Unobtrusive Health Monitoring in Private Spaces: The Smart Home

With the advances in sensor technology, big data, and artificial intelligence, unobtrusive in-home health monitoring has been a research focus for decades. Following up our research on smart vehicles, within the framework of unobtrusive health monitoring in private spaces, this work attempts to provide a guide to current sensor technology for unobtrusive in-home monitoring by a literature review of the state of the art and to answer, in particular, the questions: (1) What types of sensors can be used for unobtrusive in-home health data acquisition? (2) Where should the sensors be placed? (3) What data can be monitored in a smart home? (4) How can the obtained data support the monitoring functions? We conducted a retrospective literature review and summarized the state-of-the-art research on leveraging sensor technology for unobtrusive in-home health monitoring. For structured analysis, we developed a four-category terminology (location, unobtrusive sensor, data, and monitoring functions). We acquired 912 unique articles from four relevant databases (ACM Digital Lib, IEEE Xplore, PubMed, and Scopus) and screened them for relevance, resulting in n=55 papers analyzed in a structured manner using the terminology. The results delivered 25 types of sensors (motion sensor, contact sensor, pressure sensor, electrical current sensor, etc.) that can be deployed within rooms, static facilities, or electric appliances in an ambient way. While behavioral data (e.g., presence (n=38), time spent on activities (n=18)) can be acquired effortlessly, physiological parameters (e.g., heart rate, respiratory rate) are measurable on a limited scale (n=5). Behavioral data contribute to functional monitoring. Emergency monitoring can be built up on behavioral and environmental data. Acquired physiological parameters allow reasonable monitoring of physiological functions to a limited extent. Environmental data and behavioral data also detect safety and security abnormalities. Social interaction monitoring relies mainly on direct monitoring of tools of communication (smartphone; computer). In summary, convincing proof of a clear effect of these monitoring functions on clinical outcome with a large sample size and long-term monitoring is still lacking

Systematic review of smartphone-based passive sensing for health and wellbeing

OBJECTIVE: To review published empirical literature on the use of smartphone-based passive sensing for health and wellbeing. MATERIAL AND METHODS: A systematic review of the English language literature was performed following PRISMA guidelines. Papers indexed in computing, technology, and medical databases were included if they were empirical, focused on health and/or wellbeing, involved the collection of data via smartphones, and described the utilized technology as passive or requiring minimal user interaction. RESULTS: Thirty-five papers were included in the review. Studies were performed around the world, with samples of up to 171 (median n = 15) representing individuals with bipolar disorder, schizophrenia, depression, older adults, and the general population. The majority of studies used the Android operating system and an array of smartphone sensors, most frequently capturing accelerometry, location, audio, and usage data. Captured data were usually sent to a remote server for processing but were shared with participants in only 40% of studies. Reported benefits of passive sensing included accurately detecting changes in status, behavior change through feedback, and increased accountability in participants. Studies reported facing technical, methodological, and privacy challenges. DISCUSSION: Studies in the nascent area of smartphone-based passive sensing for health and wellbeing demonstrate promise and invite continued research and investment. Existing studies suffer from weaknesses in research design, lack of feedback and clinical integration, and inadequate attention to privacy issues. Key recommendations relate to developing passive sensing strategies matching the problem at hand, using personalized interventions, and addressing methodological and privacy challenges. CONCLUSION: As evolving passive sensing technology presents new possibilities for health and wellbeing, additional research must address methodological, clinical integration, and privacy issues. Doing so depends on interdisciplinary collaboration between informatics and clinical experts

A Sensor-Driven Visit Detection System in Older Adults Homes: Towards Digital Late-Life Depression Marker Extraction

Modern sensor technology is increasingly used in older adults to not only provide additional safety but also to monitor health status, often by means of sensor derived digital measures or biomarkers. Social isolation is a known risk factor for late-life depression, and a potential component of social-isolation is the lack of home visits. Therefore, home visits may serve as a digital measure for social isolation and late-life depression. Late-life depression is a common mental and emotional disorder in the growing population of older adults. The disorder, if untreated, can significantly decrease quality of life and, amongst other effects, leads to increased mortality. Late-life depression often goes undiagnosed due to associated stigma and the incorrect assumption that it is a normal part of ageing. In this work, we propose a visit detection system that generalizes well to previously unseen apartments - which may differ largely in layout, sensor placement, and size from apartments found in the semi-annotated training dataset. We find that by using a self-training-based domain adaptation strategy, a robust system to extract home visit information can be built (ROC AUC=0.773). We further show that the resulting visit information correlates well with the common geriatric depression scale screening tool (=-0.87, p=0.001), providing further support for the idea of utilizing the extracted information as a potential digital measure or even as a digital biomarker to monitor the risk of late-life depression

Loneliness and social isolation detection using passive sensing techniques: Scoping review

