Currently submitted to: JMIR Human Factors
Date Submitted: Jun 30, 2026
Open Peer Review Period: Jul 2, 2026 - Aug 27, 2026
(currently open for review)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Usability Evaluation of a Mobile Acoustic Monitoring and Coaching Application for Older Adults with Chronic Obstructive Pulmonary Disease
ABSTRACT
Background:
Chronic obstructive pulmonary disease (COPD) is one of the leading causes of morbidity and mortality among older adults, particularly in underserved populations. Gaps in continuity of care between outpatient clinic visits contribute to delayed recognition of exacerbations and poor outcomes.
Objective:
This study evaluates the usability of an innovative mobile health application that passively monitors sensory data and acoustic features from voice recordings to detect early physiologic changes associated with COPD exacerbations with the goal of providing adaptive coaching interventions.
Methods:
A qualitative usability study was conducted with 10 low-income, minority older adults diagnosed with COPD, Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage1 II-IV. Participants completed structured tasks using a prototype mobile application in a controlled clinic setting using a think-aloud protocol. Two iterative rounds of testing (n=5 per round) were performed to understand patient preferences, identify usability issues and inform design improvements.
Results:
Results demonstrated favorable usability and perceived value of the artificial intelligence-enabled COPD smartphone application among older adults. Most participants successfully completed core tasks, including navigation, voice recording, reviewing feedback, and responding to coaching prompts, with minimal assistance. Participants generally rated the application as easy or very easy to use, particularly those with prior smartphone experience. Key usability facilitators included simple navigation, passive data collection, and familiarity with health tracking concepts. Participant feedback highlighted strong perceived clinical benefit, including improved self-management, reassurance, and reduced anxiety related to COPD symptoms. Common challenges included difficulty understanding medical terminology, uncertainty interpreting graphs and health metrics, and accessibility concerns such as small font sizes and low-contrast text. Participants recommended larger fonts, simplified terminology, multilingual support, and more actionable clinical feedback to improve usability and engagement.
Conclusions:
This study demonstrates the usability of an artificial intelligence-driven, voice-based monitoring system for COPD management in older adults. Findings will inform further development and large-scale clinical evaluation aimed at improving early detection of COPD exacerbations and opportunities to improve outpatient continuity of care. Clinical Trial: not applicable
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