This paper illustrates the processes and results of user acceptance and satisfaction tests for the voice-activated self-monitoring (VoiS) application conducted in the field. VoiS was designed and developed for individuals with diabetes (DM) and hypertension (HTN) to support their routine and convenient self-management using a smart speaker platform. VoiS is also accessible on users' mobile devices to visualize user-generated data. A total of nine adults with DM and HTN participated and were asked to use the VoiS system at home for a week to identify its acceptability in real-world conditions. Participants completed phone interviews to report operational errors and a structured survey to assess the acceptability of VoiS. The results showed that participants agreed or strongly agreed that VoiS was easy to use and useful, and they intended to continue using it. They were highly satisfied with VoiS. They also reported operational errors and challenges including device-related technical issues and the smart reminder feature of VoiS. Overall, participants perceived VoiS as an easy and useful tool for managing their conditions and felt motivated to monitor their biomarkers routinely.

The integration of motivational strategies and self-management theory with mHealth tools is a promising approach to changing the behavior of patients with chronic disease. In this manuscript, we describe the development and current architecture of a prototype voice-activated self-monitoring application (VoiS) which is based on these theories. Unlike prior mHealth applications which require textual input, VoiS app relies on the more convenient and adaptable approach of asking users to verbally input markers of diabetes and hypertension control through a smart speaker. The VoiS app can provide real-time feedback based on these markers; thus, it has the potential to serve as a remote, regular, source of feedback to support behavior change. To enhance the usability and acceptability of the VoiS application, we will ask a diverse group of patients to use it in real-world settings and provide feedback on their experience. We will use this feedback to optimize tool performance, so that it can provide patients with an improved understanding of their chronic conditions. The VoiS app can also facilitate remote sharing of chronic disease control with healthcare providers, which can improve clinical efficacy and reduce the urgency and frequency of clinical care encounters. Because the VoiS app will be configured for use with multiple platforms, it will be more robust than existing systems with respect to user accessibility and acceptability.