Involving users in the evaluation of apps for specific health conditions

With rapid growth of Internet accessibility over recent years, the way in which we engage with healthcare services and make decisions about our own healthcare has changed. One form of engagement with the Internet is through the use of mobile applications (apps) via mobile devices such as smartphones and tablets. As a result of this, many apps have been developed to target people with varying long term conditions. These apps may aim to help educate individuals about their condition or help them to manage it. Assessing the quality of these apps is crucial especially when considering the risks associated with providing misleading information or unsubstantiated claims. This has led to a growing body of research assessing the quality of apps aimed at people living with varying long term conditions. These attempts have not involved service users to address the suitability of apps for their intended target audiences. This paper presents two examples of how service users and associated healthcare professionals can be involved in the suitability assessment of mobile apps for children and young people with Attention Deficit Hyperactivity Disorder and those living with dementia

Comparing recent reviews about touchscreens for dementia with lessons from the field

Conclusions were synthesised from recent reviews on (touchscreen)technologies and people with dementia and lessons learnt using these devices in projects in the UK, the Netherlands and Canada. The combined findings provide a strong basis for defining new strategies for exploiting touchscreen technology for people with dementia

People with dementia playing casual games on a tablet

Objective: Preserving clients’ quality of life (QoL) has become increasingly important in dementia care. Engagement in pleasant and meaningful activities may influence this QoL. We studied people with dementia’s experiences and views of independent tablet games in a practice-based study, conducted at two day-care centres and five small-scale living facilities for people with dementia in the city of Rotterdam. Method: The participants were 54 clients (24 men, 30 women; mean age 83 years) who participated in a total of 177 game-playing sessions. Ten existing iPad games and three new game prototypes were evaluated. Written informed consent was obtained from the clients or the clients’ representatives prior to the study. Data collection included epidemiological and game playing characteristics. Observers took note of the specific game(s) offered, the clients’ mood and engagement, and the duration of game playing. Immediately after each participant finished playing,a short 4-question interview was conducted to discover their opinion on the game. The participants’ answers were recorded verbatim. Qualitative content analysis was used to explore their experiences and views of the games. Results: This study revealed positive experiences related to people’s need for achievement, self-esteem, sense of connection and belonging, identity, having something to do, and admiration for the game. Negative experiences included failure (low self-esteem), annoyance and a sense of insecurity. Conclusions: This study shows there is potential for people with dementia to play casual games on a tablet as a pleasant and meaningful activity. It is important, however that there is a match between the game, the touchscreen skills of the person with dementia, and their ambitions or interests. It is challenging to find the right game for the right person. An interactive tool to support the choice of the game that is most suitable and a database of dementia-friendly tablet games may support the use of these games by people with dementia, in health care organisations as well as at home

Continuous in-home walking speed monitoring in older people with a low-cost ambient sensor: Results of a feasibility study

BACKGROUND: Walking speed predicts important clinical outcomes in older adults and is one of the most significant indicators of frailty. OBJECTIVE: To test whether it is feasible to measure walking speed frequently and unobtrusively in the home. METHODS: A longitudinal feasibility study was conducted comprising the installation and monitoring of continuous measurement walking speed sensors in twenty frail older adults’ homes for a period of twelve weeks (eighteen participants completed the study). Manual walking speed, frailty level and health status were measured at four-weekly intervals. Qualitative interviews were conducted at the end of the study to assess participants’ attitudes to the sensors and to the concept of continuous in-home walking speed measurement. RESULTS: There was a high degree of variance to the number of walking speed measurements recorded by each participant’s sensor (median 1942.39, range 2-3617). Participants indicated acceptability of both the sensor within the home and the concept of in-home walking speed measurement. CONCLUSIONS: Where regular measurement was achieved, the results indicate that walking speed might be better viewed as a distribution rather than a single figure, taking into account the natural variation to walking speed in daily life. This study demonstrates the feasibility of continuous ambient in-home walking speed monitoring of older adults with a low-cost, easily deployed device

Read and accepted? Scoping the cognitive accessibility of privacy policies of health apps and websites in three European countries

Objective Trust and accessibility are vital to adoption of health and wellness apps. This research scoped three elements of cognitive accessibility of health app privacy policies: availability, ease of navigation, and readability. Methods For this cross-sectional study, quantitative data collected in the Netherlands, Sweden, and the United Kingdom included: whether privacy information was in a country's official language (availability); number of distracting visual elements (ease of navigation); word count and Common European Framework of Reference (CEFR) reading level (readability). Health app privacy policies were compared to policies from a purposively selected sample of websites, and to benchmarks, including CEFR reading level B1. Results Health app privacy policies were less often available in countries’ official languages compared to sampled websites (Chi-Square [1, 180]  =  57.470, p < 0.001) but contained fewer distracting visual elements. More UK privacy policies were in the country's official language, whereas Swedish privacy policies contained fewest words and fewest potentially distracting design elements. Only one privacy policy met the CEFR reading level benchmark. Conclusions Lack of privacy information in non-Anglophone app-users’ native languages and high reading levels may be major barriers to cognitive accessibility. Web and app developers should consider recommendations arising from this study, to stimulate trust in and adoption of health and wellness apps

Does familiarity affect the enjoyment of touchscreen games for people with dementia?

Previous research has indicated that people living with dementia are able to use touchscreen technology, which presents an opportunity to deliver meaningful and engaging activities for people to pass the time independently. The challenge is to identify suitable applications from the thousands that are currently available, and familiarity, where an app is a digital version of an existing real world game, may be one solution