The use of interactive voice assistants (IVAs) in healthcare provides an avenue to address diverse health needs, such as gaps in the medical recovery period for older adult patients who have recently experienced serious illness. By using a voice-assisted medical recovery curriculum, discharged patients can receive ongoing support as they recover. However, there exist significant medical and technology disparities among older adults, particularly among Black older adults. We recruited 26 Black older adults to participate in the design process of an IVA-enacted medical recovery curriculum by providing feedback during the early stages of design. Lack of cultural relevancy, accountability, privacy concerns, and stigmas associated with aging and disability made participants reluctant to engage with the technology unless in a position of extreme need. This study underscored the need for Black cultural representation, whether it regarded the IVA's accent, the types of media featured, or race-specific medical advice, and the need for strategies to address participants' concerns and stigmas. Participants saw the value in the curriculum for those who did not have caregivers and deliberated about the trade-offs the technology presented. We discuss tensions surrounding inclusion and representation and conclude by showing how we enacted the lessons from this study in future design plans.

翻译：交互式语音助手在医疗保健领域的应用为解决多样化健康需求提供了途径，例如为近期经历重病的老年患者填补医疗康复期的服务空白。通过采用语音辅助的医疗康复课程，出院患者可在康复过程中持续获得支持。然而，老年人群体中存在显著的医疗与技术资源差异，这在黑人老年群体中尤为突出。我们招募了26名黑人老年人参与IVA实施的医疗康复课程设计过程，在设计初期阶段提供反馈。文化关联性缺失、责任机制不明确、隐私顾虑以及与老龄化和残疾相关的社会污名，使得参与者除非处于极端需求状态，否则不愿使用该技术。本研究强调了黑人文化表征的必要性——无论是语音助手的口音、呈现的媒体类型，还是针对特定种族的医疗建议，同时指出需要制定策略以应对参与者的顾虑和社会污名。参与者认可该课程对缺乏照护者的价值，并深入探讨了该技术带来的权衡取舍。我们围绕包容性与代表性展开讨论，最后展示了如何将本研究获得的经验应用于未来的设计规划中。