to win the practice of this difficult game they have learned before ageing.

e-VITA has the ambition to design and provide prevention services such as training, social support, gaming, incentives, stimulation, but time and continuity for theses solutions are needed.

What challenges do you see in the interactive approach between the virtual coach and the older adult?

One of the challenges in the interaction between robots and older adults is to be careful with the use and analysis of the emotional data, voice recognition and dialogue. It is crucial that the virtual coach uses a natural and intelligent voice and optimizes the dialog and understanding, providing a great support and guidance.

Ethical aspects are also important to take into consideration, as analyzing personal information and collecting personal emotions is still under discussion to respect freedom and dignity of the users.

What are the important physical aspects to take into consideration when designing a virtual coach for older adult?

Must of all, the virtual coach needs to be accessible for older adults, with a user-friendly design. Nowadays, virtual coaches remain mainly designed by young people for a representative market, without taking into consideration older adults needs, wishes and abilities. Although, more and more older adults are using digital technologies or are already acculturated with virtual coach, as this is the case in Japan.

What are the obstacles that older adult can meet when using digital technologies?

First, not all older adults are facing issues when using technologies. But if, as adults, we are experiencing difficulties, this could be linked to the huge development of connected objects and “Internet of Thing”, Internet-connected objects creating the need to secure and protect our data, including the generation of numerous passwords that we need to remember or to restore in a regular basis. Frequent changes of technologies and required updates, programmed obsolescence of devices, lack of adapted training and lack of adaption to the living environment of older adult are factors that do not facilitate the adoption of such solutions.  

Being a member of the ethical board, what are the ethical challenges e-VITA will need to overcome?

To comply with legal and ethics rules, e-VITA may be confronted with compliance and control of subcontractors, training of end-users to protect their data when using the digital technologies and dealing with the blurred frontiers between personal medical data and personal information data.

One of the ethical challenges is also to properly address the difficult questions of a comprehensive full consent for using emotion data collection in a context where people may face impairment. Expectations may differ from the end-user wishes in term of what concrete data they will agree to communicate, versus the data the family or informal carer wish to receive for safety and work alleviation reasons.

What are your expectations working in a project as e-VITA?

There are 3 general ambitions of e-Vita that are interesting for me as a gerontechnology expert and an older person myself: (i) its complex user-centric based methodology used to suggest personalized solutions (ii) the sustainability aspect of the service, (iii) finding the right balance between relevant prevention, security, control and freedom of the end-users.

I am still teaching inclusive design of innovative technology to professional care providers at Paris Sorbonne University in Charles Foix Hospital, under Professor Joël Belmin training courses management, I expect so much of this Japan-European funded project and I expect this Japan-European funded project can reach these ambitions!