MERITT

Phase I

The aim of phase 1 (2022) was to 1) define the methodology for the usability, user experience and user needs analysis 2) identify the gamification elements to be used in the new games developed in the project or adapted from the existing games, 3) develop the first version of the MERITT platform architecture and 4) disseminate the project via website, Facebook page, Linkedin page and press release.

Activity 1.1: Usability and user needs analysis (intermediate): consists of obtaining information that provides the possibility to adjust and implement technologies within the MERITT platform, and is composed of three components: 1) usability (in particular), 2) user experience (in general), and 3) needs. In this phase we have established all the necessary steps to obtain this information. This will be inferred by using semi-structured interviews combined and completed with the application of questionnaires on a target group of minimum 15 people, aged 65 years or older. We will focus on the following aspects: A) utilitarian motivation for use: expectations of performance/efficiency in use, required effort, social influences when used, perceived value, integration with existing habits and intention to use and B) hedonic motivation for use: perceived ease of use, perceived usefulness, curiosity, satisfaction/pleasure, degree of control in use, level of immersion and intention to use. Quantitative data will be analysed using statistical software and qualitative information will be analysed using the thematic analysis method.

Activity 1.2: Defining the gamification elements needed for the platform (intermediate): in order to establish the gamification elements needed for the MERITT platform, we have carried out the classification of existing serious games for elderly people. We have concentrated on those which address the maintianing and improving their cognitive abilities. For this purpose a number of existing cognitive games were analysed, such as Smart Thinker, Gifts Purchase, MCI Rehab, Memory Game, Brain Farmer, In Anticipation of Death, Kitchen and Cooking, Live Well, Live Healthy!. In order to identify the parameters necessary to adapt the reward system to the user, a meta-analysis of the literature on rewards. We have considered rewards any type of feedback that assures the user that he/she has succesfully performed a task during the game, e.g., score, voice and/or text message, vibration. These are usually offered to elderly users while playing various games. Any game relies on the actions and challenges which the users (players) have to peform during the game. Thus, we extracted information about the type of actions implemented in the analysed games: placing objects, moving, collecting objects, destroying elements in the game, communicating, constructing a building or object. Possible challenges were also analysed: time limit to complete an action, use of limited resources, use of opponents, existence of obstacles, actions that can be solved by deductive or inductive reasoning, answering test questions to progress, searching and finding objects or the possibility to save a state.

Activity 1.3: MERITT architecture design and development (intermediate): we have described the current state of the MERITT platform architecture which is a centralised architecture. The interface uses the Android system, via a tablet, which serves as the primary means of user interaction and provides both the interface to the platform and the data collection. The health and activity devices use a software gateway installed on the tablet to transfer data to the tablet from where it is transferred via the local WiFi network or via a mobile data connection to the central server. Data viewing is implemented through a portal installed on the tablet. In order to establish the communication between the components of the platform, possible solutions have been analysed: REST and gRPC and a technical evaluation of synchronous communication has been carried out.

Activity 1.4: Dissemination via website and social media, press release on the project page or in social media: dissemination via website, Facebook page, Linkedin page and press release.

Phase II

The aim of phase 2 (2022) was to 1) presenting the completed questionnaires and interviews, 2) establishing the gamification elements necessary for the platform: designing the multi-player game and adapting the reward system to the individual background of each user, 3) finalizing the design of the MERITT architecture, the design of the platform interfaces, 4) the implementation of the main functionalities of the MERITT platform with the finalization of the software interface characteristics and the development of the virtual trainer and 5) the dissemination of the project through the updated web page, social media and the publication of 5 articles in international conferences with BDI indexed proceedings and ongoing of ISI indexing.

The activities implemented in phase 2 were the following:

Activity 2.1: Analysis of usability and user needs (final): consists of a study carried out with two groups of users. In the first, eight people aged 65 to 78 participated (five women and three men). All participants had a good cognitive level and their independence in everyday life is very high. The second group (20 users aged between 65 and 80) aimed not only at evaluating the games but also the other elements of the MERITT platform. They provided feedback using a dedicated questionnaire developed to gauge interest in the platform as a whole, but also in its specific features.

