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González-Montero G, Guijarro Mata-García M, Moreno Martínez C, Recas Piorno J. Rehab-AMD: co-design of an application for visual rehabilitation and monitoring of Age-related Macular Degeneration. BMC Med Inform Decis Mak 2024; 24:233. [PMID: 39180041 PMCID: PMC11342643 DOI: 10.1186/s12911-024-02625-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 07/30/2024] [Indexed: 08/26/2024] Open
Abstract
BACKGROUND The increasing demand for remote medical care, driven by digital healthcare advancements and the COVID-19 pandemic, necessitates effective solutions tailored to patients and healthcare practitioners. Co-design, involving collaboration between software developers, patients, and healthcare practitioners, prioritizes end-user needs. Research indicates that integrating patient perspectives enhances user experience and usability. However, its application in healthcare has been limited to small projects. This work focuses on co-designing a technological solution to enhance the monitoring and visual rehabilitation of individuals with Age-Related Macular Degeneration (AMD), a condition that significantly impacts the quality of life in people over 60. Current vision rehabilitation systems lack personalization, motivation, and effective progress monitoring. Involving patients and healthcare practitioners in the design process aims to ensure the final product meets their needs. METHODS The project employs iterative and collaborative principles, involving a vision rehabilitation expert and two AMD patients as active users in the application's development and validation. The process begins by establishing requirements for user accounts and rehabilitation exercises. It continues with an initial approach extended through user validation. Co-design is facilitated by specific workshops marking each project iteration, totaling four workshops, along with continuous communication sessions between experts and developers to validate design decisions. Initial requirements gathering and constant feedback from end-users, the visual rehabilitator, and patients are crucial for refining the product effectively. RESULTS The workshops produced a prototype featuring a test to monitor changes and progression and 15 visual rehabilitation exercises. Numerous patient and vision rehabilitation-driven software modifications led to a final design that is responsive and adaptive to end-user needs. CONCLUSIONS The Rehab-AMD pilot project aims to develop a collaborative and adaptive software solution for AMD rehabilitation by actively involving stakeholders and applying iterative design principles. Co-design in the Rehab-AMD solution proves to be a methodology that identifies usability issues and needs from the initial design stages. This approach ensures that software developers create a final product that is genuinely useful and manageable for people with AMD and the targeted vision rehabilitators.
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Affiliation(s)
- Guadalupe González-Montero
- Department Optometría y Visión, Complutense University of Madrid, C. de Arcos de Jalón, 118, Madrid, 28037, Spain
| | - María Guijarro Mata-García
- Department of Computer Architecture and Automation, Complutense University of Madrid, Calle del Prof. José García Santesmases, 9, Madrid, 28040, Spain.
| | - Carlos Moreno Martínez
- Department de Ciencia, Computación y Tecnología, Universidad Europea, C. Tajo, Villaviciosa de Odón, 28670, Madrid, Spain
| | - Joaquín Recas Piorno
- Department of Computer Architecture and Automation, Complutense University of Madrid, Calle del Prof. José García Santesmases, 9, Madrid, 28040, Spain
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Saak S, Kothe A, Buhl M, Kollmeier B. Comparison of user interfaces for measuring the matrix sentence test on a smartphone. Int J Audiol 2024:1-13. [PMID: 39126397 DOI: 10.1080/14992027.2024.2385551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 07/19/2024] [Accepted: 07/24/2024] [Indexed: 08/12/2024]
Abstract
OBJECTIVE Smartphone-based self-testing could facilitate large-scale data collection and remote diagnostics. For this purpose, the matrix sentence test (MST) is an ideal candidate due to its repeatability and accuracy. In clinical practice, the MST requires professional audiological equipment and supervision, which is infeasible for smartphone-based self-testing. Therefore, it is crucial to investigate the feasibility of self-administering the MST on smartphones, including the development of an appropriate user interface for the small screen size. DESIGN We compared the traditional closed matrix user interface (10 × 5 matrix) to three alternative, newly-developed interfaces (slide, type, wheel) regarding SRT consistency, user preference, and completion time. STUDY SAMPLE We included 15 younger normal hearing and 14 older hearing-impaired participants in our study. RESULTS The slide interface is most suitable for mobile implementation, providing consistent and fast SRTs and enabling all participants to perform the tasks effectively. While the traditional matrix interface works well for most participants, some participants experienced difficulties due to its small size on the screen. CONCLUSIONS We propose the newly-introduced slide interface as a plausible alternative for smartphone screens. This might be more attractive for elderly patients that may exhibit more challenges with dexterity and vision than our test subjects employed here.