Loneliness and social isolation are associated with multiple health problems, including depression, functional impairment, and death. Mobile sensing using smartphones and wearable devices, such as fitness trackers or smartwatches, as well as ambient sensors, can be used to acquire data remotely on individuals and their daily routines and behaviors in real time. This has opened new possibilities for the early detection of health and social problems, including loneliness and social isolation. This scoping review aimed to identify and synthesize recent scientific studies that used passive sensing techniques, such as the use of in-home ambient sensors, smartphones, and wearable device sensors, to collect data on device users' daily routines and behaviors to detect loneliness or social isolation. This review also aimed to examine various aspects of these studies, especially target populations, privacy, and validation issues. A scoping review was undertaken, following the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews). Studies on the topic under investigation were identified through 6 databases (IEEE Xplore, Scopus, ACM, PubMed, Web of Science, and Embase). The identified studies were screened for the type of passive sensing detection methods for loneliness and social isolation, targeted population, reliability of the detection systems, challenges, and limitations of these detection systems. After conducting the initial search, a total of 40,071 papers were identified. After screening for inclusion and exclusion criteria, 29 (0.07%) studies were included in this scoping review. Most studies (20/29, 69%) used smartphone and wearable technology to detect loneliness or social isolation, and 72% (21/29) of the studies used a validated reference standard to assess the accuracy of passively collected data for detecting loneliness or social isolation. Despite the growing use of passive sensing technologies for detecting loneliness and social isolation, some substantial gaps still remain in this domain. A population heterogeneity issue exists among several studies, indicating that different demographic characteristics, such as age and differences in participants' behaviors, can affect loneliness and social isolation. In addition, despite extensive personal data collection, relatively few studies have addressed privacy and ethical issues. This review provides uncertain evidence regarding the use of passive sensing to detect loneliness and social isolation. Future research is needed using robust study designs, measures, and examinations of privacy and ethical concerns

Ethics and Acceptance of Smart Homes for Older Adults

Societal challenges associated with caring for the physical and mental health of the elderly worldwide have grown at an unprecedented pace, increasing demand for healthcare services and technologies [1]. Despite the development of several assistive systems tailored to older adults, the rate of adoption of health technologies is low [2, 3]. This review discusses the ethical and acceptability challenges resulting in low adoption of health technologies specifically focused on smart homes for the elderly. The findings have been structured in two categories: Ethical Considerations (Privacy, Social Support, Autonomy) and Technology Aspects (User Context, Usability, Training). The findings conclude that the elderly community is more likely to adopt assistive systems when four key criteria are met. The technology should: be personalized towards their needs, protect their dignity and independence, provide user control, and not be isolating. Finally, we recommend researchers and developers working on assistive systems to: (1) Provide interfaces via smart devices to control and configure the monitoring system with feedback for the user, (2) Include various sensors/devices to architect a smart home solution in a way that is easy to integrate in daily life and (3) Define policies about data ownership

Improving Prediction of Real-Time Loneliness and Companionship Type Using Geosocial Features of Personal Smartphone Data

Loneliness is a widely affecting mental health symptom and can be mediated by and co-vary with patterns of social exposure. Using momentary survey and smartphone sensing data collected from 129 Android-using college student participants over three weeks, we (1) investigate and uncover the relations between momentary loneliness experience and companionship type and (2) propose and validate novel geosocial features of smartphone-based Bluetooth and GPS data for predicting loneliness and companionship type in real time. We base our features on intuitions characterizing the quantity and spatiotemporal predictability of an individual's Bluetooth encounters and GPS location clusters to capture personal significance of social exposure scenarios conditional on their temporal distribution and geographic patterns. We examine our features' statistical correlation with momentary loneliness through regression analyses and evaluate their predictive power using a sliding window prediction procedure. Our features achieved significant performance improvement compared to baseline for predicting both momentary loneliness and companionship type, with the effect stronger for the loneliness prediction task. As such we recommend incorporation and further evaluation of our geosocial features proposed in this study in future mental health sensing and context-aware computing applications.This work was supported by Whole Communities—Whole Health, a research grand challenge at the University of Texas at AustinOffice of the VP for Researc

Enhancing quality of life: Human-centered design of mobile and smartwatch applications for assisted ambient living

Background: Assisted ambient living interfaces are technologies designed to improve the quality of life for people who require assistance with daily activities. They are crucial for individuals to maintain their independence for as long as possible. To this end, these interfaces have to be user-friendly, intuitive, and accessible, even for those who are not techsavvy. Research in recent years indicates that people find it uncomfortable to wear invasive or large intrusive devices to monitor health status, and poor user interface design implies a lack of user engagement. Methods: This paper presents the design and implementation of non-intrusive mobile and smartwatch applications for detecting older adults when executing their routines. The solution uses an intuitive mobile application to set up beacons and incorporates biometric data acquired from the smartwatch to measure bio-signals correlated to the user’s location. User testing and interface evaluation are carried out using the User Experience Questionnaire (UEQ). Results: Six older adults participated in the evaluation of the interfaces. Results show that users found the interaction to be excellent in all the parameters of the UEQ in the evaluation of the mobile interface. For the smartwatch application, results vary from above average to excellent. Conclusions: The applications are intuitive and easy to use, and data obtained from integrating systems is essential to link information and provide feedback to the user.info:eu-repo/semantics/publishedVersio