Activity 2.2: Establishing the platform’s gamification elements (final): consists in describing the multiplayer game that involves interaction between several users, analyzing existing games in order to identify how to establish rewards adapted to the background of each user. An important identified aspect was the creation of difficulty levels to adapt to the different abilities and preferences of the players. Existing games Match Game and Collect Objects were extended with new difficulty levels.

Activity 2.3: Design and development of the MERITT architecture (final): to finalise the design of the MERITT architecture. The interface of the system uses Android, via a tablet, which serves as the main means of interaction with the user and provides both interface with the platform and the data collection means. The devices use a software gateway installed on the tablet to transfer data to the tablet from where it is transferred via the local WiFi network or via a mobile data connection to the central server. The server also hosts the web interface for the platform. Communication between the portal and the Android components is done at the operating system level, through a monitoring service implemented as an Android daemon - watchdog. The virtual coach will generate the next level of the game based on the current state of the user. The microservice for gesture recognition (movement and touch) allows users to interact with the application using body, limb or finger movements. A study was conducted on the perceptions and preferences of older people regarding smart rings, the results showing an openness towards the adoption of smart rings, which were perceived to be useful to help with different activities. The user interface was also designed and implemented.

Activity 2.4: Implementation of the main functionalities of the MERITT platform (intermediate): the characteristics of the software interface have been defined: the interfaces intended to be used by elderly people must ensure good quality and ease of interaction, they must be attractive and intuitive to use, so as to lead to familiarity in use. The virtual coach for the two games Match Game and Collect Objects has been implemented by creating rules based on decision trees to create the next level adapted to the user's abilities and performance (including the quality of the parameters collected in the MERITT project).

Activity 2.5: Dissemination of minimum 2 publications, updated website, social media: The dissemination of the MERITT project was carried out through:

• Dissemination through the website: http://www.citst.ro/cms/index.php?id=meritt
• Facebook page: https://www.facebook.com/people/Proiectul-Meritt/100087557150971/
• Linkedin page: https://www.linkedin.com/showcase/meritt-project/
• Publication of 5 papers in international conferences with ISI and BDI indexed proceedings:
  1. Bilius, Laura-Bianca and Vatavu, Radu-Daniel. I Could Wear It All of the Time, Just Like My Wedding Ring:” Insights into Older People’s Perceptions of Smart Rings, 2023 CHI Conference on Human Factors in Computing Systems, 2023, DOI: 10.1145/3544549.3585771, https://doi.org/10.1145/3544549.3585771.
  2. Stanciu, I. D., Cramariuc, O. T., & Mocanu, I. G. (2023, July 15). Types of affordances and their role in quantitative and qualitative UX/UI research. A scoping review of affordances-focused literature. 17th International Conference on E-Learning and Digital Learning, https://www.elearning-conf.org.
  3. Irina Mocanu, Oana Cramariuc, Dorin Ionut Stanciu. An Intelligent Application for Improving Health Conditions through Gamification. 24th International Conference on Control Systems and Computer Science – CSCS24, 24-26 May 2023, in press.
  4. Irina Mocanu, Alex Imad Awada, Oana Cramariuc. A System for Engaging Older Adults in Maintaining an Active and Healthy Life Through Games. 19th eLearning and Software for Education - eLSE Conference, 27-28 April 2023, in press.
  5. Roxana Elena Stiuca, Irina Mocanu. Character Animation using LSTM Networks. 46th International Conference on Telecomunications and Signal Processing, TSP 2023, 12-14 July 2023, in press.

Activity 2.1: Analysis of usability and user needs (final): consists of a study carried out with two groups of users. In the first, eight people aged 65 to 78 participated (five women and three men). All participants had a good cognitive level and their independence in everyday life is very high. The second group (20 users aged between 65 and 80) aimed not only at evaluating the games but also the other elements of the MERITT platform. They provided feedback using a dedicated questionnaire developed to gauge interest in the platform as a whole, but also in its specific features.

Activity 2.2: Establishing the platform’s gamification elements (final): consists in describing the multiplayer game that involves interaction between several users, analyzing existing games in order to identify how to establish rewards adapted to the background of each user. An important identified aspect was the creation of difficulty levels to adapt to the different abilities and preferences of the players. Existing games Match Game and Collect Objects were extended with new difficulty levels.

