Usability Testing by Older Adults of a Computer-Mediated Health Communication Program

Abstract

This study tested the usability of a touch-screen enabled "Personal Education Program" (PEP) with Advanced Practice Registered Nurses (APRN). The PEP is designed to enhance medication adherence and reduce adverse self-medication behaviors in older adults with hypertension. An iterative research process was employed, which involved the use of: (1) pre-trial focus groups to guide the design of system information architecture, (2) two different cycles of think-aloud trials to test the software interface, and (3) post-trial focus groups to gather feedback on the think-aloud studies. Results from this iterative usability testing process were utilized to systematically modify and improve the three PEP prototype versions-the pilot, Prototype-1 and Prototype-2. Findings contrasting the two separate think-aloud trials showed that APRN users rated the PEP system usability, system information and system-use satisfaction at a moderately high level between trials. In addition, errors using the interface were reduced by 76 percent and the interface time was reduced by 18.5 percent between the two trials. The usability testing processes employed in this study ensured an interface design adapted to APRNs' needs and preferences to allow them to effectively utilize the computer-mediated health-communication technology in a clinical setting. PURPOSEThe purpose of this study was to conduct usability testing with Advanced Practice Registered Nurses (APRNs) of a computer-mediated "Personal Education Program" (PEP) that captures the self-medication behaviors of older adults with hypertension and delivers a tailored education program aimed at increasing medication adherence and reducing adverse selfmedication behaviors. The PEP uses a touchscreen interface on a tablet PC. The APRN enters the patient's medication regimen, blood pressure and other study parameters before turning the PEP over to the patient in the waiting room. After the patient answers questions about his/ her medication behaviors and interacts with the education component, a report is printed for both patient and provider listing patient-identified problems and symptoms, PEP-identified adverse self-medication behaviors, and corrective strategies.

Older adults and mobile technology: Factors that enhance and inhibit utilization in the context of behavioral health

“…A majority of older adults report positive attitudes towards technology, including the internet, email, text messaging and smartphones [9,43,67,91]. A large ethnographic study in Ireland demonstrated that older adults adapted to waves of new technologies across their lifetimes, suggesting a higher level of acceptance and readiness than previously assumed [92].…”

“…A large ethnographic study in Ireland demonstrated that older adults adapted to waves of new technologies across their lifetimes, suggesting a higher level of acceptance and readiness than previously assumed [92]. Older adults demonstrate positive attitudes towards technology, as it is "a conduit to youthfulness" [67], helping them to communicate with younger generations. Furthermore, in a national survey, adults over 50 were more likely to evaluate their smartphone as liberating compared to younger adults who viewed it as a leash [44].…”

Effects of Interactive Pictorial Education on Community Dwelling Older Adult's Self Efficacy and Knowledge for Safe Medication

“…On pictorial cards, the text of instructions was written in a large, bold font (14-point), to accommodate the expected functional health literacy levels and eyesight (Lin, Neafsey, & Strickler, 2009;Wilson, Mood, & Nordstrom, 2010) In addition, questions were provided for all items and presented potential self-medication dilemmas. The answers were selected by choosing cards labeled as O or X.…”

Usability Testing of AsthmaWise With Older Adults

“…Usability testing is particularly important with older adults as the ageing process is known to complicate computer and internet use [23][24][25] . Possible issues include vision and hearing loss which may impact users' contrast sensitivity and result in problems reading small fonts and hearing sounds embedded on sites 20,26,27 . Further, older adults may also experience: cognitive decline (both short-term memory and speed of processing) which creates difficulty for users in recalling previously viewed information; and motor limitations due to physical decline may complicate mouse use 20,[24][25][26][27] .…”

“…Possible issues include vision and hearing loss which may impact users' contrast sensitivity and result in problems reading small fonts and hearing sounds embedded on sites 20,26,27 . Further, older adults may also experience: cognitive decline (both short-term memory and speed of processing) which creates difficulty for users in recalling previously viewed information; and motor limitations due to physical decline may complicate mouse use 20,[24][25][26][27] . Despite these known challenges, there is a paucity of usability testing research reported in this population, with health websites 28 .…”