User-Centered Evaluations with Older Adults: Testing the Usability of a Mobile Health System for Heart Failure Self-Management

Abstract

Many older adults living with heart failure struggle to follow recommended self-management routines. To help older adults with heart failure more effectively and efficiently self-manage their disease, we developed Engage, a mobile health application promoting the performance, logging, and sharing of routine self-management behaviors. This paper reports on the usability evaluation of the Engage system with 15 older adults with heart failure and informal caregivers. In two phases, participants used Engage during a task-based usability test (n=5) and a scenario-based usability test (n=10). Usability and performance data were assessed through video-recorded observation and the administration of the system usability scale (SUS) and NASA Task Load Index (TLX). We found that task-based testing was useful in quickly identifying problems within our application, but scenario-based testing elicited more valuable feedback from older adults. A comparison of the different evaluation methods used and the discussion of the challenges encountered provide multiple implications for the practice of usability testing of mobile health products with older adults.

Development and usability testing of an electronic patient-reported outcome measure (ePROM) system for patients with advanced chronic kidney disease

“…[21][22][23] Patients with CKD tend to be older adults [24,25] who may have age-related physical and cognitive limitations. [26,27] They may also experience a number of debilitating CKD-related symptoms such as fatigue and cognitive impairment which could significantly affect their ability to use an ePROM system. [28,29] These age and health-related issues need to be taken into account when designing and testing an ePROM system for this patient group.…”

“…5 usability issues may be detected and addressed prior to full-scale implementation [31] in other to reduce attrition rates. [26,32,33]…”

“…number of pages to click through to a minimum, as ability to precisely position the computer cursor has been shown to diminish with age. [26,39,40] Older individuals may also have issues with visual acuity, contrast sensitivity and colour discrimination.…”

“…The omissions by the participants may be due to eyesight issues (the participants wore glasses) or cognitive impairment which may be age-related [26,27,41] or associated with advanced CKD. [28,29] The font size (12pt) might have been a contributing factor [39,41,58] as it was suggested by two of the participants that we increase the font sizes.…”

“…[76] Cornet et al suggested that qualitative methods might actual provide better results in older adults. [26] The SUS and other usability scales will be considered for use in a…”