scholarly journals Untold Stories in User-Centered Design of Mobile Health: Practical Challenges and Strategies Learned From the Design and Evaluation of an App for Older Adults With Heart Failure

10.2196/17703 ◽  
2020 ◽  
Vol 8 (7) ◽  
pp. e17703 ◽  
Author(s):  
Victor Philip Cornet ◽  
Tammy Toscos ◽  
Davide Bolchini ◽  
Romisa Rohani Ghahari ◽  
Ryan Ahmed ◽  
...  
Keyword(s):  
Heart Failure ◽  
Older Adults ◽  
Mobile Health ◽  
Stakeholder Involvement ◽  
Mobile App ◽  
User Centered Design ◽  
Mhealth Apps ◽  
Practical Recommendations ◽  
Challenges And Strategies ◽  
User Centered

Background User-centered design (UCD) is a powerful framework for creating useful, easy-to-use, and satisfying mobile health (mHealth) apps. However, the literature seldom reports the practical challenges of implementing UCD, particularly in the field of mHealth. Objective This study aims to characterize the practical challenges encountered and propose strategies when implementing UCD for mHealth. Methods Our multidisciplinary team implemented a UCD process to design and evaluate a mobile app for older adults with heart failure. During and after this process, we documented the challenges the team encountered and the strategies they used or considered using to address those challenges. Results We identified 12 challenges, 3 about UCD as a whole and 9 across the UCD stages of formative research, design, and evaluation. Challenges included the timing of stakeholder involvement, overcoming designers’ assumptions, adapting methods to end users, and managing heterogeneity among stakeholders. To address these challenges, practical recommendations are provided to UCD researchers and practitioners. Conclusions UCD is a gold standard approach that is increasingly adopted for mHealth projects. Although UCD methods are well-described and easily accessible, practical challenges and strategies for implementing them are underreported. To improve the implementation of UCD for mHealth, we must tell and learn from these traditionally untold stories.

scholarly journals Untold Stories in User-Centered Design of Mobile Health: Practical Challenges and Strategies Learned From the Design and Evaluation of an App for Older Adults With Heart Failure (Preprint)

2020 ◽  
Author(s):  
Victor Philip Cornet ◽  
Tammy Toscos ◽  
Davide Bolchini ◽  
Romisa Rohani Ghahari ◽  
Ryan Ahmed ◽  
...  
Keyword(s):  
Heart Failure ◽  
Older Adults ◽  
Mobile Health ◽  
Stakeholder Involvement ◽  
Mobile App ◽  
User Centered Design ◽  
Mhealth Apps ◽  
Practical Recommendations ◽  
Challenges And Strategies ◽  
User Centered

BACKGROUND User-centered design (UCD) is a powerful framework for creating useful, easy-to-use, and satisfying mobile health (mHealth) apps. However, the literature seldom reports the practical challenges of implementing UCD, particularly in the field of mHealth. OBJECTIVE This study aims to characterize the practical challenges encountered and propose strategies when implementing UCD for mHealth. METHODS Our multidisciplinary team implemented a UCD process to design and evaluate a mobile app for older adults with heart failure. During and after this process, we documented the challenges the team encountered and the strategies they used or considered using to address those challenges. RESULTS We identified 12 challenges, 3 about UCD as a whole and 9 across the UCD stages of formative research, design, and evaluation. Challenges included the timing of stakeholder involvement, overcoming designers’ assumptions, adapting methods to end users, and managing heterogeneity among stakeholders. To address these challenges, practical recommendations are provided to UCD researchers and practitioners. CONCLUSIONS UCD is a gold standard approach that is increasingly adopted for mHealth projects. Although UCD methods are well-described and easily accessible, practical challenges and strategies for implementing them are underreported. To improve the implementation of UCD for mHealth, we must tell and learn from these traditionally untold stories.

