Supplementary Material for: Virtual Assistant as a companion for stroke survivors post discharge: thematic analysis highlights expectations of human performance pose a key barrier to engagement

Introduction: Health-related information and support is scarcely available to stroke survivors following discharge from hospital, largely due to limited access to health professionals. Digital tools like Virtual Assistants (VAs) can address some of these needs on demand in a home environment, and there already is evidence of their effective deployment in health contexts. However, to maximise how individuals engage with such technological tools in or post development, it is integral that their design be grounded to the needs and associated expectations of the target user population. Methods: We conducted workshops where stroke survivors roleplayed as VAs and users and fed back on their expectations of a stroke-specific VA. In our one-to-one interviews with stroke survivors, we simulated VA interactions with two functions: administering PROMs and asking questions. Then, in testing sessions, stroke survivors, family, and caregivers responded to PROMs both on the VA and with a human, before sharing their thoughts about the VA. Results: Our thematic analysis yielded four themes with semantic and latent codes. Aligned with past research, we observed an unmet need for information and support on demand following discharge. Participants expected the VA to on demand provide information not typically available through healthcare interactions. Participants perceived the VA in our study as human or as a personable animate object, and the subsequent anthropomorphic expectations were the least addressable barrier to engaging with the VA. Conclusion: These qualitative findings validate that common expectations of digital tools in general adult populations extend to stroke survivors, emphasising the importance of participatory design to account for addressable barriers to initially and continuously engaging with a digital health tool.