TY - JOUR AU - López Seguí, Francesc AU - de San Pedro, Marc AU - Aumatell Verges, Eva AU - Simó Algado, Salvador AU - Garcia Cuyàs, Francesc PY - 2019 DA - 2019/08/09 TI - An Intergenerational Information and Communications Technology Learning Project to Improve Digital Skills: User Satisfaction Evaluation JO - JMIR Aging SP - e13939 VL - 2 IS - 2 KW - active aging KW - digital inclusion KW - ICT program KW - intergenerational relationships KW - civic participation KW - community service AB - Background: “Digital Partners” is an intergenerational information and communications technology learning project carried out in the municipalities of Vic and Centelles (Catalonia) from April to May 2018. Within the framework of the introduction of community service as a subject in secondary education, the Centre for Health and Social Studies (University of Vic) created a training space with 38 intergenerational partners (aged 14-15 years and >65 years), with the aim of improving the senior users’ digital skills in terms of use of smartphones and tablets, thus helping reduce the digital divide in the territory. Objective: The aim of this paper is to evaluate the satisfaction of both junior and senior participants toward the intervention and to explore its main drivers. Methods: Participants who volunteered to participate in the study were interviewed. Quantitative and qualitative data gathered in paper-based ad hoc surveys were used to assess participants’ satisfaction. Results: The experience shows a broad satisfaction of both junior and senior users. The project’s strengths include the format of working in couples; randomly pairing individuals by operating system; the ability to practice with the device itself; individuals’ free choice to decide what they wish to learn, develop, or practice; and the availability of voluntary practice material that facilitates communication and learning. With regard to aspects that could be improved, there is a need to review the timetabling flexibility of meetings to avoid hurrying the elderly and to extend the project’s duration, if necessary. Conclusions: This activity can serve to create mutual learning through the use of mobile devices and generate security and motivation on the part of the seniors, thus reducing the digital divide and improving social inclusion. UR - http://aging.jmir.org/2019/2/e13939/ UR - https://doi.org/10.2196/13939 UR - http://www.ncbi.nlm.nih.gov/pubmed/31518276 DO - 10.2196/13939 ID - info:doi/10.2196/13939 ER - TY - JOUR AU - Anderberg, Peter AU - Eivazzadeh, Shahryar AU - Berglund, Johan Sanmartin PY - 2019 DA - 2019/05/23 TI - A Novel Instrument for Measuring Older People’s Attitudes Toward Technology (TechPH): Development and Validation JO - J Med Internet Res SP - e13951 VL - 21 IS - 5 KW - technophilia KW - aging KW - internet KW - health technology KW - eHealth AB - Background: The use of health technology by older people is coming increasingly in focus with the demographic changes. Health information technology is generally perceived as an important factor in enabling increased quality of life and reducing the cost of care for this group. Age-appropriate design and facilitation of technology adoption are important to ensure functionality and removal of various barriers to usage. Development of assessment tools and instruments for evaluating older persons’ technology adoption and usage as well as measuring the effects of the interventions are of high priority. Both usability and acceptance of a specific technology or service are important factors in evaluating the impact of a health information technology intervention. Psychometric measures are seldom included in evaluations of health technology. However, basic attitudes and sentiments toward technology (eg, technophilia) could be argued to influence both the level of satisfaction with the technology itself as well as the perception of the health intervention outcome. Objective: The purpose of this study is to develop a reduced and refined instrument for measuring older people's attitudes and enthusiasm for technology based on relevant existing instruments for measuring technophilia. A requirement of the new instrument is that it should be short and simple to make it usable for evaluation of health technology for older people. Methods: Initial items for the TechPH questionnaire were drawn from a content analysis of relevant existing technophilia measure instruments. An exploratory factor analysis was conducted in a random selection of persons aged 65 years or older (N=374) on eight initial items. The scale was reduced to six items, and the internal consistency and reliability of the scale were examined. Further validation was made by a confirmatory factor analysis (CFA). Results: The exploratory factor analysis resulted in two factors. These factors were analyzed and labeled techEnthusiasm and techAnxiety. They demonstrated relatively good internal consistency (Cronbach alpha=.72 and .68, respectively). The