D2.1 User Research Report is amed at assessing the state of the art in the scientific field and the type of services that are offered by home-care provider (public/private) to people within the established target of the SAVE project, The specific differences, challenges and offers among the involved European countries (Romania, Italy and Hungary) are discussed.

1 State of the art

1.1 Position, location and orientations services

1.2 The human centric approach challenge

To determine whether a design product can or cannot accommodate these human needs, designers must be aware of the target user characteristics, adopting a user driven approach. Commonly known as User Centered Design (UCD), this approach is defined in the ISO standard on Humancentered design for interactive systems (ISO 9241-210, 2010) as the iterative proces of designing an item from the perspective of how it will be used and understood by users. This systematic procedure advocates strong adherence to a path during which:

a multidisciplinary and experienced team is engaged in the definition of the “user profile”, tasks and the environment analysis,
an in-depth involvement of end-users is assured throughout design and iterative development process,
a user-centered evaluation strategy is planned to face, drive and refine the design addressing the whole user experience.

Adopting a human centric approach implies that a multidisciplinary and experienced team is engaged to go beyond the cited gap between the user profile and the designer profile. Different viewpoints can strengthen the design approach, arising awareness on constraints, realties, enablers and barriers and defining the user profile in their needs, expectations and limitations/ barriers. Besides, geriatric medicine researchers are strongly recommended to be actively involved in ICT research projects to identify significant clinical outcomes, as well as to aim for cost-effectiveness of longterm care in different living settings (Lattanzio et al., 2014).

By answering some simple questions (Thielke et al., 2012), this experienced team can target technology and accomplish benefits for users (whether they are primary, secondary or tertiary users): which level of need does my device address? Will my device fully satisfy the users’ needs? Are these needs addressed through my device? Not only a deep focus on needs but also on limitations and barriers contributes to characterize the user’s model.

The main barriers in applying AAL technologies for seniors depend on psychological resistance of elderly users, especially related to a deep bond to their memories and their previous lifestyle, which causes an apriori rejection of changing in behavior or habits. This condition creates the perspective that technology is an interfering, invasive and troublingcomplication (Lee and Coughlin, 2015; Van Den Broek et al., 2010).

In order to overcome such problems, it is strategic to spread awareness and knowledge among end-users about benefits and utility ensured by technology. Several studies (Thielke et al., 2012; Walsh and Callan, 2010; Arning and Ziefle, 2007), have effectively underlined that older adults make use of technology to reach and realize some desirable outcomes and refuse devices with an unclear evidence of real benefits. Furthermore, another limitation depends often on poor system usability and a lack of support throughout use: tools are often so complex, difficult to control, and error-inducing. Perception of friendliness, ease-of-use, clear instructional material and constant technical support are factors to face the aforementioned lack of familiarity with ICT devices, the cognitive differences, and the incoming age-related declines, thus avoiding the overwhelming features, options and information (Mitzner et al., 2010).

2 Methodology for the definition of services

2.1 The user driven approach

As explaneid in the section before, user involvement is a significant aspect in system development. Typically, user involvement relates to participation in activities dealing with specifying, elaborating, prioritizing, reviewing and verifying the requirements, as well as testing the developed features.

Benefits derived from this strategy are copious (Damodaran, 1996): improved quality of the system arising from more accurately identified user requirements; avoiding costly system features that the user did not want or cannot use; improved levels of acceptance of the system; greater understanding of the system by the user resulting in more effective use.

Consequently, a direct contact with potential users, enables designers to learn from older people what functionalities and attributes are important to them in new products, what motivates them, and what factors would hinder the usability.

The UCD approach is a process consisting of four fundamental activities related to user involvement (Figure 1):

a) user groups are specified and the context of use is described (Activity 1: understand and specify the context of use);
b) a set of specific requirements are defined in order to create a degree of fit between device and user (Activity 2: specify the user requirements);
c) the design prototype is produced on the basis of these specifications and it is presented to the user in the form of user testing (Activity 3: Produce design solutions to meet requirement);
d) once feedbacks from the user have been received, the process begins again until all user requirements have been met (Activity 4: evaluation).

As for its iterative nature, the process requires that information are gathered from the user at each step and actions are taken based on that, in order to interpret the information correctly. To this aim, the activities previously described, can be associated with a set of methods to be chosen and used on the basis of (Rekha Devi et al., 2012; Nedopil et al., 2013): type of users to be involved, context of use, nature of the product, constraints (such as time, effort, cost and access to users).

More than 200 methods coming from different areas of knowledge are used under the UCD framework, but in the context of the SAVE project the method of co-design will be adopted.