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Affiliation(s)
- Samira Saak
- Department of Medical Physics and Acoustics, Carl von Ossietzky Universität Oldenburg, Oldenburg, Germany
- Cluster of Excellence Hearing4all, Carl von Ossietzky Universität Oldenburg, Oldenburg, Germany
| | - Angelika Kothe
- Department of Medical Physics and Acoustics, Carl von Ossietzky Universität Oldenburg, Oldenburg, Germany
- Cluster of Excellence Hearing4all, Carl von Ossietzky Universität Oldenburg, Oldenburg, Germany
| | - Mareike Buhl
- Cluster of Excellence Hearing4all, Carl von Ossietzky Universität Oldenburg, Oldenburg, Germany
- Institut Pasteur, Université Paris Cité, Inserm, Institut de l'Audition, Paris, France
| | - Birger Kollmeier
- Department of Medical Physics and Acoustics, Carl von Ossietzky Universität Oldenburg, Oldenburg, Germany
- Cluster of Excellence Hearing4all, Carl von Ossietzky Universität Oldenburg, Oldenburg, Germany
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Ma K, Gao M, Guida FE, He R. Understanding the influencing factors and mechanism of social compensation for Chinese older adults using social media in the context of smart home: a qualitative analysis. Front Public Health 2023; 11:1174920. [PMID: 37900045 PMCID: PMC10613092 DOI: 10.3389/fpubh.2023.1174920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 08/07/2023] [Indexed: 10/31/2023] Open
Abstract
As a new generation of necessary terminals for future homes, smart homes have become one of the essential mediums for smart aging at home. This paper aims to explore how older adults who age at home can overcome the digital divide of the new medium and achieve social participation in the home context to realize active aging. Based on the theory of social compensation, we select the smart-home smart screen, a representative new medium product in China, and carry out open coding, spindle coding, selective coding, and theoretical construction of the original interview data through the grounded theory research method. The results show that the main factors affecting the social compensation of older adults to smart home social media include user interface quality, interaction quality, content quality, and service quality, and these four factors are used as external variables to compensate older adults socially, thereby stimulating the emotional experience and perception changes at the cognitive level of older adults and then affecting the adoption and acceptance of smart home social media by older adults. This study refines the factors influencing the older adults' use of smart home social media from the perspective of social compensation. It explains the mechanism of acceptable behavior of older adults, bridging the gap in previous literature on the influencing factors and behavioral mechanisms of older adults of smart home social media. This paper provides a theoretical basis and guidance for the subsequent academic research and software development practice of social media under new technological devices to further help older adults in China achieve active and healthy aging.
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Affiliation(s)
- Ke Ma
- School of Design, Hunan University, Changsha, China
| | - Meng Gao
- School of Design, Hunan University, Changsha, China
| | | | - Renke He
- School of Design, Hunan University, Changsha, China
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Zhou C, Shi Z, Huang T, Zhao H, Kaner J. Impact of swiping direction on the interaction performance of elderly-oriented smart home interface: EEG and eye-tracking evidence. Front Psychol 2023; 14:1089769. [PMID: 36844328 PMCID: PMC9948611 DOI: 10.3389/fpsyg.2023.1089769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 01/23/2023] [Indexed: 02/11/2023] Open
Abstract
Introduction Smart home technology is increasingly popular, yet not all seniors are receptive and comfortable with it. This situation recognizes that the usability of smart home interfaces is particularly important. Most studies on interface swiping direction demonstrate the advantages of horizontal over vertical swiping, but the findings lack age-based as well as gender-specific judgments. Methods In this paper, we use cognitive neural techniques of EEG and eye-tracking, combined with a subjective preference questionnaire, to analyze the preference of older persons for the swiping direction of smart home interfaces in a multimodal manner. Results The EEG data showed that swiping direction had a significant effect on potential values (p = 0.001). Also, the mean power in the δ and the θ band was enhanced during vertical swiping. Gender had no significant effect on potential values (p = 0.085), but the cognitive task was more EEG stimulating for females. The eye-tracking metrics data showed a significant effect of swiping direction on fixation duration (p = 0.047) and a non-significant effect on pupil diameter (p = 0.576). These results were consistent with the results of the subjective preference questionnaire, both demonstrating a preference for vertical swiping among participants. Discussion This paper uses three research tools simultaneously, combining objective perceptions as well as subjective preferences, to make the findings more comprehensive and reliable. Gender differences were also taken into account and differentiated in the data processing. The findings of this paper are different from most previous studies and better reflect the preference of elderly people for swiping directions, which can provide a reference for the future elderly-friendly smart home interface design.