User-Centered Design Enhances Usability of an mHealth System for Users with Dexterity Impairments (Preprint)

2020 ◽  
Author(s):  
Kuntal Chowdhary ◽  
Daihua Xie Yu ◽  
Gede Pramana ◽  
Andrea Fairman ◽  
Brad Edward Dicianno ◽  
...  
Keyword(s):  
User Interface ◽  
Mobile Health ◽  
Chronic Conditions ◽  
Independent Living ◽  
Health Interventions ◽  
Self Management ◽  
User Centered Design ◽  
Entire Study ◽  
Efficiency And Effectiveness ◽  
User Centered

BACKGROUND Mobile health (mHealth) systems have been shown to be useful in supporting self-management by promoting adherence to schedules and longitudinal health interventions, especially in people with disabilities (PwD). The Interactive Mobile Health and Rehabilitation (iMHere) System was developed to empower PwD and those with chronic conditions with supports needed for self-management and independent living. Since the first iteration of the iMHere 1.0 app, several studies have evaluated accessibility and usability of the system. Potential opportunities to improve and simplify the user interface (UI) were identified, and the iMHere modules were redesigned accordingly. OBJECTIVE The aim of this study was to evaluate the usability of the redesigned modules within iMHere 1.0. METHODS This study evaluated the original and redesigned MyMeds and SkinCare modules. To assess the participants’ dexterity levels, the Purdue Pegboard Test (PPBT) was administered. Participants were then asked to perform a set of tasks using both the original and redesigned MyMeds and SkinCare modules to assess efficiency and effectiveness. Usability was measured using the Telehealth Usability Questionnaire (TUQ) to evaluate 10 new accessibility features that were added to the redesigned app. Participants were also asked which version they preferred. RESULTS Twenty-four participants with disabilities and varied degrees of dexterity impairments completed the entire study protocol. Participants displayed improved efficiency and effectiveness of use when using the redesigned modules, as compared to the original modules. Participants also reported improved usability and preferred the redesigned modules. CONCLUSIONS This study demonstrated that the iMHere System became more efficient, effective, and usable for individuals with dexterity impairments after redesigning it according to user-centered principles.

Modeling Personas for Older Adults with Heart Failure

2018 ◽  
Vol 62 (1) ◽  
pp. 1072-1076 ◽  
Author(s):  
Richard J. Holden ◽  
Pushkar Joshi ◽  
Kartik Rao ◽  
Anagha Varrier ◽  
Carly N. Daley ◽  
...  
Keyword(s):  
Heart Failure ◽  
Older Adults ◽  
Information Needs ◽  
Self Care ◽  
Chronically Ill ◽  
User Centered Design ◽  
Future Design ◽  
Patients With Heart Failure ◽  
Design Activities ◽  
Key Dimensions

In the early stages of the design process, designers often benefit from the use of personas, or archetypes of target users presented in a vivid way to highlight design-relevant characteristics. In the growing efforts to create health information technology (HIT) for older adults, empirically derived personas could help orchestrate more user-centered design activities. However, there is a lack of ready-to-use personas for older adult HIT users and more so for those designing in specific domains such as heart failure self-care. This paper presents personas of older adults derived from qualitative analysis of interviews with 24 older patients with heart failure. Analyses unearthed key dimensions distinguishing patients based on their dispositions towards the self-management of their chronic condition, including locus of control, relationship with the health/support system, information needs, and activities of self-care. Two personas are presented: Direction Follower and Researcher, with subtypes for the latter codified as Investigator and Explorer. Our work contributes to future design of systems including HIT to support chronically ill older adults.