factors were confirmed in the CFA and showed good model fit (χ28=21.2, χ2/df=2.65, comparative fit index=0.97, adjusted goodness-of-fit index=0.95, root mean square error of approximation=0.067, standardized root mean square residual=0.036). Conclusions: The construed TechPH score showed expected relations to external real-world criteria, and the two factors showed interesting internal relations. Different technophilia personality traits distinguish clusters with different behaviors of adaptation as well as usage of new technology. Whether there is an independent association with the TechPH score against outcomes in health technology projects needs to be shown in further studies. The instrument must also be validated in different contexts, such as other countries. UR - http://www.jmir.org/2019/5/e13951/ UR - https://doi.org/10.2196/13951 UR - http://www.ncbi.nlm.nih.gov/pubmed/31124467 DO - 10.2196/13951 ID - info:doi/10.2196/13951 ER - TY - JOUR AU - Quinn, Charlene C AU - Staub, Sheila AU - Barr, Erik AU - Gruber-Baldini, Ann PY - 2019 DA - 2019/05/23 TI - Mobile Support for Older Adults and Their Caregivers: Dyad Usability Study JO - JMIR Aging SP - e12276 VL - 2 IS - 1 KW - older adult KW - caregiver KW - mobile health KW - patient engagement AB - Background: Evaluation of digital health applications to support older adults’ independence and family caregiving is needed. Digital health is increasingly providing opportunities for older adults and their family caregivers to educate, engage, and share health information across digital platforms. Few apps have documented evidence of usability by older adults and their caregivers. Objective: The objective of this study was to determine the usability of a mobile app in a community-based older adult population aged ≥65 years. The app was designed to improve engagement of the patient-informal caregiver team. Methods: This observational usability study was conducted in participants’ homes and independent living facilities in Baltimore, Maryland. Community-dwelling older adults aged ≥65 years and their caregivers enrolled as a dyad (n=24, 12 dyads). The usability evaluation was a mobile and Web-based app that allowed older adult users to record social and health information and share this information with their caregivers. The older adult-caregiver dyad downloaded the app to a smart phone or accessed the Web version, participated in training and onboarding, and used the app for a 1-month period. Participants responded to weekly surveys sent by app push notifications and to the usability and satisfaction surveys at the end of the study. Participant satisfaction and usability were assessed using the Modified Mobile Application Rating Scale (M-MARS) and the System Usability Scale (SUS). Results: The final sample comprised 16 people (8 dyads). Responses to the M-MARS were comparable between older adults and caregiver respondents in terms of engagement and functionality. Caregivers rated aesthetics slightly higher (mean 3.7) than older adult participants did (mean 3.3). Although most responses to the SUS were around the mean (2.3-3.4), older adults and their caregivers differed with regard to integration of app features (mean 3.7 vs 2.8) and the need to learn more before using the app (mean 2.3 vs 3.1). Conclusions: Technology ownership and use among older adults and caregivers was high. Usability and engagement of the mobile app was average. Additional training is recommended for older adults and their caregivers, including that on targeted behaviors for digital health record keeping. UR - http://aging.jmir.org/2019/1/e12276/ UR - https://doi.org/10.2196/12276 UR - http://www.ncbi.nlm.nih.gov/pubmed/31518271 DO - 10.2196/12276 ID - info:doi/10.2196/12276 ER - TY - JOUR AU - Wang, Jing AU - Du, Yan AU - Coleman, Deidra AU - Peck, Michelle AU - Myneni, Sahiti AU - Kang, Hong AU - Gong, Yang PY - 2019 DA - 2019/05/15 TI - Mobile and Connected Health Technology Needs for Older Adults Aging in Place: Cross-Sectional Survey Study JO - JMIR Aging SP - e13864 VL - 2 IS - 1 KW - mobile health KW - connected health KW - wearable technology KW - remote monitoring KW - independent living KW - aging in place AB - Background: An increasing number of mobile and wearable devices are available in the market. However, the extent to which these devices can be used to assist older adults to age in place remains unclear. Objective: This study aimed to assess older adults’ perceptions of using mobile and connected health technologies. Methods: Using a cross-sectional design, a total of 51 participants were recruited from a senior community center. Demographics and usage of mobile or wearable devices and online health communities were collected using a survey questionnaire. Descriptive statistics assessed usage of devices and online health communities. The Fisher exact test was used to examine the relationship between technology usage and having access to a smartphone. Results: The sample was