Combining Motivating Strategies with Design Concepts for Mobile Apps to Increase Usability for the Elderly and Alzheimer Patients

Eichhorn, Christian; Plecher, David A.; Lurz, Martin; Leipold, Nadja; Böhm, Markus; Krcmar, Helmut; Ott, Angela; Volkert, Dorothee; Hiyama, Atsushi; Klinker, Gudrun

doi:10.1007/978-3-030-50249-2_4

Cited by 10 publications

(6 citation statements)

References 62 publications

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“…When developing the e-coach, design recommendations for the target group [ 29 , 30 ] were considered in advance. The button labels and the texts on the navigation screens were phrased without technical terms to make them usable even for novice technology users.…”

Section: Discussionmentioning

confidence: 99%

“…The e-coach screens were designed in Adobe XD (version 34; Adobe Systems) for a 10-inch tablet in landscape mode. Design guidelines for apps for older adults were used to take into account specific requirements, such as a decline in vision or decreased motor abilities when developing the prototype [ 29 , 30 ]. To ensure a linear navigation structure, the position and design of the navigation buttons were always identical.…”

Section: Methodsmentioning

confidence: 99%

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Iterative Development and Applicability of a Tablet-Based e-Coach for Older Adults in Rehabilitation Units to Improve Nutrition and Physical Activity: Usability Study

Happe¹,

Sgraja²,

Hein³

et al. 2022

JMIR Hum Factors

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Background Maintaining nutrition and exercise strategies after rehabilitation can be difficult for older people with malnutrition or limited mobility. A technical assistance system such as an e-coach could help to positively influence changes in dietary and exercise behavior and contribute to a sustainable improvement in one’s nutrition and mobility status. Most apps do not provide a combination of nutrition and exercise content. In most cases, these apps were evaluated with healthy individuals aged <70 years, making transferability to vulnerable patients, with functional limitations and an assumed lower affinity for technology, in geriatric rehabilitation unlikely. Objective This study aims to identify the potential for optimization and enhance usability through iterative test phases to develop a nutrition and mobility e-coach suitable for older adults (≥65 years) based on individual health behavior change stages in a rehabilitation setting. Methods Iterative testing was performed with patients aged ≥65 years in a rehabilitation center. During testing, participants used an e-coach prototype with educational elements and active input options on nutrition and mobility as a 1-time application test. The participants performed navigation and comprehension tasks and subsequently provided feedback on the design aspects. Hints were provided by the study team when required, documented, and used for improvements. After testing, the participants were asked to rate the usability of the prototype using the System Usability Scale (SUS). Results In all, 3 iterative test phases (T1-T3) were conducted with 49 participants (24/49, 49% female; mean 77.8, SD 6.2 years). Improvements were made after each test phase, such as adding explanatory notes on overview screens or using consistent chart types. The use of the user-centered design in this specific target group facilitated an increase in the average SUS score from 69.3 (SD 16.3; median 65) at T1 to 78.1 (SD 11.8; median 82.5) at T3. Fewer hints were required for navigation tasks (T1: 14.1%; T2: 26.5%; T3: 17.2%) than for comprehension questions (T1: 30.5%; T2: 21.6%; T3: 20%). However, the proportion of unsolved tasks, calculated across all participants in all tasks, was higher for navigation tasks (T1: 0%, T2: 15.2%, T3: 4.3%) than for comprehension tasks (T1: 1.9%, T2: 0%, T3: 2.5%). Conclusions The extensive addition of explanatory sentences and terms, instead of shorter keywords, to make it easier for users to navigate and comprehend the content was a major adjustment. Thus, good usability (SUS: 80th-84th percentile) was achieved using iterative optimizations within the user-centered design. Long-term usability and any possible effects on nutritional and physical activity behavior need to be evaluated in an additional study in which patients should be able to use the e-coach with increasing independence, thereby helping them to gain access to content that could support their long-term behavior change.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Iterative Development and Applicability of a Tablet-Based e-Coach for Older Adults in Rehabilitation Units to Improve Nutrition and Physical Activity: Usability Study

Happe¹,

Sgraja²,

Hein³

et al. 2022

JMIR Hum Factors

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show abstract

“…Analysis of design concepts, the results of other focus group studies with older people and the results of our study address the particular relevance of developing a system taking age-related limitations and low complexity into account. For example, a sufficient font size should be used, the handling should be simple, the screens should not be cluttered and in case of videos the volume should be high enough [ 26 , 32 , 33 ]. It would therefore make sense to use a larger screen, such as on a tablet.…”

