A Health Literacy and Usability Heuristic Evaluation of a Mobile Consumer Health Application. Helen Monkman & Andre Kushniruk

Transcription

1 A Health Literacy and Usability Heuristic Evaluation of a Mobile Consumer Health Basics! Range! Cause! Application Helen Monkman & Andre Kushniruk August 22, 2013

2 Methods Results Discussion Closing Health Literacy and Usability 1. Health Literacy the ability to access, understand, evaluate and communicate information (Rootman & Gordon-El-Bihbety, 2008, p. 11) 2. Usability the extent to which a product can be used by specified users to achieve specified goals with effectiveness, efficiency and satisfaction in a specified context of use." (ISO )

3 Methods Results Discussion Closing Health Literacy and Usability Health Literacy Usability Consumer HISs If consumers cannot understand the content, they may have difficulty achieving their goals If the system is hard to use, consumers may have challenges accessing the information

4 Methods Results Discussion Closing The Health Literacy Challenge The value of consumer HISs hinge on aligning consumers levels of health literacy with the demands these systems place on health literacy System Demands on Health Literacy Consumers with Low Health Literacy

5 Methods Results Discussion Closing Lowering Demands on Health Literacy Validated measures for evaluating users levels of health literacy exist however, they do not measure system demands on health literacy Readability measures demands on health literacy but do not assess the impact of system display and design This study focused on lowering demands on health literacy through information display and design

6 Methods Results Discussion Closing Study Objectives To develop a new set of evidence-based heuristics that evaluate both usability and demands on health literacy Based on studies of usable health websites with participants who had limited health literacy To determine the utility of these heuristics in identifying opportunities to improve the usability and decrease demands on users levels of health literacy in a mobile consumer health application

7 Methods Results Discussion Closing Heuristic Evaluation Usability experts assess how well a system complies with design principles (i.e., heuristics) Existing heuristics, such as Nielsen s (1993), or new heuristics can be used When the system violates a given heuristic it is assigned a severity rating A new set of heuristics and severity scale were developed for this study

8 Methods Results Discussion Closing Severity Scale Development Tan, Liu and Bishu s (2009) severity scale was complemented with explanations of health literacy Mild Health Literacy: Most users will understand the content. Usability: Users can easily work around these problems. Moderate Health Literacy: Some users will understand the content. Misunderstanding will not result in harm to users. Usability: Users stumble over the problem, but can quickly adapt to it. Severe Health Literacy: Few consumers will understand the content. Misunderstanding could result in harm to users. Usability: Users have difficulty, but can find workarounds and where users are unable to complete tasks.

9 Methods Results Discussion Closing Heuristic Development Health Literacy Online: A guide to writing and designing easy-to-use health Web sites (HLO Guide) was parsed for design guidelines U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion (2010) Some guidelines were modified for mobile devices Guidelines (e.g., paragraphs < 3 lines; use bulleted lists; avoid long words) è 29 heuristics (e.g., Spacious) è 5 categories (e.g., Content)

10 Methods Results Discussion Closing Screens Content Display HLO Heuristics Home Screen, Registration Hierarchy, Promotion, Positive Tone, Specific, Colloquial, Accurate, Spacious, Personal, Headings Consistency, Font, Spacious, Location of Content, Images, Contrast, Accessibility Navigation Topics, Orientation, Back Button, Linear Navigation, Buttons, Links, Search Interactivity Engage, Print, Multimedia, New Media,

11 Methods Results Discussion Closing Procedure The mobile consumer health app was described as a clear and simple reference guide for everyone to understand his or her blood test reports An evaluation table of the heuristics and their ancillary guidelines was used to evaluate the app The investigator explored all of the app s screens and recorded violations, assigned severity ratings and took screenshots of violations

12 Methods Results Discussion Closing Frequency of Heuristic Violations Screens! Content! Display! Navigation! Interactivity! 0! 5! 10! 15!

13 Methods Results Discussion Closing Examples of Heuristic Violations Content Display Spacious (no bulleted lists, dense text) Specific (no actionable content) Colloquial (acronyms were not explained) Images (none to support written explanations) Font (small, not adjustable) Navigation Orientation (random list of 47 topics) Linear Navigation (not obvious more pages existed and available through swiping motion) Interactivity Print (could neither print nor the pages)

14 Methods Results Discussion Closing Orientation & Linear Navigation Specific App Re-Design Buttons & Colloquial Headings Font Spacious Linear Nav Print & Engage Link Accessibility Linear Nav

15 Methods Results Discussion Closing Discussion Evidence-based heuristics were developed for assessing demands on health literacy and usability These heuristics demonstrated utility in generating design recommendations to improve a mobile consumer health application This set of heuristics provides specific and objective design recommendations based on studies on users with limited health literacy

16 Methods Results Discussion Closing Conclusion Consumer health information systems should be designed with considerations for health literacy and usability Design methods involving users with limited health literacy may help ensure these criteria are met However, existing systems may benefit from inspection methods for adherence to guidelines for usability and health literacy

17 Methods Results Discussion Closing

18 Methods Results Discussion Closing References Rootman I, and Gordon-El-Bihbety D. A vision for a health literate Canada. Ottawa, ON: CPHA; ISO Ergonomic requirements for office work with visual display terminals (VDTs) Part 11: Guidance on usability. International Organization for Standardization; Tan W, Liu D, and Bishu R. Web evaluation: Heuristic evaluation vs. user testing. Int J Ind Ergonom 2009; 39(4): U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion. Health literacy online: A guide to writing and designing easy-to-use health Web sites. Washington, DC

19 Methods Results Discussion Closing Appendix Screens Heuristics Screens Home Screen Registration Have a simple and engaging home page. Make registration and logging in as simple and obvious as possible

20 Methods Results Discussion Closing Appendix Content Heuristics Content Hierarchy Promotion Positive Tone Specific Colloquial Accurate Spacious Personal Headings Put the most important information first. Tell users what to do and how to do it. Stay positive and realistic. Include the benefits of taking action. Provide specific action steps. Write in plain language. Check content for accuracy. Display content clearly on the page. Include a limited amount of interactive content that users can tailor. Use meaningful headings.

21 Methods Results Discussion Closing Appendix - Heuristics Display Consistency Font Spacious Location of Content Images Contrast Accessibility Ensure styles are consistent. Ensure the font is easy to read. Use white space and avoid clutter. Keep content in the center of the screen and above the fold. Use images that facilitate learning. Use bold colors with contrast and avoid dark or busy backgrounds. Make the system accessible to people with disabilities.

22 Methods Results Discussion Closing Appendix - Heuristics Navigation Topics Orientation Back Button Linear Navigation Buttons Links Search Put topics in multiple categories. Enable easy access to home and menu screens. Make sure the Back button works. Use linear information paths (e.g., numbered screens). Simplify screen-based controls and enlarge buttons. Label links clearly and use them effectively. Include simple search and browse options.

23 Methods Results Discussion Closing Appendix - Heuristics Interactivity Engage Print Multimedia New Media Invite users to share content and provide feedback about their experiences. Include printer-friendly tools and resources. Incorporate audio and visual features. Explore new media such as Twitter or text messaging.