The effect of information architecture on the effectiveness and user experience of web-based patient education: A randomized experiment with middle-aged and older adults (Preprint)

10.2196/preprints.15846 ◽

2019 ◽

Author(s):

Tessa Dekkers ◽

Marijke Melles ◽

Stephan BW Vehmeijer ◽

Huib de Ridder

Keyword(s):

Older Adults ◽

Patient Education ◽

Active Control ◽

User Experience ◽

User Satisfaction ◽

Information Architecture ◽

Randomized Experiment ◽

Middle Aged ◽

Web Based ◽

Joint Replacement Surgery

BACKGROUND Web-based patient education is increasingly offered to improve patients’ ability to learn, remember, and apply health information. Efficient organization, display, and structural design, i.e. information architecture (IA), can support patients’ ability to independently use web-based patient education. However, the role of IA in the context of web-based patient education has not been examined systematically. OBJECTIVE To support intervention designers in making informed choices that enhance patients’ learning, the current paper describes a randomized experiment concerning the effect of IA on the effectiveness, use, and user experience of a patient education website and examines the theoretical mechanisms that explain these effects. METHODS Middle-aged and older adults with self-reported hip or knee joint complaints were recruited to use and evaluate one of three patient education websites containing information on total joint replacement surgery. Each website contained the same textual content based on an existing leaflet but differed in the employed IA design (tunnel, hierarchical, or matrix design). Participants rated the websites on satisfaction, engagement, control, relevance, trust, and novelty and completed an objective knowledge test. Analyses of variance and structural equation modelling were used to examine the effects of IA and construct a theoretical model. RESULTS We included 215 participants in our analysis. IA did not affect knowledge gain (P=.361) or overall satisfaction (P=.069) directly. However, tunnel (M=3.22, SD=0.67) and matrix (M=3.17, SD=0.69) architectures were found to provide more emotional support compared to hierarchical architectures (M=2.86, SD=0.60) (P=.002). Furthermore, increased perceptions of personal relevance in the tunnel IA (β=.18) were found to improve satisfaction (β=.17) indirectly. Increased perceptions of active control in the matrix IA (β=.11) also improved satisfaction (β=.27) indirectly. The final model of IA effects explained 74.3% of the variance in satisfaction and 6.8% of the variance in knowledge and achieved excellent fit: χ2(17,215)=14.684, P=.618, RMSEA=0.000 [CI 0.000-0.053], CFI=1.00, SRMR=0.044. CONCLUSIONS Information architecture (IA) has small but notable effects on users’ experiences with online health education interventions. Web-based patient education designers can employ tunnel IA designs to guide users through sequentially ordered content or matrix IA to offer users more control over navigation. Both improve user satisfaction by increasing user perceptions of relevance (tunnel) and active control (matrix). While additional research is needed, hierarchical IA designs are currently not recommended, as hierarchical content is perceived as less supportive, engaging, and relevant which may diminish the usage, and in turn the effect of the educational intervention. CLINICALTRIAL

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Prevalence and Factors Influencing Use of Internet and Electronic Health Resources by Middle-Aged and Older Adults in a US Health Plan Population: Cross-Sectional Survey Study (Preprint)

10.2196/preprints.11451 ◽

2018 ◽

Author(s):

Elizabeth Crouch ◽

Nancy P Gordon

Keyword(s):