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Affiliation(s)
- Chengmin Zhou
- College of Furnishings and Industrial Design, Nanjing Forestry University, Nanjing, Jiangsu, China,Jiangsu Co-Innovation Center of Efficient Processing and Utilization of Forest Resources, Nanjing Forestry University, Nanjing, Jiangsu, China,*Correspondence: Chengmin Zhou ✉
| | - Ziyan Shi
- College of Furnishings and Industrial Design, Nanjing Forestry University, Nanjing, Jiangsu, China,Jiangsu Co-Innovation Center of Efficient Processing and Utilization of Forest Resources, Nanjing Forestry University, Nanjing, Jiangsu, China
| | - Ting Huang
- College of Furnishings and Industrial Design, Nanjing Forestry University, Nanjing, Jiangsu, China,Jiangsu Co-Innovation Center of Efficient Processing and Utilization of Forest Resources, Nanjing Forestry University, Nanjing, Jiangsu, China
| | - Hanxiao Zhao
- College of Furnishings and Industrial Design, Nanjing Forestry University, Nanjing, Jiangsu, China,Jiangsu Co-Innovation Center of Efficient Processing and Utilization of Forest Resources, Nanjing Forestry University, Nanjing, Jiangsu, China
| | - Jake Kaner
- School of Art and Design, Nottingham Trent University, Nottingham, United Kingdom
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Li W, Gui J, Luo X, Yang J, Zhang T, Tang Q. Determinants of intention with remote health management service among urban older adults: A Unified Theory of Acceptance and Use of Technology perspective. Front Public Health 2023; 11:1117518. [PMID: 36778558 PMCID: PMC9909471 DOI: 10.3389/fpubh.2023.1117518] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 01/09/2023] [Indexed: 01/27/2023] Open
Abstract
Background Although older adults health management systems have been shown to have a significant impact on health levels, there remains the problem of low use rate, frequency of use, and acceptance by the older adults. This study aims to explore the significant factors which serve as determinants of behavioral intention to use the technology, which in turn promotes actual use. Methods This study took a total of 402 urban older adults over 60 years to explore the impact of the use behavior toward remote health management (RHM) through an online questionnaire. Based on the Unified Theory of Acceptance and Use of Technology (UTAUT), the author adds four dimensions: perceived risk, perceived value, perceived interactivity and individual innovation, constructed an extended structural equation model of acceptance and use of technology, and analyzed the variable path relationship. Results In this study, the factor loading is between 0.61 and 0.98; the overall Cronbach's Alpha coefficients are >0.7; The composite reliability ranges from 0.59 to 0.91; the average variance extraction ranges from 0.51 to 0.85, which shows the good reliability, validity, and discriminant validity of the constructed model. The influencing factors of the behavioral intention of the older adults to accept the health management system are: effort expectation, social influences, perceived value, performance expectation, perceived interactivity and perceived risk. Effort expectation has a significant positive impact on performance expectation. Individual innovation positively impacts performance expectation and perceived interactivity. Perceived interactivity and behavioral intention have a significant positive effect on the use behavior of the older adults, while the facilitating conditions have little effect on the use behavior. Conclusions This paper constructs and verifies the extended model based on UTAUT, fully explores the potential factors affecting the use intention of the older adult users. According to the research findings, some suggestions are proposed from the aspects of effort expectation, performance expectation, perceived interaction and perceived value to improve the use intention and user experience of Internet-based health management services in older adults.
