Amsterdam UMC, University of Amsterdam, Department of Medical Informatics, Center for Human Factors Engineering of Health Information Technology (HIT-Lab), the Netherlands; Amsterdam UMC, Department of Medical Informatics, Amsterdam Public Health Research Institute, Meibergdreef 9, Amsterdam, the Netherlands.
Amsterdam UMC, University of Amsterdam, Department of Medical Informatics, Center for Human Factors Engineering of Health Information Technology (HIT-Lab), the Netherlands; Amsterdam UMC, Department of Medical Informatics, Amsterdam Public Health Research Institute, Meibergdreef 9, Amsterdam, the Netherlands.
Int J Med Inform. 2019 Apr;124:68-77. doi: 10.1016/j.ijmedinf.2019.01.006. Epub 2019 Jan 15.
BACKGROUND: With populations aging, digital health tools and mobile health applications (mHealth) are becoming more common to assist older people in independent living and self-management of (chronic) illnesses. These mHealth services can be beneficial to older patients, provided that they are adjusted to their needs and characteristics, as the current mHealth landscape lacks user-friendly services for this target group. Understanding of intrinsic aging barriers, which cause and impact usability problems older patients encounter, is needed to achieve this. OBJECTIVES: This study set out to assess usability problems older patients encounter in two mHealth apps and aims to show the value of MOLD-US, a recent aging barriers framework, as a classification tool to identify the intrinsic cause of these problems. METHOD: A case-study design, with in-depth analysis of usability issues older adult patients' experience. Data on usability issues were collected using the Think Aloud Protocol for two mHealth apps. The MOLD-US framework and Nielsen's severity rating were used to classify identified issues and their potential impact. RESULTS: In total 28 high severe usability issues of the mHealth apps were identified. Core natures of most issues were related to motivational and cognitive barriers of older adults. Participants had difficulties in understanding the navigation structure of the apps. Important text, buttons and icon elements were overseen. CONCLUSION: Current knowledge on creating interfaces for older target groups is not well applied within the assessed mHealth designs. Specifically, design guidelines should address older adults' diminishing cognition skills, physical ability and motivational barriers. By classifying usability problems with MOLD-US, insights on these barriers can be enhanced to adequately address these issues in new designs. In addition, we propose that future research focuses on investigating suitable usability evaluation methods adapted to older patients' characteristics to ultimately be able to gain unbiased sight on usability issues older patients may experience while interacting with technology.
背景：随着人口老龄化，数字健康工具和移动健康应用程序（mHealth）越来越普及，可帮助老年人实现独立生活和慢性病的自我管理。这些 mHealth 服务对老年患者可能有益，但前提是要根据他们的需求和特点进行调整，因为当前的 mHealth 领域缺乏针对这一目标群体的用户友好型服务。要实现这一目标，需要了解导致和影响老年患者遇到的可用性问题的内在老化障碍。
目的：本研究旨在评估两名老年患者在两款 mHealth 应用程序中遇到的可用性问题，并旨在展示最近的老化障碍框架 MOLD-US 的价值，将其作为一种分类工具，以确定这些问题的内在原因。
方法：采用案例研究设计，深入分析老年患者体验的可用性问题。使用出声思维法收集关于 mHealth 应用程序的可用性问题的数据。使用 MOLD-US 框架和尼尔森的严重程度评分对确定的问题及其潜在影响进行分类。
结果：共确定了 28 个 mHealth 应用程序的高严重性可用性问题。大多数问题的核心性质都与老年人的动机和认知障碍有关。参与者在理解应用程序的导航结构方面存在困难。重要的文本、按钮和图标元素被忽略。
结论：在评估的 mHealth 设计中，当前关于为老年目标群体创建界面的知识应用得并不充分。具体而言，设计指南应解决老年人认知能力下降、身体能力下降和动机障碍等问题。通过使用 MOLD-US 对可用性问题进行分类，可以增强对这些障碍的认识，以便在新设计中充分解决这些问题。此外，我们建议未来的研究侧重于调查适合老年患者特征的合适的可用性评估方法，以便最终能够公正地了解老年患者在与技术交互时可能遇到的可用性问题。
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