ACTIVATE: An AI-Enabled Multilingual Platform for Connected and Accessible Care Coordination and Remote Monitoring. - ABSTRACT The goal of this SBIR by Health Tequity LLC is to develop and assess usability of ACTIVATE artificial intelligence accessibility engine (AIA) for multi-language mobile apps and voice navigation for chronic illness. ACTIVATE AIA makes digital care coordination accessible to improve self-management and outcomes. Problem: Chronic illnesses such as diabetes mellitus and hypertension affect millions of people worldwide and adversely impacts medically low-resourced populations. Digital care coordination programs and remote patient monitoring (RPM) can improve chronic illness care. Yet, challenges remain for low-resourced populations including device access, digital health literacy, clinic staff and providers with digital experience, and programs adapted to culture and setting. Accessibility of digital health for those who speak languages other than English, have vision and manual dexterity challenges, or have low literacy is an unmet need. Almost 68 million people in the US only speak a language other than English. Language translation and voice navigation would make digital care coordination accessible. Solution: The product of this SBIR will be a new ACTIVATE AIA prototype in three languages, English, Spanish, and Tagalog (using a hypertension use case). Patients use myACTIVATE mobile app in their preferred language to connect to a commercially-available blood pressure cuff and automatically transmit data to the community health center, navigate the app by voice, and view and have data read out to them in language. There are few available multi-language, patient-focused care coordination applications that are connected to healthcare providers and even fewer that support voice navigation for accessibility. ACTIVATE AIA fills this gap through these Specific Aims: Aim 1. Develop an artificial intelligence accessibility engine (AIA) for multi-language voice navigation. AI translation models for English, Spanish, and Tagalog will be fine-tuned and the AIA prototype for voice navigation assessed with feasibility performance metrics delivered by month 3. Aim 2. Produce a multi-language myACTIVATE app with voice navigation. Developed JSON function calls and ACTIVATE platform integrations to produce functional English, Spanish, and Tagalog apps with AIA voice navigation by month 4. Aim 3. Conduct Human-Centered Usability Study of myACTIVATE with AIA. Usability assessed among varied patients, providers, and staff (n=24) in California and Hawaii CHCs with System Usability Scale and in-depth, semi-structured interviews by month 6. ACTIVATE AIA will bring accessibility to low-resourced communities to improve chronic illness care and self-management. Investment in AIA commercialization will help scale the initial breakthrough health outcomes of ACTIVATE to many communities that are impacted by health disparities potentially impacting millions of people with chronic illness, improving self-management, and reducing cost to the health system.