Older Adults ◽

Educational Attainment ◽

Health Plan ◽

Internet Use ◽

The Internet ◽

Patient Portal ◽

Middle Aged ◽

Cross Sectional Survey ◽

Web Based ◽

Middle Aged Adults

BACKGROUND Health care organizations are increasingly using electronic health (eHealth) platforms to provide and exchange health information and advice (HIA). There is limited information about how factors beyond internet access affect use of eHealth resources by middle-aged and older adults. OBJECTIVE We aimed to estimate prevalence of use of the internet, health plan patient portal, and Web-based HIA among middle-aged and older adults; investigate whether similar sociodemographic-related disparities in eHealth resource use are found among middle-aged and older adults; and examine how sociodemographic and internet access factors drive disparities in eHealth resource use among adults who use the internet. METHODS We analyzed cross-sectional survey data for 10,920 Northern California health plan members aged 45 to 85 years who responded to a mailed and Web-based health survey (2014-2015). We used bivariate and multivariable analyses with weighted data to estimate prevalence of and identify factors associated with internet use and self-reported past year use of the health plan’s patient portal and Web-based HIA resources by middle-aged adults (aged 45 to 65 years; n=5520), younger seniors (aged 65 to 75 years; n=3014), and older seniors (aged 76 to 85 years; n=2389). RESULTS Although approximately 96% of middle-aged adults, 92% of younger seniors, and 76% of older seniors use the internet to obtain information, about 4%, 9%, and 16%, respectively, require someone’s help to do so. The percentages who used the patient portal and Web-based HIA resources were similar for middle-aged adults and younger seniors but lower among older seniors (59.6%, 61.4%, and 45.0% and 47.9%, 48.4%, and 37.5%, respectively). Disparities in use of the internet, patient portal, and Web-based HIA across levels of education and between low and higher income were observed in all age groups, with wider disparities between low and high levels of education and income among seniors. Multivariable analyses showed that for all 3 age groups, educational attainment, ability to use the internet without help, and having 1 or more chronic condition were significant predictors of patient portal and Web-based HIA use after controlling for gender, race/ethnicity, and internet use. CONCLUSIONS Internet use, and especially use without help, significantly declines with age, even within a middle-aged group. Educational attainment is significantly associated with internet use, ability to use the internet without help, and use of patient portal and Web-based HIA resources by middle-aged and older adults. Even among middle-aged and older adult internet users, higher educational attainment and ability to use the internet without help are positively associated with patient portal and Web-based HIA use. Organizations serving middle-aged and older adults should take into account target population characteristics when developing and evaluating uptake of eHealth resources and should consider offering instruction and support services to boost patient engagement.

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WEB-BASED PHYSICAL ACTIVITY INTERVENTION IN MIDDLE-AGED AND OLDER ADULT VETERANS WITH COPD

Innovation in Aging ◽

10.1093/geroni/igz038.1608 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S430-S430

Author(s):

Stephanie A Robinson ◽

Deanna L Mori ◽

Caroline R Richardson ◽

Marilyn L Moy

Keyword(s):

Physical Activity ◽

Older Adults ◽

Older Adult ◽

Physical Activity Intervention ◽

Chronic Obstructive ◽

Middle Aged ◽

Behavior Change Techniques ◽

Obstructive Pulmonary Disease ◽

Web Based ◽

Significant Difference

Abstract Physical activity (PA) is recommended in all patients with chronic obstructive pulmonary disease (COPD). Technology-based interventions can deliver effective, scalable behavior-change techniques; though feasibility and acceptability among older adults is not established. Veterans with COPD (N=112, aged 49-89 years, median=68) were randomized to a 12-week web-based and pedometer intervention or a pedometer alone (control). Across groups, there was no significant difference between middle-aged (<68 years) and older (≥68 years) adults in percentage of pedometer wear-days over the study period (83.6% vs. 89.9%). In the intervention, there were no significant differences between middle-aged and older adults in total number of website logons (15.04 vs. 16.31), or proportion who reported they recommended the intervention (96.4% vs. 96.7%), found it easy to use (93.1% vs. 90.0%), and would continue to walk (93.1% vs. 89.7%). We conclude that a web-based PA intervention with a pedometer is feasible and acceptable in an older COPD population.

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Regulation of Experienced and Anticipated Regret for Daily Decisions in Younger and Older Adults in a Swedish One-Week Diary Study

GeroPsych ◽

10.1024/1662-9647/a000102 ◽

2013 ◽

Vol 26 (4) ◽

pp. 233-241 ◽

Cited By ~ 7

Author(s):

Pär Bjälkebring ◽

Daniel Västfjäll ◽

Boo Johansson

Keyword(s):

Older Adults ◽

Diary Study ◽

Anticipated Regret ◽

Younger Adults ◽

Web Based ◽

Decision Regret ◽

Diary Method ◽

Regulation Strategies

Regret and regret regulation were studied using a weeklong web-based diary method. 108 participants aged 19 to 89 years reported regret for a decision made and a decision to be made. They also reported the extent to which they used strategies to prevent or regulate decision regret. Older adults reported both less experienced and anticipated regret compared to younger adults. The lower level of experienced regret in older adults was mediated by reappraisal of the decision. The lower level of anticipated regret was mediated by delaying the decision, and expecting regret in older adults. It is suggested that the lower level of regret observed in older adults is partly explained by regret prevention and regulation strategies.

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