Usability and feasibility of consumer-facing technology to reduce unsafe medication use by older adults

Background Mobile health technology can improve medication safety for older adults, for instance, by educating patients about the risks associated with anticholinergic medication use. Objective This study's objective was to test the usability and feasibility of Brain Buddy, a consumer-facing mobile health technology designed to inform and empower older adults to consider the risks and benefits of anticholinergics. Methods Twenty-three primary care patients aged ≥60 years and using anticholinergic medications participated in summative, task-based usability testing of Brain Buddy. Self-report usability was assessed by the System Usability Scale and performance-based usability data were collected for each task through observation. A subset of 17 participants contributed data on feasibility, assessed by self-reported attitudes (feeling informed) and behaviors (speaking to a physician), with confirmation following a physician visit. Results Overall usability was acceptable or better, with 100% of participants completing each Brain Buddy task and a mean System Usability Scale score of 78.8, corresponding to “Good” to “Excellent” usability. Observed usability issues included higher rates of errors, hesitations, and need for assistance on three tasks, particularly those requiring data entry. Among participants contributing to feasibility data, 100% felt better informed after using Brain Buddy and 94% planned to speak to their physician about their anticholinergic related risk. On follow-up, 82% reported having spoken to their physician, a rate independently confirmed by physicians. Conclusion Consumer-facing technology can be a low-cost, scalable intervention to improve older adults’ medication safety, by informing and empowering patients. User-centered design and evaluation with demographically heterogeneous clinical samples uncovers correctable usability issues and confirms the value of interventions targeting consumers as agents in shared decision making and behavior change

Challenges in Developing Applications for Aging Populations

Elderly individuals can greatly benefit from the use of computer applications, which can assist in monitoring health conditions, staying in contact with friends and family, and even learning new things. However, developing accessible applications for an elderly user can be a daunting task for developers. Since the advent of the personal computer, the benefits and challenges of developing applications for older adults have been a hot topic of discussion. In this chapter, the authors discuss the various challenges developers who wish to create applications for the elderly computer user face, including age-related impairments, generational differences in computer use, and the hardware constraints mobile devices pose for application developers. Although these challenges are concerning, each can be overcome after being properly identified

EVALUATING USER ENGAGEMENT AND READING BEHAVIOR ASPECTS OF WEB VISITORS BY ANALYZING INDICATORS ON GOOGLE ANALYTICS DATA

Nowadays, web-based technology is used as a source of information and marketing, one of which is educational institutions. This development unintentionally changes people's reading patterns, from paper to online media. However, user engagement and reading behavior on a web-based system is often overlooked while developing the plan. Understanding these two pillars can help the improvement process become more effective. Politeknik Caltex Riau has an official website that provides information about campus life and an introduction to study programs for prospective students. The information provided is quite complete and precise, yet there are many repeated questions. One example is the web visitors who are interested and asks about the registration steps, but the info is clearly on the website. Therefore, it is necessary to evaluate the understanding of the demographics, engagement, behavior, and events by implementing Google Analytics on the website. From the results, it is known that the visitors are on target. The majority of readers are high schoolers who are actively looking for university information. Many of them use smartphones to surf the website, though it is recognized that most readers do not read the content thoroughly. It can be seen from the total scroll event, which is only high at the beginning and keep decreasing while scrolling down the page. But the bounce and sessions number ​​keep rising. This phenomenon shows that the reader's engagement with the content is shallow, and reading comprehension is vague. In addition, there is also an indication of the effect of smaller screen size with the web design model as one of the reasons for the high jump rate. Thus, further studies can focus on deepening and evaluating web design and evaluating more indicators provided on Google Analytics

Redesigning pictographs for patients with low health literacy and establishing preliminary steps for delivery via smart phones.