Abstract 17378: “If My Doctors Had Recommended a Mobile App to Me Back Then, I Wouldn't Have Been in This Situation Today”: Identifying the Barriers and Facilitators to the Utilization of mHealth Apps to Improve Self-Care in Patients With Heart Failure

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Ifeanyi Madujibeya ◽  
Salman Alreshidi ◽  
Adaze Aroh
Keyword(s):  
Heart Failure ◽  
Academic Medical Center ◽  
Self Care ◽  
Mobile App ◽  
Perceived Usefulness ◽  
Intention To Use ◽  
Depth Analysis ◽  
Patients With Heart Failure ◽  
Prior Use ◽  
Mhealth Apps

Background: Mobile Health applications (mHealth apps) have been demonstrated as an effective strategy for improving self-care abilities in patients with heart failure (HF). However, the uptake of the apps by patients remains low. Little is known about the patient’s perspectives on the factors that influence their uptake of the apps. This study explored HF patients’ perspectives on the barriers and motivators to the uptake and utilization of mHealth apps. Method: Semi-structure interviews and demographic questionnaires were used to gather data from patients with HF (N= 43) recruited from an academic medical center. An in-depth analysis of the interviews was conducted using a deductive thematic approach with the help of qualitative software, Atias.ti version 8. Results: Among the participants ( median age = 62 [35-92] years, mean±SD ejection fraction = 37.3±17, 41.9% female, 70% smartphone owners), 90.7% (n =39) had no prior use of mHealth apps for self-care. The majority of the participants with no prior use of mhealth (79.5%, n = 31), including 64.7% (n= 17) of participants aged 65yrs and above, expressed an intention to use the apps for self-care. All the participants (100%) stated that their healthcare providers (HCP) had never recommended the use of mHealth apps for self-care. Other barriers included lack of knowledge of the apps, the perceived financial cost of mHealth apps or smartphones, concern for privacy, and security of personal information, resistance to the change of previous self-care strategies, and perceived technology incompetence. Motivators to the uptake of mHealth included perceived usefulness of mHealth apps, mHealth apps’ ease of use, and the belief that the use of mHealth apps may alleviate perceived threat to health, and availability of technical support. Conclusion: This study suggests that patients with HF are willing to use mHealth apps to improve their self-care abilities. Thus, the effort to improve patients’ perceptions of mHealth apps’ usefulness and HCP recommendation of the apps are warranted to turn patients' “intention to use” to actual apps usage.

scholarly journals User-Centered Design of a Mobile App for Weight and Health Management in Adolescents With Complex Health Needs: Qualitative Study

2017 ◽  
Author(s):  
Jordan Rivera ◽  
Amy C McPherson ◽  
Jill Hamilton ◽  
Catherine Birken ◽  
Michael Coons ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Health Management ◽  
Mobile App ◽  
Health Needs ◽  
User Centered Design ◽  
User Centered

scholarly journals Using the NIATx Model to Implement User-Centered Design of Technology for Older Adults

2016 ◽  
Vol 3 (1) ◽  
pp. e2 ◽  
Author(s):  
David H Gustafson Jr ◽  
Adam Maus ◽  
Julianne Judkins ◽  
Susan Dinauer ◽  
Andrew Isham ◽  
...  
Keyword(s):  
Older Adults ◽  
User Centered Design ◽  
User Centered

scholarly journals Development of the InCharge Health Mobile App to Improve Adherence to Hydroxyurea in Patients With Sickle Cell Disease: User-Centered Design Approach

10.2196/14884 ◽  
2020 ◽  
Vol 8 (5) ◽  
pp. e14884 ◽  
Author(s):  
Nicole M Alberts ◽  
Sherif M Badawy ◽  
Jason Hodges ◽  
Jeremie H Estepp ◽  
Chinonyelum Nwosu ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Health Care ◽  
Mobile App ◽  
Care Utilization ◽  
User Centered Design ◽  
Cell Disease ◽  
Mhealth Intervention ◽  
Acute Health Care ◽  
User Centered

