PROJECT SUMMARY/ABSTRACT Visual impairment causes significant losses to mobility, independence, and quality of life, contributing to elevated rates of anxiety, depression, and physical injuries, inclusive of mechanical trips and falls. These challenges are compounded in complex urban environments, such as large healthcare centers and multi-use city blocks, where navigation requires advanced spatial cognition. To address this gap, our team has developed VIS4ION (Visually Impaired Smart Service System for Spatial Intelligence and Onboard Navigation), a customizable, human-in-the-loop wearable and smartphone application delivering real-time wayfinding assistance using next-generation mapping and localization technologies. Our central hypothesis is that infrastructure-independent wearable navigation technologies can improve spatial cognition, mobility, and well-being for people with visual impairments. Building on promising R21 outcomes—including improved navigation efficiency and user confidence, along with high acceptability—we will conduct extended trials across NYU Langone Health hospital facilities and the Lighthouse Guild, a storied blindness-focused NPO headquartered in NYC, as well as surrounding multi-block outdoor environments across the NYC-metro region. This project has five aims: 1. Develop and refine an enhanced navigation system with real-time image-based localization, IMU integration for step-counting navigation, and advanced scene understanding through AI. 2. Digitally map complex multi-floor healthcare facilities and surrounding urban areas using innovative, infrastructure-free digital-twinning techniques. 3. Assess acceptability, appropriateness, feasibility, and usability through focus groups and user-centered design testing with visually impaired participants. 4. Conduct an extended-use trial to evaluate system effectiveness on longer-range navigation performance. 5. Validate generalizability of the navigation system at-scale across multi-block NYC environments, testing across diverse indoor and outdoor settings. By combining advanced mapping, robust localization, and iterative human-centered design, this project will provide a scalable, cost-effective wayfinding solution to improve independence, safety, and quality of life for people with visual impairments across the U.S.