Activity 2.3: Design and development of the MERITT architecture (final): to finalise the design of the MERITT architecture. The interface of the system uses Android, via a tablet, which serves as the main means of interaction with the user and provides both interface with the platform and the data collection means. The devices use a software gateway installed on the tablet to transfer data to the tablet from where it is transferred via the local WiFi network or via a mobile data connection to the central server. The server also hosts the web interface for the platform. Communication between the portal and the Android components is done at the operating system level, through a monitoring service implemented as an Android daemon - watchdog. The virtual coach will generate the next level of the game based on the current state of the user. The microservice for gesture recognition (movement and touch) allows users to interact with the application using body, limb or finger movements. A study was conducted on the perceptions and preferences of older people regarding smart rings, the results showing an openness towards the adoption of smart rings, which were perceived to be useful to help with different activities. The user interface was also designed and implemented.

Activity 2.4: Implementation of the main functionalities of the MERITT platform (intermediate): the characteristics of the software interface have been defined: the interfaces intended to be used by elderly people must ensure good quality and ease of interaction, they must be attractive and intuitive to use, so as to lead to familiarity in use. The virtual coach for the two games Match Game and Collect Objects has been implemented by creating rules based on decision trees to create the next level adapted to the user's abilities and performance (including the quality of the parameters collected in the MERITT project).

Activity 2.5: Dissemination of minimum 2 publications, updated website, social media: The dissemination of the MERITT project was carried out through:

• Dissemination through the website: http://www.citst.ro/cms/index.php?id=meritt
• Facebook page: https://www.facebook.com/people/Proiectul-Meritt/100087557150971/
• Linkedin page: https://www.linkedin.com/showcase/meritt-project/
• Publication of 5 papers in international conferences with ISI and BDI indexed proceedings:
  1. Bilius, Laura-Bianca and Vatavu, Radu-Daniel. I Could Wear It All of the Time, Just Like My Wedding Ring:” Insights into Older People’s Perceptions of Smart Rings, 2023 CHI Conference on Human Factors in Computing Systems, 2023, DOI: 10.1145/3544549.3585771, https://doi.org/10.1145/3544549.3585771.
  2. Stanciu, I. D., Cramariuc, O. T., & Mocanu, I. G. (2023, July 15). Types of affordances and their role in quantitative and qualitative UX/UI research. A scoping review of affordances-focused literature. 17th International Conference on E-Learning and Digital Learning, https://www.elearning-conf.org.
  3. Irina Mocanu, Oana Cramariuc, Dorin Ionut Stanciu. An Intelligent Application for Improving Health Conditions through Gamification. 24th International Conference on Control Systems and Computer Science – CSCS24, 24-26 May 2023, in press.
  4. Irina Mocanu, Alex Imad Awada, Oana Cramariuc. A System for Engaging Older Adults in Maintaining an Active and Healthy Life Through Games. 19th eLearning and Software for Education - eLSE Conference, 27-28 April 2023, in press.
  5. Roxana Elena Stiuca, Irina Mocanu. Character Animation using LSTM Networks. 46th International Conference on Telecomunications and Signal Processing, TSP 2023, 12-14 July 2023, in press.

Phase III

The aim of phase 3 was the following: 1) implementation of the database storing the parameters acquired with the MERITT platform, 2) implementation of the first version of the multi-player game, 3) laboratory testing, 4) study of existing commercial solutions and 5) dissemination of the project. The proposed objectives were achieved in the following activities.

Activity 3.1: Implementation of the main functionalities of the MERITT platform: present: (i) implementation of the database, with related tables for saving the acquired data, (ii) extension of the match game, so that the transition to the next level can be made according to the current performance of the user (without the user being able to choose a divel with a higher difficulty if his current performance is poor); (iii) implementation of an application created in Unity 3D for the use of the smart toothbrush (owned by CITST) that allows real-time visualization of the progress of the brushing time, the duration reported to 2 minutes as recommended by dentists; to acquire the parameters from the brush and use them in the Unity engine the Bluetooth LE for iOS, tvOS and Android library was used; (iv) the multi-player game, implemented in Unity 3D, involves the interaction between 2 users with the aim of solving a puzzle; each player has access to a number of pieces, with which he will be able to solve only a certain area of the puzzle. The number of pieces and cells for each user is given by the amount of health and wellness parameters measured by the MERITT platform - regular measurement of the parameters and performing an optimal number of steps/day leads to obtaining a higher number of puzzle pieces and cells; (v) implementation of the interaction via smart rings and empirical examination of the perceptions and preferences of older people for the wearable device technology of smart rings, for using the semi-structured interview method with nine participants.

