Apo AI

Many older adults with low digital health literacy experience gaps in access to the health care they need, and this is concerning for the MA program, whose enrollee population includes individuals age 65 and older (as well as individuals under age 65 with disabilities). For example, the American Association of Retired Persons (AARP) annual technology survey found that more than half of older adults (age 50 and older) in 2021 indicated they need more digital education, while more than one in three indicated they lacked confidence when using technology. Of the 32 million Americans who cannot use a computer, approximately one-third are seniors. Further, less than one-third of Medicare beneficiaries over 65 have at-home digital access, and those over age 75 and with less than high school-level education are less likely to use telehealth. For people with disabilities, 15 percent reported not using the internet as opposed to 5 percent in the general population in a Pew Foundation Survey, while 62 percent of people with disabilities, as opposed to 81 percent of the general population, own their own desktop or laptop computers. Other studies have confirmed a significant gap in digital literacy among people with disabilities. Another survey found that Black, Latino, and Filipino seniors and those 75 years and older are significantly less likely to own devices like computers and smartphones compared to non-Hispanic whites, Chinese, and younger seniors (ages 65–69); this was also true in terms of these groups' respective use of the internet and email, as well as their ability and willingness to use technology for telehealth purposes. The digital divide continues to be a looming health equity issue for older adults.

Apo AI is a text-based AI-powered coach that improves digital health literacy skills among older adults, thus promoting health equity and healthy aging. The chatbot can do the following:

1. Respond to a wide range of technical queries, provide personalized resources, and offer empathetic responses.
2. Designed to deliver easily understandable and accessible information, making it easier for older adults to navigate digital tools and platforms. 
3. Empower older adults to confidently use technology, fostering independence, social inclusion, and digital health self-management.

Additionally, the chatbot's capacity to offer encouragement and feedback creates a supportive environment that encourages older adults to engage with digital health tools more effectively.

Reliance on digital technologies is increasing in society and healthcare as a means of socialization and improving health outcomes. As the world increasingly becomes digital, older adults are disadvantaged due to their lack of digital literacy. Digital literacy influences areas linked to health outcomes like access to community support and health services and is thus considered a super social determinant of health. The reliance on digital tools and apps like patient portals and health trackers continues to grow in healthcare, and so are disparities between those who have the skills to access such tools and those who don’t. Older adults with digital health literacy skills maintain a more active life by interacting and sharing information with others via health promotion and have an increased interest in health and awareness of health management and disease prevention. Older adults can use digital tools to improve their health self-management by communicating with medical professionals, participating in health programs, and seeking health services. Supporting the health self-management for older adults is essential to improving the overall health of this population.

The project's success will contribute to bridging the digital divide, improving care, and enhancing the quality of life for older adults. It will enable them to access healthcare resources more easily, engage in social interactions, and become active participants in their own health management, leading to better health outcomes, overall well-being, and healthy aging.

The Carevocacy team, led by Stefano and Samantha Selorio, is exceptionally positioned to actualize the proposed plans for Apo AI. They bring together a fusion of expertise in marketing, technology development, community outreach, and public health, tailored to meet and exceed the demands of the project.

Stefano Selorio - Founder & CEO
Stefano Selorio's entrepreneurial journey and dedication to enhancing digital health literacy are the lifeblood of Carevocacy. With a rich background in marketing and business development, he has demonstrated his prowess by establishing Carevocacy amidst the challenges of a global pandemic and securing pivotal alliances with top-tier health entities. His personal investment as a caregiver provides him with profound empathy and understanding of the user base Apo AI aims to serve. Despite this being his inaugural role as a principal investor, Stefano's track record of adaptive problem-solving and strategic partnerships, exemplified by his collaborative efforts with Conviva Care Centers, underscores his readiness to lead this innovative project. His lived experience, coupled with his unwavering dedication, infuses authenticity and passion into his leadership approach to the research initiative.

Samantha Selorio - Public Health Consultant
Samantha Selorio's educational foundation in public health and her pragmatic experience with health-focused campaigns lend a critical eye to the efficacy and outreach of Apo AI. Her Bachelor of Science in Public Health and her previous engagements with Broward County nonprofit entities and academic research projects have honed her ability to evaluate and implement health promotion strategies effectively. Her expertise will be instrumental in tailoring the health literacy components of Apo AI to resonate with its audience and in assessing the program's impact, ensuring the interventions are both innovative and evidence-based.

