NHRI Intelligent Voice Interactive Platform for High-Quality Community Living Among Older Adults

SF-36 Health Survey (SF-36 v1) Subscale Scores (score)

Health-related quality of life is assessed using the SF-36 Taiwan Version, evaluating 8 subscales: Physical Functioning (PF, 10 items, raw 10-30), Role-Physical (RP, 4 items, raw 4-8), Bodily Pain (BP, 2 items, raw 2-12), General Health (GH, 5 items, raw 5-25), Vitality (VT, 4 items, raw 4-24), Social Functioning (SF, 2 items, raw 2-10), Role-Emotional (RE, 3 items, raw 3-6), and Mental Health (MH, 5 items, raw 5-30). Per standard Taiwanese scoring guidelines, raw scores are linearly transformed into an identical 0 to 100 standardized scale: \[(raw score - min score) / score range\] \* 100. The outcome reports changes in each standardized subscale score (Unit of Measure: points, range 0-100), where higher scores indicate superior functional health. Changes from baseline to 6 months are evaluated.

Health-Promoting Lifestyle Profile II (HPLP-II) Total Score (score)

Self-care and daily health practices are assessed using the Health-Promoting Lifestyle Profile II (HPLP-II, Chinese version). The instrument evaluates 52 items across six dimensions: health responsibility, physical activity, nutrition, spiritual growth, interpersonal relations, and stress management, each rated on a 4-point Likert scale (1 = "never" to 4 = "routinely"). The outcome is reported as the overall mean composite score across all items (Unit of Measure: score on a scale of 1.0 to 4.0), where higher scores indicate more frequent adoption of health-promoting self-management behaviors. Changes from baseline to 6 months are evaluated.

30-Second Arm Curl Test (counts)

Upper-body muscular strength and endurance are assessed using the 30-Second Arm Curl Test from the Senior Fitness Test protocol. Participants sit upright and complete as many biceps curls as possible within 30 seconds using their dominant hand (5-pound dumbbell for females, 8-pound for males). The outcome is reported as the total count of correctly completed repetitions (Unit of Measure: repetitions). For clinical interpretation, repetition counts are categorized against sex- and age-specific normative tiers (Excellent, Good, Average, Below Average, Poor). Higher counts indicate superior functional muscle strength. Changes from baseline to 6 months are evaluated.

4-Meter Walk Test Functional Mobility (category)

Mobility and gait function are assessed using the 4-Meter Walk Test adapted from the Short Physical Performance Battery (SPPB) protocol. Participants walk a 4-meter course at their usual, comfortable pace. Walk performance is converted into a 4-point ordinal category reflecting functional mobility tiers: 3 = \<3.5 seconds (fast gait speed, superior mobility), 2 = 3.5-4.9 seconds, 1 = 5.0-8.0 seconds, and 0 = \>8.0 seconds (slow gait speed, mobility impairment). The outcome is reported as the change in this single ordinal category score (Unit of Measure: category on a scale of 0 to 3), where higher scores indicate superior functional mobility. Changes from baseline to 6 months are evaluated.

Technology Acceptance Model (TAM) Total Score (score)

Participants' acceptance of the smart voice platform is evaluated using an adapted 11-item Technology Acceptance Model (TAM) questionnaire. Each item is scored on a 7-point Likert scale ranging from 1 ("strongly disagree") to 7 ("strongly agree"). The outcome is reported as the total sum score across all 11 items (Unit of Measure: points, range 11 to 77), evaluating perceived usefulness, perceived ease of use, and behavioral intention to use the platform. Higher scores represent greater technology acceptance. Changes from baseline to 6 months are evaluated.

System Usability Scale (SUS) (score)

Platform usability and user satisfaction are evaluated using the 10-item System Usability Scale (SUS). Each item is rated on a 5-point Likert scale (1 = "strongly disagree" to 5 = "strongly agree"). Raw item scores are converted according to the standard Brooke scoring algorithm into a composite score from 0 to 100 (Unit of Measure: points, range 0 to 100). Higher scores indicate superior platform usability (scores \>=68 represent acceptable usability). Changes from baseline to 6 months are evaluated.

Digital Service Utilization (counts)

Adoption of daily digital services is assessed across 7 domains: online information search, mobile payments, online finance/stocks, social messaging, digital healthcare/telehealth, online entertainment, and digital learning. Each domain is scored dichotomously (0 = No, 1 = Yes). The outcome is reported as the total count of regularly utilized digital services (Unit of Measure: counts, range 0 to 7). Higher counts indicate broader digital autonomy in community living. Changes from baseline to 6 months are evaluated.

Perceived Informal Social Support Composite Score (score)

Perceived informal emotional and social support is assessed through 3 core items: willingness of others to listen (1-5), perceived care from family/friends (1-5), and satisfaction with emotional support received (1-5). The outcome is reported as the mean composite score across the three items (Unit of Measure: score on a scale of 1.0 to 5.0). Higher scores indicate stronger perceived informal social support. Changes from baseline to 6 months are evaluated.

Educational Attainment Level (category)

Assessed using the formal educational attainment classification. Educational levels are categorized as: 1 = Elementary school or below (≦6 years), 2 = Junior high school (7-9 years), 3 = Senior high/vocational school (10-12 years), 4 = Junior college, 5 = University (bachelor's degree), and 6 = Master's degree or above. The outcome is measured by the formal educational level (categorical tier 1 to 6). Higher scores represent higher educational attainment and formal cognitive reserve.

Self-Reported Chronic Medical Conditions (counts)

Multimorbidity burden is assessed using a standardized checklist of 13 physician-diagnosed chronic conditions (e.g., hypertension, diabetes, hyperlipidemia, cardiovascular disease, stroke, arthritis). Each condition is scored dichotomously (0 = No, 1 = Yes). The outcome is reported as the total count of co-existing chronic conditions (Unit of Measure: counts, range 0 to 13). Changes from baseline to 6 months are evaluated.