VIS4ION-FiT (Visually Impaired Smart Service System for Spatial Intelligence and Onboard Navigation for Fitness in Thailand) - PROJECT SUMMARY/ABSTRACT Persons with blindness or low vision (PBLV) lead more sedentary lifestyles, with reduced mobility, lower physical activity, and an increase in associated non-communicable. PBLV often fear travel/journeys, given frequent dependence on others and the looming threat of getting lost or stranded. PBLV also face substantial increases in mechanical trips, falls, and fractures. These barriers lower their health outcomes, some of which could be mediated by physical exercise. Despite an intensive evidence base supporting physical activity to promote health, there is a large practice gap for PBLV in almost every high-income country, with larger gaps in low- and middle-income countries, including urban/city centers such as Bangkok, Thailand. Smart wearables can close this accessibility and implementation gap by providing wayfinding and scene understanding solutions to guide safe exercise within public parks in a manner that does not require additional physical infrastructure (e.g. signs, beacons). We will implement our wearable and smartphone application (with updates), VIS4ION-FiT (Visually Impaired Smart Service System for Spatial Intelligence and Onboard Navigation for Fitness in Thailand) and test it as an implementation strategy to improve physical activity in PBLV. VIS4ION-FiT is a customizable personal mobility solution that uses artificial intelligence (AI) to process camera/sensor data, both locally on the system, and remotely on servers, to provide safe guiding instructions delivered as speech, audio alerts, and tactile feedback. Our central hypothesis is that PBLV who use the VIS4ION-FiT implementation strategy will increase their `moderate-equivalent' minutes of physical activity minutes per week and this improve personal health metrics (blood pressure, resting heart rate, weight). The proposal has three aims of evaluation to validate this approach – technical, behavioral / biological, and as an implementation strategy. First, we will interview 10 PBLV to identify key access barriers to physical activity. Then, we will update our AI navigation technology with GPS to create a more robust and precise hybrid solution for user wayfinding. We will map walking routes and places of interest in large public parks, like Lumpini Park in Bangkok. User testing (25 sighted, 25 PBLV) will guide the evaluation of our navigation and scene understanding assistance. Second, we will conduct a randomized controlled crossover trial with 40 PBLV using VIS4ION-FiT for 6 of 12 months, providing everyone park access for exercise. We will measure physical activity metrics, adherence, and health-related changes over a 12-month period. Our primary outcome is moderate-equivalent minutes of physical activity per week, with daily steps, blood pressure, resting heart rate, and weight as secondary outcomes. Users will also provide feedback on VIS4ION- FiT's acceptability, appropriateness, and feasibility as an implementation strategy. Third, we will perform a process evaluation of our implementation strategy using the RE-AIM framework, gathering data on how the intervention facilitated physical activity and health. Collective results will guide future directions to enhance physical activity for PBLV in urban/city areas in Thailand as well as other countries.