Together, Stefano and Samantha Selorio represent a well-rounded team. Stefano brings an entrepreneurial spirit and personal drive, paired with Samantha's scientific rigor and public health perspective. Their complementary skills ensure that the Apo AI project is not only theoretically sound but practically poised for success, thereby fulfilling Carevocacy's commitment to enhance digital health literacy among the older population.

The team also represents the population that is being served. Carevocacy is a Filipino-owned venture and was created because of the founder's current experience as caregivers to their grandma living with Alzheimer's.

Chatbots have been found to facilitate personalized learning, real-time feedback, and scalability. These bots can support a learning environment and interact with many students. Yet, chatbots in education are still a novel application. Educational chatbots (EC) typically focus on language learning, economics, and programming courses. Subsequently, the role of EC in the academic context is limited within the disciplines that the literature has explored so far. Additionally, there is a knowledge and application gap on the potential of EC in mentoring students and in the effect of chatbot adaptation capabilities for educational purposes. Addressing these limitations and gaps in digital health literacy may contribute to chatbots becoming more effective educational tools that can support learners.

Previous digital health literacy interventions for older adults have occurred in informal settings (e.g., libraries and senior centers), phone, radio, and television in the form of educators delivering predominantly NIH Senior Health training materials. This uniformity in the material has raised issues in the adaptivity of the interventions to teach on the growing variety of devices and platforms that the contemporary technological environment features. According to literature reviews of digital health literacy interventions for older adults, there has yet to be an intervention that utilizes chatbot technology. Investigating the use of chatbot technology in this context can help overcome barriers older adults face when adopting new technology.

The proposed project is innovative because it will develop a clear pedagogical role and explore the effect of EC adaptation capabilities in improving and supporting digital health literacy education in older adults. In this feasibility study, we will look into what aspects of EC (e.g., role, characteristics, adaptation approaches) are helpful and desirable to a diverse population of older adults and develop them into the final product. The Apo AI technology will engage older adults through follow-ups and reminders to hold the user accountable for what they have learned. We will also distribute text-based assessments, build in bespoke conversational pathways based on the DHL level of the user, and track that data on a back-end platform. These efforts are innovative strategies that address the pressing need to implement digital health literacy interventions for older adults.

Our solution, centered on the development and implementation of the Apo AI chatbot technology, aligns closely with the United Nations Sustainable Development Goal (SDG) 3, which focuses on ensuring good health and well-being for all at all ages.

1. Promoting Healthy Lives and Well-being for Older Adults: Our AI technology is designed specifically to address the health needs of older adults. By providing personalized health information, reminders for medication, and tips for managing various age-related health conditions, the chatbot plays a crucial role in promoting healthier lifestyles and enhancing well-being among the elderly.

2. Improving Access to Health Information: Our solution tackles one of the key challenges in healthcare - accessibility to accurate and timely health information. For many older adults, especially in remote or underserved areas, access to healthcare professionals can be limited. The Apo AI chatbot bridges this gap by offering an easily accessible platform for health-related queries, thus contributing to better health literacy.

3. Supporting Mental Health and Social Well-being: The chatbot also addresses aspects of mental health and social well-being, by providing a conversational interface that can offer emotional support and combat feelings of loneliness - common issues among the aging population. This contributes to the broader aim of SDG 3, which encompasses mental health and well-being.

4. Enabling Age-Inclusive Health Solutions: Our approach aligns with the goal of making health systems more inclusive and responsive to the needs of older individuals. By designing our solution with a focus on ease of use and accessibility, we ensure that even those with limited technological skills or cognitive impairments can benefit.

5. Providing Data for Informed Health Policies: Through the collection and analysis of user interaction data (while ensuring privacy and confidentiality), our project can provide valuable insights for health policymakers to develop more effective aging-related health strategies and interventions.

In summary, our project contributes to SDG 3 by enhancing health literacy, providing accessible health support, promoting mental well-being, ensuring inclusivity in health technology, and aiding the formulation of data-driven health policies for older adults.

