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.
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