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Affiliation(s)
- Wenjia Li
- College of Communication and Art Design, University of Shanghai for Science and Technology, Shanghai, China
| | - Jingjing Gui
- College of Communication and Art Design, University of Shanghai for Science and Technology, Shanghai, China
| | - Xin Luo
- College of Communication and Art Design, University of Shanghai for Science and Technology, Shanghai, China
| | - Jidong Yang
- School of Creativity and Art, Shanghai Tech University, Shanghai, China
| | - Ting Zhang
- School of Design and Art, Shanghai Dianji University, Shanghai, China
| | - Qinghe Tang
- Shanghai East Hospital, Tongji University, Shanghai, China,*Correspondence: Qinghe Tang ✉
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Kushniruk A, Middelweerd A, van Empelen P, Preuhs K, Konijnendijk AAJ, Oude Nijeweme-d'Hollosy W, Schrijver LK, Laverman GD, Vollenbroek-Hutten MMR. A Digital Lifestyle Coach (E-Supporter 1.0) to Support People With Type 2 Diabetes: Participatory Development Study. JMIR Hum Factors 2023; 10:e40017. [PMID: 36633898 PMCID: PMC9947918 DOI: 10.2196/40017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 09/29/2022] [Accepted: 11/20/2022] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND A healthy lifestyle, including regular physical activity and a healthy diet, is becoming increasingly important in the treatment of chronic diseases. eHealth interventions that incorporate behavior change techniques (BCTs) and dynamic tailoring strategies could effectively support a healthy lifestyle. E-Supporter 1.0 is an eCoach designed to support physical activity and a healthy diet in people with type 2 diabetes (T2D). OBJECTIVE This paper aimed to describe the systematic development of E-Supporter 1.0. METHODS Our systematic design process consisted of 3 phases. The definition phase included the selection of the target group and formulation of intervention objectives, and the identification of behavioral determinants based on which BCTs were selected to apply in the intervention. In the development phase, intervention content was developed by specifying tailoring variables, intervention options, and decision rules. In the last phase, E-Supporter 1.0 integrated in the Diameter app was evaluated using a usability test in 9 people with T2D to assess intervention usage and acceptability. RESULTS The main intervention objectives were to stimulate light to moderate-vigorous physical activities or adherence to the Dutch dietary guidelines in people with T2D. The selection of behavioral determinants was informed by the health action process approach and theories explaining behavior maintenance. BCTs were included to address relevant behavioral determinants (eg, action control, self-efficacy, and coping planning). Development of the intervention resulted in 3 types of intervention options, consisting of motivational messages, behavioral feedback, and tailor-made supportive exercises. On the basis of IF-THEN rules, intervention options could be tailored to, among others, type of behavioral goal and (barriers to) goal achievement. Data on these variables could be collected using app data, activity tracker data, and daily ecological momentary assessments. Usability testing revealed that user experiences were predominantly positive, despite some problems in the fixed delivery of content. CONCLUSIONS The systematic development approach resulted in a theory-based and dynamically tailored eCoach. Future work should focus on expanding intervention content to other chronic diseases and lifestyle behaviors, enhancing the degree of tailoring and evaluating intervention effects on acceptability, use, and cost-effectiveness.
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Affiliation(s)
| | - Anouk Middelweerd
- Department of Biomedical Signals and Systems, University of Twente, Enschede, Netherlands
| | - Pepijn van Empelen
- Department of Child Health, TNO (Netherlands Organization for Applied Scientific Research), Leiden, Netherlands
| | - Katharina Preuhs
- Department of Child Health, TNO (Netherlands Organization for Applied Scientific Research), Leiden, Netherlands
| | | | | | - Laura K Schrijver
- Department of Biomedical Signals and Systems, University of Twente, Enschede, Netherlands
| | - Gozewijn D Laverman
- Department of Biomedical Signals and Systems, University of Twente, Enschede, Netherlands.,Department of Internal Medicine/Nephrology, Ziekenhuisgroep Twente, Almelo, Netherlands
| | - Miriam M R Vollenbroek-Hutten
- Department of Biomedical Signals and Systems, University of Twente, Enschede, Netherlands.,Board of Directors, Medisch Spectrum Twente, Enschede, Netherlands
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Chhabra M, Sharan B, Kumar M. A fuzzy cognitive map of the quality of user experience determinants in mobile application design. JOURNAL OF INTELLIGENT & FUZZY SYSTEMS 2022. [DOI: 10.3233/jifs-222111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The users of mobile phone are exponentially increasing. The applications are developed every day in a variety of domains to enhance the Quality of User Experience (QoUE) along with utility determinants. The design of the mobile application impacts the QoUE. QoUE in mobile applications is a measure that describes the appropriateness of the purpose of the application and the need for user retention. However, the challenge is to identify, understand, focus and interconnect the variety of determinants influencing the QoUE based on mobile application design. These determinants are based on the diversity of users and the related functional needs, user-specific needs, and background functioning of the application. The modelling and analysis help mobile application developers to improve, increase and retain user engagement on the app based on improved QoUE. To do so, a qualitative analytical method is employed in the following steps. The first ever Fuzzy Cognitive Map (FCM) is proposed to show the causal-effect links of the interdependent determinants in mobile applications based on QoUE. In our model, the existence of relationships between determinants relies on a thorough literature review. The weight of these links is estimated by users of different ages and lines of work. This is performed by an empirical study based on a questionnaire filled by experts. The questionnaire is based on the formal utility and perceived QoUE-based topics. Finally, scenario-based analysis on formed FCM based on these inputs is performed. We show that small changes in cases using different direct determinants can be used to enhance QoUE. These changes can be studied before launching an application for the user, thereby limiting the need to rework the improvements based on QoUE and providing useful guidance for the possible increase in user base and behaviour change.
