End-Users’ Perspectives on Implementation Outcomes of Digital Voice Assistants Delivering a Home-Based Lifestyle Intervention in Older Obese Adults with Type 2 Diabetes Mellitus: A Qualitative Analysis

Managing blood glucose levels and adhering to exercise is challenging for older adults with obesity and type 2 diabetes mellitus (T2DM). Digital voice assistants (DVAs) utilising conversation-based interactions and natural language may overcome barriers to accessing home-based lifestyle programs, but end-user perspectives are essential for implementation. This analysis investigated end-user perspectives on implementation outcomes of a DVA-delivered lifestyle program nested within a randomised controlled trial of 50 older adults (aged 50–75 years) with obesity and T2DM (DVA n = 25; control n = 25). Following trial completion, 10 DVA participants (mean ± SD age 67 ± 4 years) completed semi-structured interviews guided by the Practical Planning for Implementations and Scale-up guide and Proctor’s implementation outcome taxonomy. Over half (60%) were willing to pay for the DVA-delivered program, indicating perceived value. DVA audiovisual and conversation-based modalities enhanced engagement and acceptability. Most end-users found the DVA program feasible as a modality for delivering lifestyle programs, but suggested greater personalisation to bolster sustainability. Overall, the intervention was identified as acceptable and appropriate, suggesting digitally delivered programs may be feasible and sustainable for long-term use. Findings should be interpreted cautiously, given the small sample size and short intervention period. Nevertheless, end-users’ suggestions could inform the implementation of digital health interventions into healthcare systems.