Section: Discussionmentioning

confidence: 99%

What do geriatric rehabilitation patients and experts consider relevant? Requirements for a digitalised e-coach for sustainable improvement of nutrition and physical activity in older adults – a qualitative focus group study

2021

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Background During geriatric rehabilitation, attempts are made to increase the patients’ health and functional capacity. In order to maintain these improvements in the medium- and long-term, behavioural changes regarding mobility and nutrition are also targeted, but these are often not sustainable. International studies show positive effects on the sustainability of the improvement of physical activity behaviour in healthy seniors through the use of electronic devices and software applications. Comparable approaches that include nutrition topics or combine them and were additionally developed for geriatric rehabilitation patients (≥70 years) to date are not known. The aim of this study was to identify what geriatric rehabilitation patients require from an electronic coaching system (e-coach) to support them in improving their nutritional and physical activity behaviour, and what content and features physiotherapists and dieticians consider relevant. Method Focus group interviews (09–11/2019) were conducted in a geriatric rehabilitation centre in Germany with patients aged 70 years and older, relatives and experts (physiotherapists and nutritionists). The focus groups were recorded, transcribed verbatim and analysed using content analysis. Results Three focus groups with patients and relatives (n = 17, 65% female, 16 (94%) in age category 70–99 years) and one focus group with experts (2 dieticians and 1 physiotherapist) were conducted. Relevant contents and feedback elements for nutrition and physical activity in old age were identified. The patients’ comments show that an e-coach must offer obvious benefits for the older persons and promote motivation in order to be used. The willingness to change nutrition and physical activity behaviour and the previous experiences in these areas are very heterogeneous, therefore content should be adaptable to different requirements. Conclusion Experts and patients identified quite similar contents, barriers and facilitators for a nutrition and physical activity e-coach. The e-coach needs to be able to address different points of behaviour change, enable adaptations to the individual patient and convince the older person that using it will help them to improve their nutrition and physical activity. It is also important that the e-coach is easy to use and can be easily integrated into the patient’s everyday life after rehabilitation.

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“…Concerns adding visual cues to multimedia learning materials within the system to help users find elements that are relevant at any given moment fluidly. [14,16,27,31,32] R11.…”

Section: Use Signalling Principlementioning

confidence: 99%

“…Concerns providing system users the tools to manage the speed of system operation and not enforcing unreasonable, fixed time constraints on user actions. [18,23,31] R17.…”

Section: Provide Clear Error and Warning Messagesmentioning

confidence: 99%

Towards High Usability in Gamified Systems: A Systematic Review of Key Concepts and Approaches

2022

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Gamification is widely used in various domains as it helps increase user motivation and engagement. Therefore, it is important to ensure that the gamified system meets usability requirements and conforms to user experience and human-centred design guidelines, as poor usability may lead to undesired side-effects, such as a loss of user retention. Unfortunately, it is not entirely clear what usability guidelines are related to gamified systems and how they depend on the gamification target audience and on the gamified system application domain. This paper provides a systematic review of usability, user experience and human-centred design guidelines for gamified systems. A systematic search was performed in Web of Science, Scopus, IEEE Xplore, ScienceDirect, and ACM Digital Library databases, following the PRISMA guidelines. The results show that most of the recommendations listed in analysed papers are related to improving learnability of gamified systems. Furthermore, the system application domain is generally viewed as very important when making usability-related decisions. The key distinctive gamification application domains are medicine, education, and business. The findings may be useful to usability and gamification researchers, as well as the developers and owners of gamified systems who want to grasp the state of research into the specifics of gamified systems usability.

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Combining Motivating Strategies with Design Concepts for Mobile Apps to Increase Usability for the Elderly and Alzheimer Patients

Cited by 10 publications

References 62 publications

Iterative Development and Applicability of a Tablet-Based e-Coach for Older Adults in Rehabilitation Units to Improve Nutrition and Physical Activity: Usability Study

Iterative Development and Applicability of a Tablet-Based e-Coach for Older Adults in Rehabilitation Units to Improve Nutrition and Physical Activity: Usability Study

What do geriatric rehabilitation patients and experts consider relevant? Requirements for a digitalised e-coach for sustainable improvement of nutrition and physical activity in older adults – a qualitative focus group study

Towards High Usability in Gamified Systems: A Systematic Review of Key Concepts and Approaches

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