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Affiliation(s)
- Megha Chhabra
- Department of Computer Science & Engineering, School of Engineering, Technology Sharda University, Gr. Noida, UP, India
| | - Bhagwati Sharan
- Department of Computer Science and Engineering, APEX institute of Technology, Chandigarh University, Mohali, India
| | - Manoj Kumar
- Faculty of Engineering and Information Sciences, University of Wollongong in Dubai, Dubai Knowledge Park, Dubai, UAE
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Kongjit C, Nimmolrat A, Khamaksorn A. Mobile health application for Thai women: investigation and model. BMC Med Inform Decis Mak 2022; 22:202. [PMID: 35907950 PMCID: PMC9338500 DOI: 10.1186/s12911-022-01944-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 07/19/2022] [Indexed: 11/23/2022] Open
Abstract
Background Women’s mobile health (m-health) applications are currently widely used for health education, medication, prevention of illness, etcetera. However, women are extremely sensitive to their design. While the number of m-health applications for women is increasing, many are of poor quality and have development issues. Objective This paper aims to develop and evaluate an m-health application for Thai women based on a user-centred design (UCD). Current women’s m-health applications were investigated to identify any lack of development in usability, functionality and graphical user interface. The results were evaluated and used to create criteria for the trial of a prototype application. Methods UCD methodology was used to design a graphical user interface, analyse the application’s functionality, and enhance its usability. Data from thirty female end-users were collected and maintained locally, and thirteen information technology (IT) experts provided feedback on the prototype trial. Interviews and questionnaires were used to gather user data and identify problems. Results The average scores of the evaluation by the end-users (n = 30) and IT experts (n = 13) were compared using a t-test statistical analysis. For the first version, the end-users gave higher usability scores (average = 4.440), with no statistical significance and a P value of 0.05. In comparison, lower scores for functionality were given by the IT experts (average = 4.034), with no statistical significance and a P value of 0.05. For the second version, the average scores from the end-users were higher than those from the IT experts. The highest score was related to usability (average = 4.494), with no statistical significance and a P value of 0.05. The lowest score was for the user interface from the group of IT experts (average = 4.084), with no statistical significance and a P value of 0.05. Conclusion A UCD was utilised to construct a process taxonomy to understand, analyse, design and develop an application suitable for Thai women. It was found from an evaluation of the currently-available women’s m-health applications that usability is their main weakness; therefore, this aspect needed to be prioritised in the new design. According to the results, IT experts’ perspective of the development of an m-health application was different from that of end-users. Hence, it was evident that both end-users and IT experts needed to be involved in helping developers to analyse, prioritise and establish a strategy for developing an m-health application, particularly one for women’s health. This would give researchers an in-depth understanding of the end-users’ expectations.
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Affiliation(s)
- Chalermpon Kongjit
- College of Arts, Media and Technology, Chiang Mai University, Chiang Mai, 50200, Thailand.
| | - Acrapol Nimmolrat
- College of Arts, Media and Technology, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Achara Khamaksorn
- Research Group of Embedded Systems and Mobile Application in Health Science, College of Arts, Media and Technology, Chiang Mai University, Chiang Mai, 50200, Thailand
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Zhou C, Yuan F, Huang T, Zhang Y, Kaner J. The Impact of Interface Design Element Features on Task Performance in Older Adults: Evidence from Eye-Tracking and EEG Signals. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159251. [PMID: 35954608 PMCID: PMC9367723 DOI: 10.3390/ijerph19159251] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 07/21/2022] [Accepted: 07/26/2022] [Indexed: 12/04/2022]
Abstract
It is crucial that the interface design of mobile apps be age-appropriate at this stage of global aging, as the new epidemic has resulted in a higher sense of isolation among older persons. In this study, four typical senior social service mobile applications were chosen to give older persons the ability to complete user login duties. The participants were 16 older adults (7 men and 9 women) aged 55 to 76. Both objective and subjective data, including task completion time, gaze length, pupil diameter changes, EEG wave amplitude changes, and subjective sensations of older persons, were gathered using a combination of eye-movement and EEG signal approaches. The program was created to investigate the effects of interface design aspects on older people’s task performance, including interface layout, interface color, information density, icon size and position, etc. The study’s findings revealed that when the user task completion time and average fixation duration were shorter, the line of sight was more equally distributed, the visual focus was closer to the login button, and the average EEG amplitude of the user changed more, the older adults performed better. The palace layout had a more positive effect on job completion among older individuals when it came to interface layout. In terms of interface color, colored (contrasting) colors should serve to highlight the interface’s essential information points while they can be removed. In terms of interface information density, a low-density level interface design can simplify and lower the cognitive load of task execution for older people. The first level of icons in the interface and their position in the visual center of the interface is the best interface design for older persons in terms of icon size and position. The results of this study have theoretical ramifications for a thorough understanding of the factors influencing older people’s task performance, practical ramifications for the design of older people-centered interfaces, and they contribute to our understanding of the characteristics of older people’s interface interaction behavior.
