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Technology developments have expanded the diversity of interaction modalities that can be used by an agent (either a human or machine) to interact with a computer system. This expansion has created the need for more natural and user-friendly interfaces in order to achieve effective user experience and usability. More than one modality can be provided to an agent for interaction with a system to accomplish this goal, which is referred to as a multimodal interaction (MI) system. The Internet of Things (IoT) and augmented reality (AR) are popular technologies that allow interaction systems to combine the real-world context of the agent and immersive AR content. However, although MI systems have been extensively studied, there are only several studies that reviewed MI systems that used IoT and AR. Therefore, this paper presents an in-depth review of studies that proposed various MI systems utilizing IoT and AR. A total of 23 studies were identified and analyzed through a rigorous systematic literature review protocol. The results of our analysis of MI system architectures, the relationship between system components, input/output interaction modalities, and open research challenges are presented and discussed to summarize the findings and identify future research and development avenues for researchers and MI developers.

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Background The older population needs solutions for independent living and reducing the burden on caregivers while maintaining the quality and dignity of life. Objective The aim of this study was to design, develop, and evaluate an older adult health care app that supports trained caregivers (ie, formal caregivers) and relatives (ie, informal caregivers). We aimed to identify the factors that affect user acceptance of interfaces depending on the user’s role. Methods We designed and developed an app with 3 user interfaces that enable remote sensing of an older adult’s daily activities and behaviors. We conducted user evaluations (N=25) with older adults and their formal and informal caregivers to obtain an overall impression of the health care monitoring app in terms of user experience and usability. In our design study, the participants had firsthand experience with our app, followed by a questionnaire and individual interview to express their opinions on the app. Through the interview, we also identified their views on each user interface and interaction modality to identify the relationship between the user’s role and their acceptance of a particular interface. The questionnaire answers were statistically analyzed, and we coded the interview answers based on keywords related to a participant’s experience, for example, ease of use and usefulness. Results We obtained overall positive results in the user evaluation of our app regarding key aspects such as efficiency, perspicuity, dependability, stimulation, and novelty, with an average between 1.74 (SD 1.02) and 2.18 (SD 0.93) on a scale of −3.0 to 3.0. The overall impression of our app was favorable, and we identified that “simple” and “intuitive” were the main factors affecting older adults’ and caregivers’ preference for the user interface and interaction modality. We also identified a positive user acceptance of the use of augmented reality by 91% (10/11) of the older adults to share information with their formal and informal caregivers. Conclusions To address the need for a study to evaluate the user experience and user acceptance by older adults as well as both formal and informal caregivers regarding the user interfaces with multimodal interaction in the context of health monitoring, we designed, developed, and conducted user evaluations with the target user groups. Our results through this design study show important implications for designing future health monitoring apps with multiple interaction modalities and intuitive user interfaces in the older adult health care domain.