primarily comprised non-Hispanic white (35/51, 69%), educated (39/51, 76% any college), and female (36/51, 71%) participants, with an average age of 70 (SD 8) years. All participants were insured and nearly all lived at home (49/51, 94%). A total of 86% (44/51) of the participants had heard of wearable health devices, but only 18 out of 51 (35%) had ever used them. Over 80% (42/51) expressed interest in using such devices and were interested in tracking exercise and physical activity (46/51, 90%), sleep (38/51, 75%), blood pressure (34/51, 67%), diet (31/51, 61%), blood sugar (28/51, 55%), weight (26/51, 51%), and fall risk (23/51, 45%). The greatest concerns about using wearable devices were cost (31/51, 61%), safety (14/51, 28%), and privacy (13/51, 26%); one-fourth (12/51) reported having no concerns. They were mostly interested in sharing data from mobile and connected devices with their health care providers followed by family, online communities, friends, and no one. About 41% (21/51) of the older adults surveyed reported having ever heard of an online health community, and roughly 40% (20/51) of the participants reported being interested in joining such a community. Most participants reported having access to a smartphone (38/51, 74%), and those with such access were significantly more likely to show interest in using a wearable health device (P<.001) and joining an online health community (P=.05). Conclusions: Our findings suggest that, although few older adults are currently using mobile and wearable devices and connected health technologies for managing health, they are open to this idea and are mostly interested in sharing such data with their health care providers. Further studies are warranted to explore strategies to balance the data sharing preference of older adults and how to best integrate mobile and wearable device data with clinical workflow for health care providers to promote healthy aging in place. UR - http://aging.jmir.org/2019/1/e13864/ UR - https://doi.org/10.2196/13864 UR - http://www.ncbi.nlm.nih.gov/pubmed/31518283 DO - 10.2196/13864 ID - info:doi/10.2196/13864 ER - TY - JOUR AU - Ding, Eric Y AU - Han, Dong AU - Whitcomb, Cody AU - Bashar, Syed Khairul AU - Adaramola, Oluwaseun AU - Soni, Apurv AU - Saczynski, Jane AU - Fitzgibbons, Timothy P AU - Moonis, Majaz AU - Lubitz, Steven A AU - Lessard, Darleen AU - Hills, Mellanie True AU - Barton, Bruce AU - Chon, Ki AU - McManus, David D PY - 2019 DA - 2019/05/15 TI - Accuracy and Usability of a Novel Algorithm for Detection of Irregular Pulse Using a Smartwatch Among Older Adults: Observational Study JO - JMIR Cardio SP - e13850 VL - 3 IS - 1 KW - mobile health KW - mHealth KW - atrial fibrillation KW - screening KW - photoplethysmography KW - electrocardiography KW - smartwatch AB - Background: Atrial fibrillation (AF) is often paroxysmal and minimally symptomatic, hindering its diagnosis. Smartwatches may enhance AF care by facilitating long-term, noninvasive monitoring. Objective: This study aimed to examine the accuracy and usability of arrhythmia discrimination using a smartwatch. Methods: A total of 40 adults presenting to a cardiology clinic wore a smartwatch and Holter monitor and performed scripted movements to simulate activities of daily living (ADLs). Participants’ clinical and sociodemographic characteristics were abstracted from medical records. Participants completed a questionnaire assessing different domains of the device’s usability. Pulse recordings were analyzed blindly using a real-time realizable algorithm and compared with gold-standard Holter monitoring. Results: The average age of participants was 71 (SD 8) years; most participants had AF risk factors and 23% (9/39) were in AF. About half of the participants owned smartphones, but none owned smartwatches. Participants wore the smartwatch for 42 (SD 14) min while generating motion noise to simulate ADLs. The algorithm determined 53 of the 314 30-second noise-free pulse segments as consistent with AF. Compared with the gold standard, the algorithm demonstrated excellent sensitivity (98.2%), specificity (98.1%), and accuracy (98.1%) for identifying irregular pulse. Two-thirds of participants considered the smartwatch highly usable. Younger age and prior cardioversion were associated with greater overall comfort and comfort with data privacy with using a smartwatch for rhythm monitoring, respectively. Conclusions: A real-time realizable algorithm analyzing smartwatch pulse recordings demonstrated high accuracy for identifying pulse irregularities among older participants. Despite advanced age, lack of smartwatch familiarity, and high burden of comorbidities, participants found the smartwatch to be highly acceptable. UR - http://cardio.jmir.org/2019/1/e13850/ UR - https://doi.org/10.2196/13850 UR - http://www.ncbi.nlm.nih.gov/pubmed/31758787 DO - 10.2196/13850 ID - info:doi/10.2196/13850 ER - TY - JOUR AU - Portz, Jennifer Dickman AU - Bayliss, Elizabeth A AU - Bull, Sheana AU - Boxer, Rebecca S AU - Bekelman, David B AU - Gleason, Kathy AU - Czaja, Sara PY - 2019 DA - 2019/04/08 TI - Using the Technology Acceptance Model to Explore User Experience, Intent to Use, and Use Behavior of a Patient Portal Among Older Adults With Multiple Chronic Conditions: Descriptive Qualitative Study JO - J Med Internet Res SP - e11604 VL - 21 IS - 4 KW - multiple chronic conditions KW - personal health record KW - patient portals KW - aging KW - health information technology AB - Background: Patient portals offer modern digital tools for older adults with multiple chronic conditions (MCC) to engage in their health management. However, there are barriers to portal adoption among older adults. Understanding portal user interface and user experience (UI and UX) preferences of older adults with MCC may improve the accessibility, acceptability, and adoption of patient portals. Objective: The aim of this study was to use the Technology Acceptance Model (TAM) as a framework for qualitatively describing the UI and UX, intent to use, and use behaviors among older patients with MCC. Methods: We carried out a qualitative descriptive study of Kaiser Permanente Colorado’s established patient portal, My Health Manager. Older patients (N=24; mean 78.41 (SD 5.4) years) with MCC participated in focus groups. Stratified random sampling was used to maximize age and experience with the portal among participants. The semistructured focus groups used a combination of discussion and think-aloud strategies. A total of 2 coders led the theoretically driven analysis based on the TAM to determine themes related to use behavior, portal usefulness and ease of use, and intent to use. Results: Portal users commonly used email, pharmacy, and lab results sections of the portal. Although, generally, the portal was seen to be easy to use, simple, and quick, challenges related to log-ins, UI design (color and font), and specific features were identified. Such challenges inhibited participants’ intent to use the portal entirely or specific features. Participants indicated that the portal improved patient-provider communication, saved time and money, and provided relevant health information. Participants intended to use features that were beneficial to their health management and easy to use. Conclusions: Older adults are interested in using patient portals and are already taking advantage of the features available to them. We have the opportunity to better engage older adults in portal use but need to pay close attention to key considerations promoting usefulness and ease of use. UR - https://www.jmir.org/2019/4/e11604/ UR - https://doi.org/10.2196/11604 UR - http://www.ncbi.nlm.nih.gov/pubmed/30958272 DO - 10.2196/11604 ID - info:doi/10.2196/11604 ER - TY - JOUR AU - Kononova, Anastasia AU - Li, Lin AU - Kamp, Kendra AU - Bowen, Marie AU - Rikard, RV AU - Cotten, Shelia AU - Peng, Wei PY - 2019 DA - 2019/04/05 TI - The Use of Wearable Activity Trackers Among Older Adults: Focus Group Study of Tracker Perceptions, Motivators, and Barriers in the Maintenance Stage of Behavior Change JO - JMIR Mhealth Uhealth SP - e9832 VL - 7 IS - 4 KW - aging KW - wearable electronic devices KW - biobehavioral sciences KW - transtheoretical model of behavior change KW - exercise KW - physical activity AB - Background: Wearable activity trackers offer the opportunity to increase physical activity through continuous monitoring. Viewing tracker use as a beneficial health behavior, we explored the factors that facilitate and hinder long-term activity tracker use, applying the transtheoretical model of behavior change with the focus on the maintenance stage and relapse. Objective: The aim of this study was to investigate older adults’ perceptions and uses of activity trackers at different points of use: from nonuse and short-term use to long-term use and abandoned use to determine the factors to maintain tracker use and prevent users from discontinuing tracker usage. Methods: Data for the research come from 10 focus groups. Of them, 4 focus groups included participants who had never used activity trackers (n=17). These focus groups included an activity tracker trial. The other 6 focus groups (without the activity tracker trial) were conducted with short-term (n=9), long-term (n=11), and former tracker users (n=11; 2 focus groups per user type). Results: The results revealed that older adults in different tracker use stages liked and wished for different tracker features, with long-term users (users in the maintenance stage) being the most diverse and sophisticated users of the technology. Long-term users had developed a habit of tracker use whereas other participants made an effort to employ various encouragement strategies to ensure behavior maintenance. Social support through collaboration was the primary motivator for long-term users to maintain activity tracker use. Short-term and former users focused on competition, and nonusers engaged in vicarious