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Affiliation(s)
- Chengmin Zhou
- College of Furnishings and Industrial Design, Nanjing Forestry University, Nanjing 210037, China; (F.Y.); (T.H.); (Y.Z.)
- Jiangsu Co-Innovation Center of Efficient Processing and Utilization of Forest Resources, Nanjing 210037, China
- Correspondence: ; Tel.:+86-138-5156-2125
| | - Fangfang Yuan
- College of Furnishings and Industrial Design, Nanjing Forestry University, Nanjing 210037, China; (F.Y.); (T.H.); (Y.Z.)
- Jiangsu Co-Innovation Center of Efficient Processing and Utilization of Forest Resources, Nanjing 210037, China
| | - Ting Huang
- College of Furnishings and Industrial Design, Nanjing Forestry University, Nanjing 210037, China; (F.Y.); (T.H.); (Y.Z.)
- Jiangsu Co-Innovation Center of Efficient Processing and Utilization of Forest Resources, Nanjing 210037, China
| | - Yurong Zhang
- College of Furnishings and Industrial Design, Nanjing Forestry University, Nanjing 210037, China; (F.Y.); (T.H.); (Y.Z.)
- Jiangsu Co-Innovation Center of Efficient Processing and Utilization of Forest Resources, Nanjing 210037, China
| | - Jake Kaner
- Nottingham School of Art and Design, Nottingham Trent University, Nottingham NG1 4FQ, UK;
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Ahmad NA, Mat Ludin AF, Shahar S, Mohd Noah SA, Mohd Tohit N. Willingness, perceived barriers and motivators in adopting mobile applications for health-related interventions among older adults: a scoping review. BMJ Open 2022; 12:e054561. [PMID: 35264349 PMCID: PMC8915330 DOI: 10.1136/bmjopen-2021-054561] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES This scoping review aims to identify the level of willingness, the existing barriers, and motivators among older adults in using mobile applications to monitor and manage their health conditions. The secondary aim of this paper is to categorise these willingness, barriers and motivators using the Theoretical Domains Framework (TDF). DESIGN Scoping review. DATA SOURCE PubMed, Embase, CINAHL, Cochrane Library, Google Scholar and Science Direct (January 2009-December 2020). STUDY SELECTION Studies that describe older adults' perspectives with regard to their willingness, barriers or motivators towards the use of mobile applications in monitoring and managing their health condition were included. DATA EXTRACTION Titles and abstracts were initially screened by two reviewers. Articles agreed by both reviewers were proceeded to full-text screening. One reviewer extracted the data, which were verified by a second reviewer. Findings were further classified according to the 14 TDF domains by two researchers. RESULTS Six studies were included in the final scoping review. Barriers to adopting mobile applications for health-related interventions among older adults were the most common topic identified in the included studies. Barriers included being unaware of the existence of mobile health applications, lack of technological skills, lack of perceived ability and time, absence of professional involvements, and violation of trust and privacy. With regard to willingness, older adults are willing to use mobile applications if the apps incorporated features from a trusted source and have valid credentials. Motivators included continuous improvements of mobile applications' design interface and personalised features tailored to older adults' needs. CONCLUSIONS With the constant research for more diversified technology, the development of mobile applications to help older adults to manage and monitor health is seen as feasible, but barriers have to be addressed. The most prominent barriers linked to TDF domains were: (1) technological skills, (2) belief about consequences, and (3) memory, attention and decision process. Future interventions should use behaviour change techniques that target these three TDF domains in order to improve the ability to engage older adults with mobile technology.