Activity 3.2: Component integration and lab testing: We have integrated the developed components into a web application, which controls each component through an Android application (watchdog). In order to test the availability of the applications in case of multiple concurrent requests, we implemented a test platform using Google Cloud infrastructure. Lab testing was also performed, under the supervision of members of the development teams, with target users. Twenty seniors between 62 and 83 years old participated in this test, with equal gender distribution.

Activity 3.3: Study of competing solutions in the literature: We have studied competing solutions in the literature and have analysed various health monitoring platforms integrating medical devices and games.

Activity 3.4: Dissemination via webpage, social media: Contributions to dissemination via webpage, social media, minimum 1 scientific publication, report on large scale dissemination strategy: - In which the project webpage, Facebook page and Linkedin were updated, 1 paper was presented at the international conference with BDI indexed proceedings (Springer), paper being published and presentation of the project at the Centre of Excellence in Care and Assistance for the Elderly and Prevention of Memory Disorders Vitalitas, at the second national conference of long-term care services organized by the Association of Directors of Institutions for the Elderly and at the NetZeRoCities workshop.

Phase IV

The purpose of phase 4 consisted in: 1) testing the integrated platform, 2) adjusting and optimizing the platform, 3) studying competing solutions in databases, 4) protecting intellectual property rights by filing a patent application and producing a first version of the business plan and 5) disseminating the project. The objectives of phase 4 were fully achieved, with 100% of the results achieved. The proposed objectives were achieved in the following activities.

Activity 4.1: Pilot studies testing the integrated platform under real-life conditions - end-user testing: A total of 9 seniors participated in the testing of the MERITT platform, and their feedback was collected using a questionnaire containing both closed and open-ended questions. The questionnaire was administered by an interviewer, whose role was to clarify certain aspects that were not very clear to the respondents, to ensure that the answers were accurate and reflected their real experience. Participants ranged in age from 61 to 85 years, with an average age of 69 years. The gender distribution was relatively unbalanced, with 2 women for every 1 man involved; the area of residence was exclusively urban. The predominant marital status was married, with 6 people in this category, and the remaining 3 widowed.
The tested MERITT platform is implemented as a web application with functionalities that are accessed through a webpage. Several Android applications are supporting the gamification part as well as the health monitoring and oral health data collection. In order to be able to connect to the MERITT platform, the user has to log in to the home page, either by entering a username and password or by using an RFID tag. Interaction with the interface can be done both by touch and gestures using smart rings. Testing of the latter has revealed that their use can bring significant benefits by promoting an intuitive user experience tailored to the needs and preferences of elderly users.

Activity 4.2: Tuning and optimization: In this phase, pre-existing gesture recognition models were retrained. New gestures were also collected, using dedicated functionality, categorized accordingly and used for retraining. The multiplayer game was also modified by implementing functionalities and rules for the virtual trainer based on which he assignes the pieces and the cells to the players. The implementation uses decission trees.

Activity 4.3: Study of competing solutions in the database: In this activity, competing solutions were studied in the database of the European Patent Office (https://www.epo.org/en) using different keyword combinations such as: e-health AND gamification, e-health AND oral hygiene, eHealth AND sensors, e-health AND wearable sensors, e-health AND social platform, health monitoring AND social platform, health monitoring platform and wearable devices.

Activity 4.4: Protecting intellectual property rights by filing a patent application and realizing a first version of the business plan: The results obtained from the studies carried out as part of Activity 4.4 were analyzed and the most suitable patents were selected based on their similarities with the MERITT platform. These were included in the patent application filed with OSIM (A/00341/19.06.2024). Also, a first business plan has been developed presenting the company's strategy in commercializing the MERITT platform and services, the opportunity and target market segment, competitors, canvas model, marketing strategy and financial forecasts.

Activity 4.5: Dissemination through website, social media, minimum 1 scientific publication: The project webpage, Facebook and Linkedin pages have been updated, 3 articles have been presented at international conferences with proceedings under ISI indexing. One Q2 indexed journal article was submitted for publication. Information about the project was disseminated at the National Forum of Patients' Associations organized by COPAC on 23-24 May. The forum was attended by CITST.