tracker use experiences. Former users, or those who relapsed by abandoning their trackers, indicated that activity tracker use was fueled by curiosity in quantifying daily physical activity rather than the desire to increase physical activity. Long-term users saw a greater range of pros in activity tracker use whereas others focused on the cons of this behavior. Conclusions: The results suggest that activity trackers may be an effective technology to encourage physical activity among older adults, especially those who have never tried it. However, initial positive response to tracker use does not guarantee tracker use maintenance. Maintenance depends on recognizing the long-term benefits of tracker use, social support, and internal motivation. Nonadoption and relapse may occur because of technology’s limitations and gaining awareness of one’s physical activity without changing the physical activity level itself. UR - https://mhealth.jmir.org/2019/4/e9832/ UR - https://doi.org/10.2196/mhealth.9832 UR - http://www.ncbi.nlm.nih.gov/pubmed/30950807 DO - 10.2196/mhealth.9832 ID - info:doi/10.2196/mhealth.9832 ER - TY - JOUR AU - Manini, Todd Matthew AU - Mendoza, Tonatiuh AU - Battula, Manoj AU - Davoudi, Anis AU - Kheirkhahan, Matin AU - Young, Mary Ellen AU - Weber, Eric AU - Fillingim, Roger Benton AU - Rashidi, Parisa PY - 2019 DA - 2019/03/26 TI - Perception of Older Adults Toward Smartwatch Technology for Assessing Pain and Related Patient-Reported Outcomes: Pilot Study JO - JMIR Mhealth Uhealth SP - e10044 VL - 7 IS - 3 KW - smartwatch KW - focus group KW - ecological momentary assessment (EMA) KW - patient-reported outcomes (PRO) AB - Background: Chronic pain, including arthritis, affects about 100 million adults in the United States. Complexity and diversity of the pain experience across time and people and its fluctuations across and within days show the need for valid pain reports that do not rely on patient’s long-term recall capability. Smartwatches can be used as digital ecological momentary assessment (EMA) tools for real-time collection of pain scores. Smartwatches are generally less expensive than smartphones, are highly portable, and have a simpler user interface, providing an excellent medium for continuous data collection and enabling a higher compliance rate. Objective: The aim of this study was to explore the attitudes and perceptions of older adults towards design and technological aspects of a smartwatch framework for measuring patient report outcomes (PRO) as an EMA tool. Methods: A focus group session was conducted to explore the perception of participants towards smartwatch technology and its utility for PRO assessment. Participants included older adults (age 65+), with unilateral or bilateral symptomatic knee osteoarthritis. A preliminary user interface with server communication capability was developed and deployed on 10 Samsung Gear S3 smartwatches and provided to the users during the focus group. Pain was designated as the main PRO, while fatigue, mood, and sleep quality were included as auxiliary PROs. Pre-planned topics included participants’ attitude towards the smartwatch technology, usability of the custom-designed app interface, and suitability of the smartwatch technology for PRO assessment. Discussions were transcribed, and content analysis with theme characterization was performed to identify and code the major themes. Results: We recruited 19 participants (age 65+) who consented to take part in the focus group study. The overall attitude of the participants toward the smartwatch technology was positive. They showed interest in the direct phone-call capability, availability of extra apps such as the weather apps and sensors for tracking health and wellness such as accelerometer and heart rate sensor. Nearly three-quarters of participants showed willingness to participate in a one-year study to wear the watch daily. Concerns were raised regarding usability, including accessibility (larger icons), notification customization, and intuitive interface design (unambiguous icons and assessment scales). Participants expressed interest in using smartwatch technology for PRO assessment and the availability of methods for sharing data with health care providers. Conclusions: All participants had overall positive views of the smartwatch technology for measuring PROs to facilitate patient-provider communications and to provide more targeted treatments and interventions in the future. Usability concerns were the major issues that will require special consideration in future smartwatch PRO user interface designs, especially accessibility issues, notification design, and use of intuitive assessment scales. UR - http://mhealth.jmir.org/2019/3/e10044/ UR - https://doi.org/10.2196/10044 UR - http://www.ncbi.nlm.nih.gov/pubmed/30912756 DO - 10.2196/10044 ID - info:doi/10.2196/10044 ER - TY - JOUR AU - Mehra, Sumit AU - Visser, Bart AU - Cila, Nazli AU - van den Helder, Jantine AU - Engelbert, Raoul