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Affiliation(s)
- Nurul Asilah Ahmad
- Center for Healthy Ageing and Wellness, National University of Malaysia, Faculty of Health Sciences, Kuala Lumpur, Wilayah Persekutuan, Malaysia
| | - Arimi Fitri Mat Ludin
- Center for Healthy Ageing and Wellness, National University of Malaysia, Faculty of Health Sciences, Kuala Lumpur, Wilayah Persekutuan, Malaysia
- Biomedical Science Programme, Universiti Kebangsaan Malaysia Faculty of Health Sciences, Kuala Lumpur, Malaysia
| | - Suzana Shahar
- Center for Healthy Ageing and Wellness, National University of Malaysia, Faculty of Health Sciences, Kuala Lumpur, Wilayah Persekutuan, Malaysia
| | - Shahrul Azman Mohd Noah
- Faculty of Information, Science and Technology, Universiti Kebangsaan Malaysia, Bangi, Selangor, Malaysia
| | - Noorlaili Mohd Tohit
- Department of Family Medicine, Universiti Kebangsaan Malaysia, Bangi, Selangor, Malaysia
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Androutsou T, Kouris I, Anastasiou A, Pavlopoulos S, Mostajeran F, Bamiou DE, Genna GJ, Costafreda SG, Koutsouris D. A Smartphone Application Designed to Engage the Elderly in Home-Based Rehabilitation. Front Digit Health 2021; 2:15. [PMID: 34713028 PMCID: PMC8521815 DOI: 10.3389/fdgth.2020.00015] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 08/03/2020] [Indexed: 12/30/2022] Open
Abstract
As life expectancy increases, it is imperative that the elderly take advantage of the benefits of technology to remain active and independent. Mobile health applications are widely used nowadays as they promote a healthy lifestyle and self-management of diseases, opening new horizons in the interactive health service delivery. However, adapting these applications to the needs and requirements of the elderly is still a challenge. This article presents a smartphone application that is part of a multifactorial intervention to support older people with balance disorders. The application aims to enable users to self-evaluate their activity and progress, to communicate with each other and, through strategically selected motivational features, to engage with the system with undiminished interest for a long period of time. Mock-up interfaces were evaluated in semi-structured focus groups and interviews that were performed across three European countries. Further evaluation in the form of four pilot studies with 160 participants will be performed and qualitative and quantitative measures will be used to process the feedback about the use of the application.
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Affiliation(s)
- Thelma Androutsou
- Biomedical Engineering Laboratory, National Technical University of Athens, School of Electrical and Computer Engineering, Athens, Greece
| | - Ioannis Kouris
- Biomedical Engineering Laboratory, National Technical University of Athens, School of Electrical and Computer Engineering, Athens, Greece
| | - Athanasios Anastasiou
- Biomedical Engineering Laboratory, National Technical University of Athens, School of Electrical and Computer Engineering, Athens, Greece
| | - Sotiris Pavlopoulos
- Biomedical Engineering Laboratory, National Technical University of Athens, School of Electrical and Computer Engineering, Athens, Greece
| | - Fariba Mostajeran
- Department of Informatics, Human-Computer Interaction, University of Hamburg, Hamburg, Germany
| | - Doris-Eva Bamiou
- University College London, UCL Ear Institute and UCLH Biomedical Research Centre, National Institute for Health Research, London, United Kingdom
| | - Gregory J Genna
- University College London, UCL Ear Institute and UCLH Biomedical Research Centre, National Institute for Health Research, London, United Kingdom
| | - Sergi G Costafreda
- Division of Psychiatry, University College London, London, United Kingdom
| | - Dimitrios Koutsouris
- Biomedical Engineering Laboratory, National Technical University of Athens, School of Electrical and Computer Engineering, Athens, Greece
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Luengo-Polo J, Conde-Caballero D, Rivero-Jiménez B, Ballesteros-Yáñez I, Castillo-Sarmiento CA, Mariano-Juárez L. Rationale and Methods of Evaluation for ACHO, A New Virtual Assistant to Improve Therapeutic Adherence in Rural Elderly Populations: A User-Driven Living Lab. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18157904. [PMID: 34360194 PMCID: PMC8345470 DOI: 10.3390/ijerph18157904] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 07/19/2021] [Accepted: 07/22/2021] [Indexed: 11/23/2022]
Abstract
Low therapeutic adherence is a concern for health professionals as it decreases therapeutic efficiency while increasing costs, especially in elderly populations. To increase therapeutic adherence in elderly populations, the technology applied in the medical devices that are used must be adapted to improve usability. This paper outlines the rationale behind, and methods applied to assess the usability of, ACHO (Assistant on Care and Health Offline), a voice assistant that provides elderly patients with reminders of medical appointments to attend and when they need to take their medication. This work is a descriptive, cross-sectional, observational study, and will include a three-phase (analysis, testing and refinement) multidimensional usability analysis of an initial prototype, in the setting of a user-driven Living Lab, which enables the needs and characteristics of the end users to be identified and incorporated into the prototype with each iteration, in which a multidisciplinary team of researchers and users will participate as co-creators. This methodology will allow us to develop a better prototype, increasing usability and, thus, increasing therapeutic adherence.