The AI/Technology approach will leverage affective computing, natural language processing, user-facing software and platforms, and virtual assistants and chatbots according to the technical objectives that revolve around 1) Accessibility, 2) Contextual Understanding, and 3) Interactive Learning.

1. Accessibility: Apo will be available through various user-facing software and platforms in a simple, user-friendly format that aims for low latency and an instant, conversational experience. The project entails expanding the delivery of Apo from SMS to web, mobile, and voice interfaces with dictation and text-to-speech to support diverse needs.

2. Contextual Understanding: Natural language processing will be used to enable Apo to grasp context, provide accurate responses, and handle complex questions. Apo will decipher technical terms, recall interactions, and personalize responses. The project entails mapping 80-90% of the users’ tech support needs and generating responses dynamically.

3. Interactive Learning: Mechanisms for Apo will be embedded to refine responses over time using feedback and reinforcement learning. Integration of affective computing will allow older adults to feel comfortable with the learning experience as the ability for the technology to recognize emotions and provide empathetic responses is encouraging and empowering for the user. Different approaches will need to be examined to determine optimal solutions.

The R&D involves user-centered design, usability testing, and user feedback with focus groups encompassing a population of older adults of different sexes/genders, races, ethnicities, and ages. Through this approach, the product can address the unique needs and desires pertinent to older adults.

Our project, involving human subjects' data, will strictly adhere to ethical guidelines (such as the a2 Collective Data and Resource Sharing Plan Agreement) and legal requirements to protect data privacy and confidentiality. Firstly, all data collection will comply with HIPAA regulations and the General Data Protection Regulation (GDPR), ensuring sensitive information is securely handled. We will obtain informed consent from all participants, clearly outlining data usage and their rights.

Data will be anonymized, removing any identifiable information before analysis. Secure, encrypted databases will be used for storage, with access restricted to authorized personnel only. Regular audits will be conducted to ensure compliance with data protection policies.

Furthermore, we will employ advanced cybersecurity measures, including firewalls and intrusion detection systems, to safeguard against unauthorized access. All team members will undergo training in data confidentiality and privacy protocols. Lastly, any data sharing will be subject to strict data use agreements, ensuring recipients uphold the same level of data protection.

In the next year, we hope to reach 100,000 older adults using our AI, and we can achieve this by partnering with community-based organizations, health systems, and healthcare plans and providers. In the next five years,  our product is not accessible to most Medicare Advantage members in the United States. This means that older adults don't have to pay out of pocket to access digital health literacy. We will achieve this goal by leveraging relationships and building our network on LinkedIn.

3

3

Carevocacy is a Filipino minority-owned small business that aims to continue to be diverse, equitable, and inclusive by consistently working with underserved/minority populations.

The market is senior living communities, non-profits, and Medicare Advantage organizations, which CMS now requires to offer digital health education. The business strategy involves partnerships with these organizations to offer the chatbot as a value-added service. The share of older adults who are using digital technology has rapidly increased in the past decade. Yet, pain points involving feelings of intimidation, anxiety, and stress with technology and digital exclusion still remain. Organizations can use the chatbot as an educational tool to satisfy their population’s digital literacy needs. Organizations have a choice of a subscription-based, pay-per-use, or hybrid model. Targeted advertising within the chatbot interface with technology products and services for older adults is also a means of revenue. The marketing strategy includes targeted online campaigns and social media marketing with an emphasis on empowering older adults to stay connected, access healthcare, and enjoy life via technology.

Carevocacy's core business has provided on-site and online tech classes for older adults in over 24 locations, serving about 25,000 patients. We envision utilizing the locations as distribution clinics. Also, we've applied for non-dilutive funding like SBIR/STTR grants, pitch competitions, and simply through contracts.

Our current operating costs are $28,340.00. In the next year, our operating cost might be doubled due to the new set of classes that have been registered for us.

To fund this project, we are seeking $100,000 because it would cover the cost of personnel, marketing, and product development. We are currently applying for non-dilutive funding like grants and seeking contracts. For example. We are going through the a2 Pilot Awards, where we can win up to $200,000.

Working from the Cure Residency would be a massive opportunity for our team because we now have a physical location to do our work. Yet, the best part is being able to connect with industry leaders in healthcare and leverage the Cure's network to be able to meet them.