HH AU - Weijs, Peter JM AU - Kröse, Ben JA PY - 2019 DA - 2019/02/01 TI - Supporting Older Adults in Exercising With a Tablet: A Usability Study JO - JMIR Hum Factors SP - e11598 VL - 6 IS - 1 KW - frail elderly KW - aged KW - activities of daily living KW - exercise KW - health behavior KW - telemedicine KW - mobile devices KW - tablet computers KW - usability testing KW - mobile phone AB - Background: For older adults, physical activity is vital for maintaining their health and ability to live independently. Home-based programs can help them achieve the recommended exercise frequency. An application for a tablet computer was developed to support older adults in following a personal training program. It featured goal setting, tailoring, progress tracking, and remote feedback. Objective: In line with the Medical Research Council Framework, which prescribes thorough testing before evaluating the efficacy with a randomized controlled trial, the aim of this study was to assess the usability of a tablet-based app that was designed to support older adults in doing exercises at home. Methods: A total of 15 older adults, age ranging from 69 to 99 years old, participated in a usability study that utilized a mixed-methods approach. In a laboratory setting, novice users were asked to complete a series of tasks while verbalizing their ongoing thoughts. The tasks ranged from looking up information about exercises and executing them to tailoring a weekly exercise schedule. Performance errors and time-on-task were calculated as proxies of effective and efficient usage. Overall satisfaction was assessed with a posttest interview. All responses were analyzed independently by 2 researchers. Results: The participants spent 13-85 seconds time-on-task. Moreover, 79% (11/14)-100% (14/14) participants completed the basic tasks with either no help or after having received 1 hint. For expert tasks, they needed a few more hints. During the posttest interview, the participants made 3 times more positive remarks about the app than negative remarks. Conclusions: The app that was developed to support older adults in doing exercises at home is usable by the target audience. First-time users were able to perform basic tasks in an effective and efficient manner. In general, they were satisfied with the app. Tasks that were associated with behavior execution and evaluation were performed with ease. Complex tasks such as tailoring a personal training schedule needed more effort. Learning effects, usefulness, and long-term satisfaction will be investigated through longitudinal follow-up studies. UR - http://humanfactors.jmir.org/2019/1/e11598/ UR - https://doi.org/10.2196/11598 UR - http://www.ncbi.nlm.nih.gov/pubmed/30707106 DO - 10.2196/11598 ID - info:doi/10.2196/11598 ER - TY - JOUR AU - Backman, Chantal AU - Harley, Anne AU - Peyton, Liam AU - Kuziemsky, Craig AU - Mercer, Jay AU - Monahan, Mary Anne AU - Schmidt, Sandra AU - Singh, Harvinder AU - Gravelle, Deborah PY - 2018 DA - 2018/9/24 TI - Development of a Path to Home Mobile App for the Geriatric Rehabilitation Program at Bruyère Continuing Care: Protocol for User-Centered Design and Feasibility Testing Studies JO - JMIR Res Protoc SP - e11031 VL - 7 IS - 9 KW - patient discharge KW - care transition KW - user-centered design KW - geriatric rehabilitation KW - mHealth KW - transitional care KW - rehabilitation KW - health services for the aged KW - telemedicine AB - Background: As the population ages, the need for appropriate geriatric rehabilitation services will also increase. Pressures faced by hospitals to reduce length of stay and reduce costs have driven the need for more complex care being delivered in the home or community setting. As a result, a multifaceted approach that can provide geriatric rehabilitation patients with safe and effective person- and family-centered care during transitions from hospital to home is required. We hypothesize that a technology-supported person- and family-centered care transition could empower geriatric rehabilitation patients, engage them in shared decision making, and ultimately help them to safely manage their personalized needs during care transitions from hospital to home. Objective: The purpose of this study is to design and test the feasibility of a novel Path to Home mobile app to manage the personalized needs of geriatric rehabilitation patients during their transitions from hospital to home. Methods: This study will consist of (1) codesigning a patient- and provider-tailored mobile app, and (2) feasibility pilot testing of the mobile app to manage the needs of geriatric rehabilitation patients when leaving the hospital. In phase 1, we will follow a user-centered design process integrated with a modern agile software development methodology to iteratively codesign the personalized care transition Path to Home mobile app. In phase 2, we will conduct a single-arm feasibility pilot test with geriatric rehabilitation patients using the