Figure 1 Interdependence of human-centered activities (ISO 9241-210)

2.2 The co-design method

Co-design is often used as an umbrella term for participatory, co-creation and open design processes. In co-design, diverse experts come together, such as researchers, designers or developers, and (potential) customers and users—who are also experts, that is, “experts of their experiences” (Sleeswijk Visser, Stappers, Van der Lugt, & Sanders, 2005) to cooperate creatively. In this way, co-design becomes critical to service design since different perspectives, are needed to understand both a service’s demand side and its supply side in order to develop successful services. According to Steen et. All, (2011). this method could lead to determine:

benefits for the service design project itself, such as improving the creative process, developing better service definitions and organizing the project more effectively or efficiently;
benefits for the service’s customers or users, such as creating a better fit between the service offer and customers’ or users’ needs, a better service experience and higher satisfaction;
benefits for the organization(s) involved, such as improving creativity, a focus on customers or users, cooperation between disciplines, and capabilities and enthusiasm for innovation.

Whitin the WP2 “End-user involvement and service feasibility” this method will be used to gather usefull information for defining services of the SAVE plathform by involved end users.

2.2.1 The target

As shown in Figure 2, at least 6 primary, secondary and teritiary end users will be involved in separate co-design sessions in each pilot site (Rumenia, Italy and Hungary).

Primary end users are 65+ older adults suffering fro moderate medical conditions or moderate impairments

Secondary end users are formal and/or informal caregivers.

Tertiary end users are stakeholders including care providers, public social service, end users organizations, medical and nursing researchers.

Figure 2 The rationale behind the co-design method

2.2.2 The tool:

The tool used to show the cocenpt idea of the services offfered by the SAVE platform is the storyboard. Some storyboards will be presented to the participants with some pre-defined elements suc as drawing supplies and informatio that guide the participant without being prescriptive. A storyboard for each service will be created according to the template designed by Lab delle Idee (Figure 3).

Figure 3 An example of storyboard used for the servive location and orientation

2.2.3 Procedure to follow

After having collecting the written informed consent (see Annex 1), the designers and/or the researchers will illustrate all the storyboards to the participants asking to free to think aloud about:

if and what is missing in the storyboard (features, services, or just suggestions to improve the system),
why it is interesting for them or not (which is the added value for them, pains and gains).

General guidelines to followed by moderators in the three countries are listed below:

Create a cosy atmosphere (introduction, information, get to know each other).
Keep a neutral attitude.
Stay focused, if the discussion removes from the main theme.
Define superficial terms precisely.
Let people talk, let them finish speaking.
Let some time for thinking, tolerate little breaks.
Get involved into argumentation, if there is silence.
Pay attention to body language of the participants (e.g. Why did you hesitate?).
Ask if something hasn’t been mentioned.
Are there discrepancies in the results? Ask for them!

Conclusion, thank you-gift and farewell

At the end of at least 30 minutes of thinking aloud, a service evaluation questionnaire will be administered (please, see Annex 2)

The questionnaire is composed by the following sections:

socio-demographic information
current use of moder technology
specif info about each service in terms of a) perceived utility/benefit, b) easy to use, c) availability to purchase

Users will respond on a scale from 1 to 7, 1 corresponds to the minimum value, 7 to the maximum value.

3 The pilot site profiles and their recruitment strategy

This section contains the informations about each pilot site and the specifc recruitment strategy that will be adopted.

3.1 Romania

3.2 INRCA-Italy

INRCA is the leading Italian public Institute in gerontology and geriatrics, devoted to improve quality of life of older persons. It consists of five centres in Italy, comprising four geriatric hospitals, an Alzheimer day care centre, a nursing home and scientific and technology research units.

The objectives of the Institute are focused on successful ageing and the promotion of health of the older person and prevention. Social gerontology is one of the most important research fields, developed in both national and international sphere, cooperating with universities and other research institutes. Currently, there are four lines of research: (1) Biogerontology: cellular determinants, molecular and genetic aging, longevity and age-associated diseases; (2) Prevention and treatment of frailty: management of geriatric diseases and syndromes; (3) Aging and Medicines and (4) Multidimensional assessment and continuity of care. INRCA pursues its goal mainly in an interdisciplinary way, through clinical and translational research, training in the biomedical field as well as in the organization and management of health care services, in particular by means of highly specialized hospitalization and health care.

