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 ◽  
...  
2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 708-708
Author(s):  
Edie Sanders ◽  
Robin Stuart ◽  
Alexander Exum ◽  
Walter Boot

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.


10.2196/17809 ◽  
2020 ◽  
Vol 22 (9) ◽  
pp. e17809 ◽  
Author(s):  
Vera Stara ◽  
Sara Santini ◽  
Johannes Kropf ◽  
Barbara D'Amen

Background The rapid increase of the aging population is pushing many national governments to reshape retirement legislation in order to extend older adults’ working life. Once retired, older adults can be invaluable resources for the community as family carers, as volunteers, or by returning to work. Healthy aging is one of the main conditions for being able to work longer and being active after retirement. The latter, indeed, represents a very sensitive life transition, which can entail psychological and social difficulties. Interventions for promoting older workers’ health and well-being and supporting the transition to retirement are on the top of the policy agenda of most European countries. Recently, computer-based and digital health interventions have been seen as promising means to reach this purpose. Objective This systematic literature review aimed to explore studies on digital health coaching programs for older workers that followed a user-centered design approach and evaluated their effectiveness in providing older adults with guidance for adopting a healthy lifestyle and being active in the community. Methods The search identified 1931 papers, and 2 relevant articles were selected by applying specific eligibility criteria. Results To our knowledge, only few digital health coaching programs have targeted the population of older workers to date; there is an insufficient number of studies on the efficacy of such programs. The results show the difficulties of assessing the efficacy of digital coaching itself and with respect to older employees. The 2 studies suggest that digital health programs for workplaces can improve various aspects of older employees’ well-being; however, they considered health mainly from a physical perspective and neglected contextual, social, psychological, and cultural factors that can influence older workers’ health and general well-being. Future digital health coaching programs should adopt the healthy aging paradigm as a multidimensional lens for interpreting the impact of eHealth technology on aging and retirement. The literature around this issue remains at an embryonic state, and this gap needs to be filled by further investigations that apply a user-centered approach for designing the technology, test innovative research methodologies, and adopt new technical solutions for high-quality interaction design. Conclusions Further digital health coaching programs aimed at supporting healthy and active living for older workers and retirees are necessary. The user-centered design approach is recommended in order to fully address the users’ health needs and the technological requirements throughout development. Moreover, the healthy aging perspective allows inclusion of physical, social, and psychological factors influencing the transition from work to retirement, as well as the experiences and interactions of individuals with the technology.


10.2196/17703 ◽  
2020 ◽  
Vol 8 (7) ◽  
pp. e17703 ◽  
Author(s):  
Victor Philip Cornet ◽  
Tammy Toscos ◽  
Davide Bolchini ◽  
Romisa Rohani Ghahari ◽  
Ryan Ahmed ◽  
...  

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.


Author(s):  
Mirjam Ekstedt ◽  
Marie Kirsebom ◽  
Gunilla Lindqvist ◽  
Åsa Kneck ◽  
Oscar Frykholm ◽  
...  

The increasing prevalence of chronic conditions and multimorbidity poses great challenges to healthcare systems. As patients’ engagement in self-managing their chronic conditions becomes increasingly important, eHealth interventions are a promising resource for the provision of adequate and timely support. However, there is inconclusive evidence about how to design eHealth services to meet the complex needs of patients. This study applied an evidence-based and theory-informed user-centered design approach in three phases to identify the needs of older adults and healthcare professionals in the collaborative management of multimorbidity (phase 1), develop an eHealth service to address these needs (phase 2), and test the feasibility and acceptance of the eHealth service in a clinical setting (phase 3). Twenty-two user needs were identified and a web-based application—ePATH (electronic Patient Activation in Treatment at Home)—with separate user interfaces for patients and healthcare professionals was developed. The feasibility study with two nurses and five patients led to a redesign and highlighted the importance of adequately addressing not only varying user needs but also the complex nature of healthcare organizations when implementing new services and processes in chronic care management.