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Affiliation(s)
- Jeronimo Luengo-Polo
- Department of Nursing, Faculty of Nursing & Occupational Therapy, University of Extremadura, 10003 Cáceres, Spain; (J.L.-P.); (D.C.-C.); (L.M.-J.)
| | - David Conde-Caballero
- Department of Nursing, Faculty of Nursing & Occupational Therapy, University of Extremadura, 10003 Cáceres, Spain; (J.L.-P.); (D.C.-C.); (L.M.-J.)
| | - Borja Rivero-Jiménez
- Department of Computer Systems and Telematics, Polytechnic School, University of Extremadura, 10003 Cáceres, Spain;
| | - Inmaculada Ballesteros-Yáñez
- Department of Inorganic, Organic Chemistry and Biochemistry, School of Medicine, University of Castilla-La Mancha, 13071 Ciudad Real, Spain;
- Regional Center for Biomedical Research, University of Castilla-La Mancha, 02008 Albacete, Spain
| | - Carlos A. Castillo-Sarmiento
- Regional Center for Biomedical Research, University of Castilla-La Mancha, 02008 Albacete, Spain
- Department of Nursing, Physiotherapy and Occupational Therapy, School of Physiotherapy and Nursing, University of Castilla-La Mancha, 45071 Toledo, Spain
- Correspondence: ; Tel.: +34-926-295-300 (ext. 5670)
| | - Lorenzo Mariano-Juárez
- Department of Nursing, Faculty of Nursing & Occupational Therapy, University of Extremadura, 10003 Cáceres, Spain; (J.L.-P.); (D.C.-C.); (L.M.-J.)
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Alsana S, Trapsilawati F, Wijayanto T. Enabling health application accessibility through interface modalities for elderly. BIO WEB OF CONFERENCES 2020. [DOI: 10.1051/bioconf/20202802003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Along with the development of technology, the launching of new devices often leaves the usability problems for the elderly behind. It happens not only for devices but also its application, i.e., entertainment applications, health applications, learning applications, etc. Most of the time, the elderly find it hard to use due to its usability problems or unfamiliar feelings. This research focused on empirically investigating a health application interface so that elderly could use it easily without obstacles and help the treatment independently. Three interface modalities were tested, namely, textual, pictorial, and typing interfaces. The result showed that the option-based interfaces (i.e., textual and pictorial) led to shorter performance time than input-based interface (i.e., typing) among the three interfaces. Also, the pictorial interface has the highest SUS score. All respondents chose the pictorial interface as their first choice, enabling health application accessibility through the appropriate interface modality for the elderly.
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Wang JW. Retrieving critical design factor of ebook for older people in Taiwan. TELEMATICS AND INFORMATICS 2018. [DOI: 10.1016/j.tele.2018.07.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Aging barriers influencing mobile health usability for older adults: A literature based framework (MOLD-US). Int J Med Inform 2018; 114:66-75. [PMID: 29673606 DOI: 10.1016/j.ijmedinf.2018.03.012] [Citation(s) in RCA: 198] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2017] [Revised: 12/13/2017] [Accepted: 03/23/2018] [Indexed: 12/20/2022]
Abstract
BACKGROUND With the growing population of older adults as a potential user group of mHealth, the need increases for mHealth interventions to address specific aging characteristics of older adults. The existence of aging barriers to computer use is widely acknowledged. Yet, usability studies show that mHealth still fails to be appropriately designed for older adults and their expectations. To enhance designs of mHealth aimed at older adult populations, it is essential to gain insight into aging barriers that impact the usability of mHealth as experienced by these adults. OBJECTIVES This study aims to synthesize literature on aging barriers to digital (health) computer use, and explain, map and visualize these barriers in relation to the usability of mHealth by means of a framework. METHODS We performed a scoping review to synthesize and summarize reported physical and functional age barriers in relation to digital (mobile) health applications use. Aging barriers reported in the literature were mapped onto usability aspects categorized by Nielsen to explain their influence on user experience of mHealth. A framework (MOLD-US) was developed summarizing the evidence on the influence of aging barriers on mHealth use experienced by older adults. RESULTS Four key categories of aging barriers influencing usability of mHealth were identified: cognition, motivation, physical ability and perception. Effective and satisfactory use of mHealth by older adults is complicated by cognition and motivation barriers. Physical ability and perceptual barriers further increase the risk of user errors and fail to notice important interaction tasks. Complexities of medical conditions, such as diminished eye sight related to diabetes or deteriorated motor skills as a result of rheumatism, can cause errors in user interaction. CONCLUSIONS This research provides a novel framework for the exploration of aging barriers and their causes influencing mHealth usability in older adults. This framework allows for further systematic empirical testing and analysis of mHealth usability issues, as it enables results to be classified and interpreted based on impediments intrinsic to usability issues experienced by older adults. Importantly, the paper identifies a key need for future research on motivational barriers impeding mhealth use of older adults. More insights are needed in particular to disaggregating normal age related functional changes from specific medical conditions that influence experienced usefulness of mHealth by these adults.
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