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Quantifying usability: an evaluation of a diabetes mHealth system on effectiveness, efficiency, and satisfaction metrics with associated user characteristics
Blekinge Tekniska Högskola, Fakulteten för datavetenskaper, Institutionen för kreativa teknologier.ORCID-id: 0000-0002-9854-7690
2016 (engelsk)Inngår i: JAMIA Journal of the American Medical Informatics Association, ISSN 1067-5027, E-ISSN 1527-974X, Vol. 23, nr 1, s. 5-11Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Objective Mobile health (mHealth) systems are becoming more common for chronic disease management, but usability studies are still needed on patients' perspectives and mHealth interaction performance. This deficiency is addressed by our quantitative usability study of a mHealth diabetes system evaluating patients' task performance, satisfaction, and the relationship of these measures to user characteristics. Materials and Methods We used metrics in the International Organization for Standardization (ISO) 9241-11 standard. After standardized training, 10 patients performed representative tasks and were assessed on individual task success, errors, efficiency (time on task), satisfaction (System Usability Scale [SUS]) and user characteristics. Results Tasks of exporting and correcting values proved the most difficult, had the most errors, the lowest task success rates, and consumed the longest times on task. The average SUS satisfaction score was 80.5, indicating good but not excellent system usability. Data trends showed males were more successful in task completion, and younger participants had higher performance scores. Educational level did not influence performance, but a more recent diabetes diagnosis did. Patients with more experience in information technology (IT) also had higher performance rates. Discussion Difficult task performance indicated areas for redesign. Our methods can assist others in identifying areas in need of improvement. Data about user background and IT skills also showed how user characteristics influence performance and can provide future considerations for targeted mHealth designs. Conclusion Using the ISO 9241-11 usability standard, the SUS instrument for satisfaction and measuring user characteristics provided objective measures of patients' experienced usability. These could serve as an exemplar for standardized, quantitative methods for usability studies on mHealth systems.

sted, utgiver, år, opplag, sider
Oxford University Press, 2016. Vol. 23, nr 1, s. 5-11
Emneord [en]
diabetes; mobile health; self-management; usability evaluation; user-centered design
HSV kategori
Identifikatorer
URN: urn:nbn:se:bth-11378DOI: 10.1093/jamia/ocv099ISI: 000374179500003OAI: oai:DiVA.org:bth-11378DiVA, id: diva2:892108
Tilgjengelig fra: 2016-01-08 Laget: 2016-01-08 Sist oppdatert: 2018-01-26bibliografisk kontrollert
Inngår i avhandling
1. Toward Patient-centered, Standardized, and Reproducible Approaches of Evaluating the Usability of mHealth Chronic Disease Self-management Systems for Diabetes
Åpne denne publikasjonen i ny fane eller vindu >>Toward Patient-centered, Standardized, and Reproducible Approaches of Evaluating the Usability of mHealth Chronic Disease Self-management Systems for Diabetes
2018 (engelsk)Doktoravhandling, med artikler (Annet vitenskapelig)
Abstract [en]

Diabetes is a chronic disease affecting 422 million patients worldwide according to World Health Organization data with 30.3 million in the United States and 64 million in Europe. The prevalence speaks to the need for improved ways to support patients in disease self-management. mHealth solutions are increasingly used for this; however, usability is a current challenge affecting patients’ mHealth use. Recent literature emphasizes an increased focus on patient-centeredness in diabetes care, user-centeredness in chronic disease mHealth system design and standardized, systematic approaches for usability evaluation. The aim of this thesis and its individual studies was to incorporate these foci into the evaluation of two mobile health self-management systems for diabetes.

Study I used ISO standard 9241-11 to examine the relationship between selected group characteristics of diabetes patients on specific interaction outcomes to quantitatively identify needed system modifications. Study II utilized a multi-method design to assess diabetes patients’ mHealth usage and combined two novel analytic methods to structure and analyze results. Study III used a modified, user-oriented heuristic evaluation (HE) method, validated tasks and in-depth severity factor ratings to identify critical problems from patients’ point of view. By developing and employing a modified, user-centered cognitive walkthrough method (UC-CW), study IV assessed its effectiveness and efficiency in finding relevant usability problems for users as well as patients’ acceptance. The modified CW was validated against the golden-standard user test with Think Aloud.

Study I emphasized the importance of considering user characteristics in mHealth performance as these influenced interaction outcomes. All patients had difficulties with multiple-step tasks. Patients more recently diagnosed were able to perform tasks more successfully, with fewer errors and at faster times and had higher satisfaction scores; similar outcomes to the more experienced users. Educational level did not, however, seem to influence performance. In study II, the usability test with Think-Aloud (TA), in-depth interviews and questionnaires contributed to 19 consolidated issues, and triangulated on 5 critical usability problems for users. The combined analysis methods resulted in structured, categorized descriptions to aid in problem-solving. In Study III, the disease-related, critical information deficiencies found by expert evaluators using the modified, structured method also converged on and highlighted potentially adverse user concerns. Study IV demonstrated that the UC-CW found more critical user problems compared to the user test with TA despite both methods producing similar major average severity ratings and violations of heuristic categories. The modified method was more efficient per detected problem and experienced as less cognitively demanding and with a higher ease of use.

These studies offer different approaches that include patient-centered, efficient and user-acceptable methods and method modifications to detect critical usability issues for users. Importantly, improved mHealth designs for users could mean improvement in interactions, interaction performance, increased adoption, and long-term perhaps even increased adherence to interventions for chronic conditions.

sted, utgiver, år, opplag, sider
Karlskrona: Blekinge Tekniska Högskola, 2018. s. 165
Serie
Blekinge Institute of Technology Doctoral Dissertation Series, ISSN 1653-2090 ; 03
Emneord
Chronic Disease, Diabetes, Mobile Health, mHealth, Self-management, Usability Evaluation, User-centered Design
HSV kategori
Identifikatorer
urn:nbn:se:bth-15140 (URN)978-91-7295-349-9 (ISBN)
Disputas
2018-02-23, J1650, BTH, Valhallavägen 1, 37179, Karlskrona, 09:30 (svensk)
Opponent
Veileder
Merknad

Tillämpad Hälsoteknik

Applied Health Technology

Tilgjengelig fra: 2018-01-29 Laget: 2018-01-26 Sist oppdatert: 2018-04-06bibliografisk kontrollert

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