personalized care transition Path to Home mobile app to manage their needs during the transition from hospital to home. Results: The project was funded in May 2018, and enrollment and data analysis are underway. First results are expected to be submitted for publication in 2019. Conclusions: Our findings will help validate the use of this technology for geriatric rehabilitation patients discharged from the hospital to home. Future research will more rigorously evaluate the health and economic benefits to inform wide-scale adoption of the technology. Registered Report Identifier: RR1-10.2196/11031 UR - http://www.researchprotocols.org/2018/9/e11031/ UR - https://doi.org/10.2196/11031 UR - http://www.ncbi.nlm.nih.gov/pubmed/30249591 DO - 10.2196/11031 ID - info:doi/10.2196/11031 ER - TY - JOUR AU - Theis, Sabine AU - Rasche, Peter Wilhelm Victor AU - Bröhl, Christina AU - Wille, Matthias AU - Mertens, Alexander PY - 2018 DA - 2018/07/09 TI - Task-Data Taxonomy for Health Data Visualizations: Web-Based Survey With Experts and Older Adults JO - JMIR Med Inform SP - e39 VL - 6 IS - 3 KW - classification KW - data display KW - computer graphics KW - task performance and analysis KW - medicine KW - telemedicine KW - user/machine systems KW - human factors AB - Background: Increasingly, eHealth involves health data visualizations to enable users to better understand their health situation. Selecting efficient and ergonomic visualizations requires knowledge about the task that the user wants to carry out and the type of data to be displayed. Taxonomies of abstract tasks and data types bundle this knowledge in a general manner. Task-data taxonomies exist for visualization tasks and data. They also exist for eHealth tasks. However, there is currently no joint task taxonomy available for health data visualizations incorporating the perspective of the prospective users. One of the most prominent prospective user groups of eHealth are older adults, but their perspective is rarely considered when constructing tasks lists. Objective: The aim of this study was to construct a task-data taxonomy for health data visualizations based on the opinion of older adults as prospective users of eHealth systems. eHealth experts served as a control group against the bias of lacking background knowledge. The resulting taxonomy would then be used as an orientation in system requirement analysis and empirical evaluation and to facilitate a common understanding and language in eHealth data visualization. Methods: Answers from 98 participants (51 older adults and 47 eHealth experts) given in an online survey were quantitatively analyzed, compared between groups, and synthesized into a task-data taxonomy for health data visualizations. Results: Consultation, diagnosis, mentoring, and monitoring were confirmed as relevant abstract tasks in eHealth. Experts and older adults disagreed on the importance of mentoring (χ24=14.1, P=.002) and monitoring (χ24=22.1, P<.001). The answers to the open questions validated the findings from the closed questions and added therapy, communication, cooperation, and quality management to the aforementioned tasks. Here, group differences in normalized code counts were identified for “monitoring” between the expert group (mean 0.18, SD 0.23) and the group of older adults (mean 0.08, SD 0.15; t96=2431, P=.02). Time-dependent data was most relevant across all eHealth tasks. Finally, visualization tasks and data types were assigned to eHealth tasks by both experimental groups. Conclusions: We empirically developed a task-data taxonomy for health data visualizations with prospective users. This provides a general framework for theoretical concession and for the prioritization of user-centered system design and evaluation. At the same time, the functionality dimension of the taxonomy for telemedicine—chosen as the basis for the construction of present taxonomy—was confirmed. UR - http://medinform.jmir.org/2018/3/e39/ UR - https://doi.org/10.2196/medinform.9394 UR - http://www.ncbi.nlm.nih.gov/pubmed/29986844 DO - 10.2196/medinform.9394 ID - info:doi/10.2196/medinform.9394 ER - TY - JOUR AU - Zheng, Hua AU - Rosal, Milagros C AU - Li, Wenjun AU - Borg, Amy AU - Yang, Wenyun AU - Ayers, David C AU - Franklin, Patricia D PY - 2018 DA - 2018/04/30 TI - A Web-Based Treatment Decision Support Tool for Patients With Advanced Knee Arthritis: Evaluation of User Interface and Content Design JO - JMIR Hum Factors SP - e17 VL - 5 IS - 2 KW - usability evaluation KW - patient decision support KW - knee osteoarthritis KW - total knee replacement KW - outcome prediction AB - Background: Data-driven surgical decisions will ensure proper use and timing of surgical care. We developed a Web-based patient-centered treatment decision and assessment tool to guide treatment decisions among patients with advanced knee osteoarthritis who are considering total knee replacement surgery. Objective: The aim of this study was to examine user experience and