2020 ◽  
Author(s):  
Vera Stara ◽  
Sara Santini ◽  
Johannes Kropf ◽  
Barbara D'Amen

BACKGROUND The rapid increase of the aging population is pushing many national governments to reshape retirement legislation in order to extend older adults’ working life. Once retired, older adults can be invaluable resources for the community as family carers, as volunteers, or by returning to work. Healthy aging is one of the main conditions for being able to work longer and being active after retirement. The latter, indeed, represents a very sensitive life transition, which can entail psychological and social difficulties. Interventions for promoting older workers’ health and well-being and supporting the transition to retirement are on the top of the policy agenda of most European countries. Recently, computer-based and digital health interventions have been seen as promising means to reach this purpose. OBJECTIVE This systematic literature review aimed to explore studies on digital health coaching programs for older workers that followed a user-centered design approach and evaluated their effectiveness in providing older adults with guidance for adopting a healthy lifestyle and being active in the community. METHODS The search identified 1931 papers, and 2 relevant articles were selected by applying specific eligibility criteria. RESULTS To our knowledge, only few digital health coaching programs have targeted the population of older workers to date; there is an insufficient number of studies on the efficacy of such programs. The results show the difficulties of assessing the efficacy of digital coaching itself and with respect to older employees. The 2 studies suggest that digital health programs for workplaces can improve various aspects of older employees’ well-being; however, they considered health mainly from a physical perspective and neglected contextual, social, psychological, and cultural factors that can influence older workers’ health and general well-being. Future digital health coaching programs should adopt the healthy aging paradigm as a multidimensional lens for interpreting the impact of eHealth technology on aging and retirement. The literature around this issue remains at an embryonic state, and this gap needs to be filled by further investigations that apply a user-centered approach for designing the technology, test innovative research methodologies, and adopt new technical solutions for high-quality interaction design. CONCLUSIONS Further digital health coaching programs aimed at supporting healthy and active living for older workers and retirees are necessary. The user-centered design approach is recommended in order to fully address the users’ health needs and the technological requirements throughout development. Moreover, the healthy aging perspective allows inclusion of physical, social, and psychological factors influencing the transition from work to retirement, as well as the experiences and interactions of individuals with the technology.


10.2196/16862 ◽  
2020 ◽  
Vol 8 (8) ◽  
pp. e16862
Author(s):  
Curtis Lee Petersen ◽  
Ryan Halter ◽  
David Kotz ◽  
Lorie Loeb ◽  
Summer Cook ◽  
...  

Background Sarcopenia, defined as the age-associated loss of muscle mass and strength, can be effectively mitigated through resistance-based physical activity. With compliance at approximately 40% for home-based exercise prescriptions, implementing a remote sensing system would help patients and clinicians to better understand treatment progress and increase compliance. The inclusion of end users in the development of mobile apps for remote-sensing systems can ensure that they are both user friendly and facilitate compliance. With advancements in natural language processing (NLP), there is potential for these methods to be used with data collected through the user-centered design process. Objective This study aims to develop a mobile app for a novel device through a user-centered design process with both older adults and clinicians while exploring whether data collected through this process can be used in NLP and sentiment analysis Methods Through a user-centered design process, we conducted semistructured interviews during the development of a geriatric-friendly Bluetooth-connected resistance exercise band app. We interviewed patients and clinicians at weeks 0, 5, and 10 of the app development. Each semistructured interview consisted of heuristic evaluations, cognitive walkthroughs, and observations. We used the Bing sentiment library for a sentiment analysis of interview transcripts and then applied NLP-based latent Dirichlet allocation (LDA) topic modeling to identify differences and similarities in patient and clinician participant interviews. Sentiment was defined as the sum of positive and negative words (each word with a +1 or −1 value). To assess utility, we used quantitative assessment questionnaires—System Usability Scale (SUS) and Usefulness, Satisfaction, and Ease of use (USE). Finally, we used multivariate linear models—adjusting for age, sex, subject group (clinician vs patient), and development—to explore the association between sentiment analysis and SUS and USE outcomes. Results The mean age of the 22 participants was 68 (SD 14) years, and 17 (77%) were female. The overall mean SUS and USE scores were 66.4 (SD 13.6) and 41.3 (SD 15.2), respectively. Both patients and clinicians provided valuable insights into the needs of older adults when designing and building an app. The mean positive-negative sentiment per sentence was 0.19 (SD 0.21) and 0.47 (SD 0.21) for patient and clinician interviews, respectively. We found a positive association with positive sentiment in an interview and SUS score (ß=1.38; 95% CI 0.37 to 2.39; P=.01). There was no significant association between sentiment and the USE score. The LDA analysis found no overlap between patients and clinicians in the 8 identified topics. Conclusions Involving patients and clinicians allowed us to design and build an app that is user friendly for older adults while supporting compliance. This is the first analysis using NLP and usability questionnaires in the quantification of user-centered design of technology for older adults.