BackgroundPictographs (or pictograms) have been widely utilized to convey medication related messages and to address nonadherence among patients with low health literacy. Yet, patients do not always interpret the intended messages on commonly used pictographs correctly and there are questions how they may be delivered on mobile devices.ObjectiveOur objectives are to refine a set of pictographs to use as medication reminders and to establish preliminary steps for delivery via smart phones.MethodsCard sorting was used to identify existing pictographs that focus group members found "not easy" to understand. Participants then explored improvements to these pictographs while iterations were sketched in real-time by a graphic artist. Feedback was also solicited on how selected pictographs might be delivered via smart phones in a sequential reminder message. The study was conducted at a community learning center that provides literacy services to underserved populations in Seattle, WA. Participants aged 18 years and older who met the criteria for low health literacy using S-TOFHLA were recruited.ResultsAmong the 45 participants screened for health literacy, 29 were eligible and consented to participate. Across four focus group sessions, participants examined 91 commonly used pictographs, 20 of these were ultimately refined to improve comprehensibility using participatory design approaches. All participants in the fifth focus group owned and used cell phones and provided feedback on preferred sequencing of pictographs to represent medication messages.ConclusionLow literacy adults found a substantial number of common medication label pictographs difficult to understand. Participative design processes helped generate new pictographs, as well as feedback on the sequencing of messages on cell phones, that may be evaluated in future research

Reading on small displays: reading performance and perceived ease of reading

The present thesis explores and discusses reading continuous text on small screens, namely on mobile devices, and aims at identifying a model capturing those factors that most influence the perceived experience of reading. The thesis also provides input for the user interface and content creation industries, offering them some direction as to what to focus on when producing interfaces intended for reading or text-based content that is likely to be read on a small display. The thesis starts with an overview of the special characteristics of reading on small screens and identifies, through existing literature, issues that may affect fluency and ease of reading on mobile devices. The thesis then presents six experiments and studies on reading performance and perceived experience when reading on small screens. The mixed-methods research presented in the thesis showed that reading performance and subjective perception of reading fluency and ease do not always correspond, and perceived experience can have a strong influence over an end-user’s choice of whether to access text based content on a small display device or not. The research shows that it is important to measure interface quality not only in terms of functionality, but also for the user experience offered – and, ideally, to measure experience through more than one variable. The thesis offers a factor model (mobile reading acceptance model) of those factors that collectively influence subjective experience when reading via small screens. The key factors in the model are visibility of text, overview of contents, navigation within the contents and interaction with the interface/device. Further contributions include methods for cost-efficient user experience testing: a modified critical incident technique and using an optical character recognition to gauge legibility user experience at early design iterations

Comprehension of Ads-supported and Paid Android Applications: Are They Different?

The Android market is a place where developers offer paid and-or free apps to users. Free apps are interesting to users because they can try them immediately without incurring a monetary cost. However, free apps often have limited features and-or contain ads when compared to their paid counterparts. Thus, users may eventually need to pay to get additional features and-or remove ads. While paid apps have clear market values, their ads-supported versions are not entirely free because ads have an impact on performance. In this paper, first, we perform an exploratory study about ads-supported and paid apps to understand their differences in terms of implementation and development process. We analyze 40 Android apps and we observe that (i) ads-supported apps are preferred by users although paid apps have a better rating, (ii) developers do not usually offer a paid app without a corresponding free version, (iii) ads-supported apps usually have more releases and are released more often than their corresponding paid versions, (iv) there is no a clear strategy about the way developers set prices of paid apps, (v) paid apps do not usually include more functionalities than their corresponding ads-supported versions, (vi) developers do not always remove ad networks in paid versions of their ads-supported apps, and (vii) paid apps require less permissions than ads-supported apps. Second, we carry out an experimental study to compare the performance of ads-supported and paid apps and we propose four equations to estimate the cost of ads-supported apps. We obtain that (i) ads-supported apps use more resources than their corresponding paid versions with statistically significant differences and (ii) paid apps could be considered a most cost-effective choice for users because their cost can be amortized in a short period of time, depending on their usage.Comment: Accepted for publication in the proceedings of the IEEE International Conference on Program Comprehension 201