For the SAVE project, the Geriatrics Operative Unit of INRCA will be involved. It aims at studying, screening, diagnosing and treating age-related diseases. In particular, this OU has a long-standing experience in the diagnosis and care of neurologically-based problems in adults and geriatric individuals (including MCI, mood disorders, etc). The research activity is mainly focused on multidimensional aspects of aging, in particular by means of the use of Comprehensive Geriatric Assessment, including cognitive decline, quality of life, life-style, psychosocial and nutritional aspects in aging. It has a know-how on studying the multidisciplinary approach in aging. Moreover, for what concerns the research on the technology acceptance, the Centre of Innovative Models for Ageing Care and Technology aims at studying the needs of the elderly in the User Centred Design process, as well as the impact and acceptance of the technology to support everyday life, great emphasis is given to technological innovation, promotion and acceptance of technology for the elderly. The lab is indeed involved in various activities aimed at the study of usability and acceptance of smart environments to support the independence and autonomy of the elderly. This commitment is supported through regional, national and international collaborations with universities, research institutes and companies specializing in technology, home automation and artifacts from the house computer, without architectural barriers, with sensors that detect possible hazards, smart appliances and tools with communication interfaces easy for their remote control. For the analysis of Human-Machine and Human-Computer Interactions, and of the acceptability and usability of technology, the Centre benefits from the presence of the Casamica Lab, a smart home of about 60 square feet, located close to the Rehabilitation Unit of the INRCA hospital in Ancona. The intelligent environment consists of a kitchen, a bedroom and a bathroom, equipped with assistive devices and home automation technology. The Casamica lab was designed to enable greater independence of older people and to avoid their admission to care facilities. It represents a unique opportunity to directly test technology with the people in real life, thanks its strategic location.

The recruitment strategy at INRCA will be performed in the city of Ancona where a staff composed by a psychologist and a reseacher will identifying possible participants that met the target of the SAVE project within the organization and its widenetwork. The psychologist will contact primary and secondary end-users, asked them some screening questions for checking their inclusion characteristics, explained the study purpose and methods (i.e. co-design sessions) and proposed them to take part into it. Individuals who accepted to participate were provided with and asked to sign a written informed consent to data treatment in accordance with the GDPR 2018 and the national legislation on privacy and data protection.

3.3 Hungary

4 Conclusion

5 Annex 1 Informed Consent

INFORMED CONSENT
Project title: SAVE
Principal Investigators:
Background: SAVE project aims to develop …… The system is composed by …. The SAVE project requires two different session of co-design. During each phase, some voluntary participants will be recruited in Romania, Italy and Hungary. Participants will be introduced to the project and asked to check some pictures to evaluate. This could last for not longer of 30 munutes and at the end a questionnaire will be adminusterd
Participant Declaration:
I have read or have had the information about the project and I understand the contents.	Yes	No
I have been given an opportunity to ask questions and am satisfied with answers. I have had enough time to decide whether or not to participate.	Yes	No
I consent to take part in the study.	Yes	No
I understand that participation is voluntary and that I can withdraw at any time. Without having to provide any reason.	Yes	No
I understand that withdrawal will not affect my access to services or legal rights.	Yes	No
I consent to possible anonymous publication of results.	Yes	No
I consent to the use of pictures, and sound recordings containing personal data for research purposes.	Yes	No
– I know that for study monitoring purposes some individuals could have access to all my data. Those people are listed in this information letter. I consent to that access by these persons.	Yes	No
I give my permission to: Use the data obtained from you in other future studies without the need for additional consent.	Yes	No
Researcher Declaration:
I have explained the study to the participant	Yes	No
I have answered questions put to me by the participant about the research	Yes	No
I believe that the participant understands and is freely giving consent	Yes	No
I guarantee the protection of natural persons with regard to the processing of personal data and on the free movement of such data according to the Regulation (EU) 2016/679 of the European Parliament and of the Council of 27 April 2016.	Yes	No
Participant’s Statement: I have read, or had read to me, this consent form. I have had the opportunity to ask questions and all my questions have been answered to my satisfaction. I freely and voluntarily agree to be part of this research study, though without prejudice to my legal and ethical rights. I understand I may withdraw from the study at any time. I have received a copy of this consent form. Participant’s Name: Contact Details: Participant Signature: Date: The form needs to be signed by the consenter and dated.
Researcher’s Statement: I have explained the nature and purpose of this research study, the procedures to be undertaken and any risks that may be involved. I have offered to answer any questions and fully answered such questions. I believe that the participant understands my explanation and has freely given informed consent. Signature: Date:

6 Annex 2 Service evaluation questionnaire

REFERENCES

[1] https://blog.webland.ro/2017/10/ce-este-arhitectura-bazata-pe-microservicii/

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