2016 ◽  
Vol 1 (2) ◽  
pp. 24-50
Author(s):  
Tracy L. Mitzner ◽  
Katinka Dijkstra

Health care related technology, or E-health, has the potential to lessen the impact of the growing aging population on the health care system and support older adults' preference for aging in place. However, for technologies to be adopted by older users, research is needed to understand older adults' unique health care needs, their preferences for support, and their perceptions of technologies designed for health care. Specifically directed toward older users, this article highlights the need for user-centered design and the implications for technology acceptance, and describes studies that employed systematic subjective methods such as focus groups, interviews, and questionnaires to provide a rich, detailed depiction of older users' interactions with E-health. User-centered design evaluations involving older adults can help designers create products and services that are more likely to be adopted by older adult end users.


2020 ◽  
Author(s):  
Jason Fanning ◽  
Amber Brooks ◽  
Edward Ip ◽  
Barbara Nicklas ◽  
W. Jack Rejeski

BACKGROUND Participating in physical activity and minimizing time spent sitting is an effective strategy for managing pain in older adults. Theory-based mHealth tools are integral to effective day-long physical activity interventions, but it is vital that mHealth tools undergo an iterative development process alongside members of the target population to ensure their uptake and use. OBJECTIVE We subjected a preliminary social cognitive smartphone application (Companion App) designed to promote day-long movement to a user centered design process with the assistance of low-active older adults with chronic multisite pain. The Companion App integrates ecological momentary assessments of pain, Fitbit activity monitor data, and smart weight scale data to provide real-time feedback on the relationships between movement, sitting, and pain and to facilitate goal setting and achievement. METHODS We recruited participants (N=5; 71.8 5.54 years old) sequentially to participate in a three-phase iterative design study. First, each participant received a brief orientation to physical activity, was exposed to the application, and engaged in a Think Aloud protocol. Use and usability issues were noted by study staff. The participant then used the app for one week in their daily lives, and then returned to provide feedback. Issues were identified from participant feedback, discussed with the study team, and modified before the next participant began the study. RESULTS Participant interviews yielded feedback in areas related to technology selection and operation, app design/form, and intervention clarity. Regarding technology, the use of the Fitbit activity monitor revealed no issues, but there were barriers to the use of the Fitbit Aria 2 scale, including incompatibility with a widely used home internet router. Switching to a cellular enabled scale alleviated this issue. With regard to form, modifications were made to several key interface elements in response to participant feedback to aid in clarity. Finally, initial participant experiences revealed the need to separate the intervention orientation from the technology orientation to minimize informational load. CONCLUSIONS Our brief user-centered design process produced key changes in our intervention orientation, the form and function of the Companion App, and the technologies that support the app. These are vital elements that are likely to hamper the perceived usefulness and utility of the Companion App in the context of a large trial and eventual public use. We recommend the conduct of such a process any time mHealth is used in research or medicine to account for changing populations and preferences. Moreover, publication of lessons learned can help to establish a foundation of knowledge for designing apps for underserved populations such as older adults. CLINICALTRIAL ClinicalTrials.gov Identifier: NCT03377634


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