PROJECT SUMMARY Forty to eighty percent of clinic visit information is forgotten by patients immediately post visit, a significant barrier to self-management leading to poor health outcomes. Visit summaries can improve recall, yet patient uptake is limited and clinicians report significant burden in creating summaries for laypeople. Patients are beginning to audio record visits and clinics are now offering this service. When patients receive a clinic recording, 71% listen and 68% share it with a caregiver, resulting in improved understanding and self- management. Yet, unstructured recordings are difficult to navigate. Personal health libraries (PHLs) may help patients organize health information;; yet current PHLs do not facilitate clinic-recordings. The objective of this project is to develop a PHL that integrates clinic audio-recordings (Audio-PHL), using data science methods to link medical terms from the recording to trustworthy patient resources, which can be retrieved, organized, edited and shared by patients. The specific aims are: Aim 1 Identify health information seeking needs and strategies of older adults with multimorbidity and caregivers;; Aim 2 Develop an Audio-PHL using data science methods to securely analyze clinic visit recordings and make this information accessible and understandable for patients;; and Aim 3 Demonstrate the usability and use of an Audio-PHL in older adults with multimorbidity and caregivers. Applicants hypothesize: (1) The Audio-PHL will surpass acceptable usability metrics in older adults and caregivers and (2) natural language processing (NLP) methods developed for the Audio-PHL will accurately identify key visit information (e.g. medication) and connect it to credible patient resources. The development of the Audio-PHL follows a user centered design model. In Aim 1, the applicants will use participatory design activities with 48 end-users to inform Audio-PHL design. In Aim 2, the Audio-PHL will be created in iterative cycles informed by findings from Aim 1. In Aim 3, extensive usability evaluation will be conducted in human computer interaction (HCI) laboratory settings to ensure Audio-PHL surpasses acceptable usability metrics. Field testing of the Audio-PHL will follow via a patient-randomized pilot trial with older adults with multimorbidity from primary care. Participants (N=70) will receive an Audio-PHL (intervention) or PHL (control) with no recordings. Usability metrics and satisfaction will be assessed at one-month. Preliminary data on the impact of an Audio-PHL on patient ability to seek, find and use health information with high confidence, patient activation and caregiver confidence will also be gathered. The research is innovative because it will provide patients and caregivers secure access to a PHL based on clinic-recordings that uses data science methods to organize visit information and connect it to trusted resources. The results are expected ...