Voice-Activated Technology to Improve Mobility in Multimorbid, Frail, Homebound Older Adults (EngAGE)

The purpose of this study is to test the efficacy of EngAGE (an interactive, voice-activated app) vs usual care on improving older adult physical and social function.

Inclusion Criteria: * age greater than or equal to 60 years * has at least 2 chronic conditions * requires any assistance to leave the home (this may include requiring someone to drive, requiring the use of a cane or walker, or similar) * can read 14 point font from a 2-foot distance on a tablet-sized screen * can hear spoken voice from 2-foot distance * SPPB score of less than or equal to 9 but greater than 3 on a 12-point scale to target moderate but not severe functional impairment. Exclusion Criteria: * reported history of moderate to advanced cognitive impairment; * inability to stand unassisted; * inability to understand English (because the intervention is currently only available in English); * life expectancy less than 12 months or enrolled in Hospice; * a medical condition making unsupervised physical activity potentially unsafe including: stroke within prior 12 months, acute myocardial infarction or unstable angina in the prior 6 months, uncontrolled arrhythmias, dissecting aortic aneurysm, acute endo/pericarditis, acute thromboembolism, acute or severe heart or respiratory failure, uncontrolled hypertension greater than 180/100, fracture or joint replacement within the prior 3 months, infections affecting one's general health condition, severe peripheral vascular disease. * severe functional impairment as indicated by an SPPB score less than 3 (out of 12); * baseline Montreal Cognitive Assessment of less than or equal to 18/30; * inability to understand consent (teach back).