Systematic Co-Design of Artificial Intelligence-Enabled Innovations for Healthy Aging: A Demonstration Study...

Artificial intelligence-enabled technologies offer new opportunities to support healthy aging and the long-term care needs of older adults. However, inclusive practices are paramount to ensuring that accessibility, usability, privacy, and equitable use are factored into the design and deployment of these emerging technologies. This article explores the role of co-design in health technology development and highlights the application of three methodological tools-the NIH Stage Model for Behavioral Intervention Development, the Unified Theory of Acceptance and Use of Technology, and Goal Attainment Scaling-to create a smart-home-based socially assistive robot (SAR) for the care of individuals living with Alzheimer's disease and related dementias (ADRD). Ten participants (five caregiver-care recipient dyads) from an ongoing mixed-methods pilot feasibility study trialed the SAR in their homes for 1-6 months, with the robot personalized to their daily functioning, home layout, and caregiving needs. Qualitative analysis of monthly interviews derived themes pertaining to technical design, care protocol design, training management, and complementary care. These themes, combined with goal attainment analysis, offered several insights that allowed us to iteratively scale and refine the technology tailored to ADRD care. The study offers a practical framework for future co-design efforts aimed at enhancing the adoption of AI-enabled health technologies among older adults.