acceptance of the Web-based treatment decision support tool among older adults. Methods: User-centered formative and summative evaluations were conducted for the tool. A sample of 28 patients who were considering total knee replacement participated in the study. Participants’ responses to the user interface design, the clarity of information, as well as usefulness, satisfaction, and acceptance of the tool were collected through qualitative (ie, individual patient interviews) and quantitative (ie, standardized Computer System Usability Questionnaire) methods. Results: Participants were older adults with a mean age of 63 (SD 11) years. Three-quarters of them had no technical questions using the tool. User interface design recommendations included larger fonts, bigger buttons, less colors, simpler navigation without extra “next page” click, less mouse movement, and clearer illustrations with simple graphs. Color-coded bar charts and outcome-specific graphs with positive action were easiest for them to understand the outcomes data. Questionnaire data revealed high satisfaction with the tool usefulness and interface quality, and also showed ease of use of the tool, regardless of age or educational status. Conclusions: We evaluated the usability of a patient-centered decision support tool designed for advanced knee arthritis patients to facilitate their knee osteoarthritis treatment decision making. The lessons learned can inform other decision support tools to improve interface and content design for older patients’ use. UR - http://humanfactors.jmir.org/2018/2/e17/ UR - https://doi.org/10.2196/humanfactors.8568 UR - http://www.ncbi.nlm.nih.gov/pubmed/29712620 DO - 10.2196/humanfactors.8568 ID - info:doi/10.2196/humanfactors.8568 ER - TY - JOUR AU - Harte, Richard AU - Hall, Tony AU - Glynn, Liam AU - Rodríguez-Molinero, Alejandro AU - Scharf, Thomas AU - Quinlan, Leo R AU - ÓLaighin, Gearóid PY - 2018 DA - 2018/04/26 TI - Enhancing Home Health Mobile Phone App Usability Through General Smartphone Training: Usability and Learnability Case Study JO - JMIR Hum Factors SP - e18 VL - 5 IS - 2 KW - smartphone KW - aged KW - elderly KW - wearable electronic devices KW - telemedicine KW - user-computer interface KW - education KW - user centered-design KW - usability KW - connected health KW - human factors KW - falls detection AB - Background: Each year, millions of older adults fall, with more than 1 out of 4 older people experiencing a fall annually, thereby causing a major social and economic impact. Falling once doubles one’s chances of falling again, making fall prediction an important aspect of preventative strategies. In this study, 22 older adults aged between 65 and 85 years were trained in the use of a smartphone-based fall prediction system. The system is designed to continuously assess fall risk by measuring various gait and balance parameters using a smart insole and smartphone, and is also designed to detect falls. The use case of the fall prediction system in question required the users to interact with the smartphone via an app for device syncing, data uploads, and checking system status. Objective: The objective of this study was to observe the effect that basic smartphone training could have on the user experience of a group that is not technically proficient with smartphones when using a new connected health system. It was expected that even short rudimentary training could have a large effect on user experience and therefore increase the chances of the group accepting the new technology. Methods: All participants received training on how to use the system smartphone app; half of the participants (training group) also received extra training on how to use basic functions of the smartphone, such as making calls and sending text messages, whereas the other half did not receive this extra training (no extra training group). Comparison of training group and no extra training group was carried out using metrics such as satisfaction rating, time taken to complete tasks, cues required to complete tasks, and errors made during tasks. Results: The training group fared better in the first 3 days of using the system. There were significant recorded differences in number of cues required and errors committed between the two groups. By the fourth and fifth day of use, both groups were performing at the same level when using the system. Conclusions: Supplementary basic smartphone training may be critical in trials where a smartphone app–based system for health intervention purposes is being introduced to a population that is not proficient with technology. This training could prevent early technology rejection and increase the engagement of older participants and their overall user experience with the system. UR - http://humanfactors.jmir.org/2018/2/e18/ UR - https://doi.org/10.2196/humanfactors.7718 UR - http://www.ncbi.nlm.nih.gov/pubmed/29699969 DO - 10.2196/humanfactors.7718 ID - info:doi/10.2196/humanfactors.7718 ER -