PROJECT SUMMARY/ABSTRACT The world's population is aging and the increasing number of older adults with chronic health conditions is a challenge our society must address. While the idea of smart environments is now a reality, there remain gaps in our knowledge about how to scale smart homes technologies for use in complex settings and to use machine learning and activity learning technologies to design automated health assessment and intervention strategies. The long-term objective of this project is to improve human health and impact health care delivery by developing smart environments that aid with health monitoring and intervention. The primary objective of this application is to design a “clinician in the loop” smart home to empower individuals in managing their chronic health conditions by automating health monitoring, assessment, and evaluation of intervention impact. Building on our prior work, the approach will be to generate analytics describing an individual's behavior routine using smart homes, smart phones, and activity learning (Aim 1). Our trained clinicians will use the analytics to perform health assessment and detection of health events (Aim 2). In addition, we will introduce brain health interventions to support sustainable improvement of brain health (Aim 3). Finally, we train machine learning algorithms from the clinical observations to automate assessment of health and intervention impact (Aim 4). The use of these technologies is expected to improve and extend the functional health and wellbeing of older adults, lead to more proactive and preventative health care, and reduce the caregiver burden of health monitoring and assistance. By understanding situational factors that impact prompt adherence, adherence situations can be increased. The approach is innovative because it will explore and validate new machine learning techniques for activity learning and health assessment based on clinical ground truth. These contributions are significant because they can extend the health self-management of our aging society through proactive health care and real-time intervention, and reduce the emotional and financial burden for caregivers and society. Given nursing home care costs, the impact of family-based care, and the importance that people place on staying at home, technologies that increase functional independence and thus support aging in place while improving quality of life for both individuals and their caregivers are of significant value to both individuals and society.