Background Sickle cell disease (SCD) is an inherited blood disorder causing acute complications and chronic progressive end organ damage. SCD is associated with significant morbidity, early mortality, impaired health-related quality of life, and increased acute health care utilization. Hydroxyurea is a US Food and Drug Administration–approved medication that reduces disease complications, acute health care utilization, and costs. However, adherence to hydroxyurea is suboptimal. Mobile health (mHealth) interventions have the potential to improve hydroxyurea adherence, but few examples exist that are specific to the SCD population. Objective This study aimed to design a mHealth intervention for individuals with SCD to improve adherence to hydroxyurea, using a user-centered design that was informed by specific barriers to hydroxyurea adherence and utilization in this population. Methods This study consisted of 4 phases. In phase 1, individuals with SCD and health care providers participated in an optimization digital workshop. In phase 2, patients completed surveys pertaining to their interest in mHealth use, barriers and facilitators to hydroxyurea use, and health literacy. Phases 3 and 4 involved semistructured interviews and focus groups, respectively, and used the Health Belief Model (HBM) as the framework to investigate drivers of poor hydroxyurea adherence and to inform the development of an app prototype. In addition, in phase 4, we have incorporated the patients’ feedback on the preliminary app prototype and its features. Results Barriers to hydroxyurea adherence were consistent with the literature and included forgetfulness and several specific thoughts and emotions associated with hydroxyurea use (eg, fear of side effects, depression, stigma, and hopelessness). In addition, more than half of the participants reported potentially low health literacy. Preferred patient app features included 7 key components, namely (1) medication reminders and tracker, (2) disease education, (3) communication, (4) personalization, (5) motivation, (6) support during pain episodes, and (7) social support. Utilizing a user-centered design approach, data obtained from patients and providers were translated into features within the app, mapping to components of the HBM and the specific drivers of hydroxyurea adherence and matching the literacy level of the population, resulting in the development of a novel mobile app called InCharge Health. Conclusions The InCharge Health app is an mHealth intervention developed with substantial input from users and by mapping the HBM as the framework that guided the choice for its components. InCharge Health is a customized product for the SCD population aimed at optimizing medication adherence, with the end goal of improving quality of life and health outcomes among patients with SCD. The efficacy and implementation of the InCharge Health app as an mHealth intervention to promote hydroxyurea adherence will be tested in a future stepped-wedge multicenter trial for adolescents and adults with SCD.

scholarly journals Technology Supporting Cognitively Impaired Older Adults: A Scoping Review for the ENHANCE Center

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 708-708
Author(s):  
Edie Sanders ◽  
Robin Stuart ◽  
Alexander Exum ◽  
Walter Boot
Keyword(s):  
Older Adults ◽  
Prospective Memory ◽  
Scoping Review ◽  
Adult Population ◽  
Relevant Literature ◽  
User Centered Design ◽  
Wide Range ◽  
Research Meeting ◽  
Older Adult Population ◽  
User Centered

Abstract Cognitive impairments (CIs) result in difficulties with a wide range of daily activities. Older adults are especially at risk for CIs, and as the older adult population increases, so does the importance of understanding and supporting the needs of those with CIs. The Enhancing Neurocognitive Health, Abilities, Networks, and Community Engagement (ENHANCE) Center was established with a focus on developing technology-based support for socialization, transportation, and prospective memory needs of older adults with CIs due to mild cognitive impairment (MCI), traumatic brain injury (TBI), and stroke. The extent to which relevant literature in these domains existed was unknown. We conducted a scoping review to identify existing research meeting the following criteria: participants aged 50+ years classified as having a CI due to MCI, TBI, or stroke; and a focus on technology-based support for socialization, transportation, and/or prospective memory needs. Using PRISMA guidelines, we searched three electronic databases, and reviewers screened citations for inclusion and completed data charting. Following screening, only 11 studies met our inclusion criteria. Qualitative and quantitative data are reported for each study. In addition to few studies available, it was common for studies to include 20 or fewer participants. Most assessed technology interactions at one time and few studies examined longitudinal use and benefits. While each paper examined one aspect of user-centered design, no technologies were reported that underwent all stages of the user-centered design process, from needs assessment to iterative design and usability testing, to efficacy trial. Such gaps highlight the important role ENHANCE can play.

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