Eugène Loos

Using cognitive and affective illustrations to enhance older adults’ website satisfaction and recall of online cancer-related information

This study examined the effect of adding cognitive and affective illustrations to online health information (vs. text only) on older adults’ website satisfaction and recall of cancer-related information. Results of an online experiment among younger and older adults showed that illustrations increased satisfaction with attractiveness of the website. Younger adults were significantly more satisfied with the comprehensibility of the website than older adults, whereas older adults were more satisfied with perceived emotional support from the website than younger adults. Being more emotionally satisfied with the website led to greater recall of information for older adults, but not for younger adults. Illustrations can be used to enhance older adults’ website satisfaction and consequently recall of online cancer-related information.

In search of information on websites: a question of age?

To fight against info-exclusion in an aging society, it is important to make website information available to all generations. If we want to achieve this goal we need to know the impact of not only age but also gender, educational background and frequency of internet use. Therefore, this paper presents the results of an explorative Dutch eye-tracking case study, which focuses on information search behaviour (navigation patterns and use of the search box, effectiveness, efficiency and user satisfaction). 29 younger and 29 older participants completed a search task on three websites. It was found that the greatest factor impacting on information search behaviour is not always age. In one case, heatmaps showed clearly that the navigation patterns of older participants using internet daily were quite similar to those of younger ones. Finally, I present some implications for organisations wanting to (re)design their own website.

The effect of modality and narration style on recall of online health information: Results from a web-based experiment

Background Older adults are increasingly using the Internet for health information; however, they are often not able to correctly recall Web-based information (eHealth information). Recall of information is crucial for optimal health outcomes, such as adequate disease management and adherence to medical regimes. Combining effective message strategies may help to improve recall of eHealth information among older adults. Presenting information in an audiovisual format using conversational narration style is expected to optimize recall of information compared to other combinations of modality and narration style. Objective The aim of this paper is to investigate the effect of modality and narration style on recall of health information, and whether there are differences between younger and older adults. Methods We conducted a Web-based experiment using a 2 (modality: written vs audiovisual information) by 2 (narration style: formal vs conversational style) between-subjects design (N=440). Age was assessed in the questionnaire and included as a factor: younger (<65 years) versus older (≥65 years) age. Participants were randomly assigned to one of four experimental webpages where information about lung cancer treatment was presented. A Web-based questionnaire assessed recall of eHealth information. Results Audiovisual modality (vs written modality) was found to increase recall of information in both younger and older adults (P=.04). Although conversational narration style (vs formal narration style) did not increase recall of information (P=.17), a synergistic effect between modality and narration style was revealed: combining audiovisual information with conversational style outperformed combining written information with formal style (P=.01), as well as written information with conversational style (P=.045). This finding suggests that conversational style especially increases recall of information when presented audiovisually. This combination of modality and narration style improved recall of information among both younger and older adults. Conclusions We conclude that combining audiovisual information with conversational style is the best way to present eHealth information to younger and older adults. Even though older adults did not proportionally recall more when audiovisual information was combined with conversational style than younger adults, this study reveals interesting implications for improving eHealth information that is effective for both younger and older adults.

How Are Online Health Messages Processed? Using Eye Tracking to Predict Recall of Information in Younger and Older Adults

Little research has focused on what precedes the processing of health messages to predict recall of information and whether age matters in this regard. To address this gap, this study investigates the relationship between attention and recall among younger (<65 years) and older (≥65 years) adults. Using eye tracking, we exposed participants to a webpage consisting of text-only information, text with cognitive illustrations, or text with affective illustrations. When attention to text increased, older adults recalled more information, whereas younger adults did not. However, younger adults paid more attention to cognitive illustrations than older adults and recalled more information. These results reveal conditions under which health messages are effectively recalled by younger and older adults.

Online Health Information Tool Effectiveness for Older Patients: A Systematic Review of the Literature.

Online health information tools (OHITs) have been found to be effective in improving health outcomes. However, the effectiveness of these tools for older patients has been far from clear. This systematic literature review therefore provides an overview of online health information tool effectiveness for older patients using a two-dimensional framework of OHIT functions (i.e., providing information, enhancing information exchange, and promoting self-management) and outcomes (i.e., immediate, intermediate, and long-term outcomes). Comprehensive searches of the PubMed, EMBASE, and PsycINFO databases are conducted to identify eligible studies. Articles describing outcomes of patient-directed OHITs in which a mean sample or subgroup of age ≥65 years was used are included in the literature review. A best evidence synthesis analysis provides evidence that OHITs improve self-efficacy, blood pressure, hemoglobin levels, and cholesterol levels. Limited evidence is found in support of OHIT effects on knowledge, perceived social support, health service utilization, glycemic control, self-care adherence, exercise performance, endurance, and quality of life. OHITs seem promising tools to facilitate immediate, intermediate, and long-term outcomes in older patients by providing information, enhancing information exchange, and promoting self-management. However, future studies should evaluate the effectiveness of OHITs for older patients to achieve stronger levels of evidence.

Silver Gaming: Serious Fun for Seniors?

This exploratory qualitative study provides insight into the role that exergames play for seniors. 15 participants (aged 53–78) engaged in playing Your Shape Fitness Evolved 2 on the Xbox 360 Kinect, after which we conducted a semi-structured interview with each participant. We found that in all cases, the innate psychological needs of autonomy and competence (Self Determination Theory) were met. Playing the exergame served not only as a therapeutic instrument with a capability to exert a positive effect on physical and social wellbeing, it also brought entertainment, providing excitement and fun.

12 – Older Adults

This chapter is a review of user research involving eye tracking to gain insights into the extent that age has an impact on the way people navigate websites. It discusses how eye tracking can help researchers to understand the difficulties older adults have when using websites, applications, mobile devices, and other technologies.

Older Cancer Patients’ User Experiences With Web-Based Health Information Tools: A Think-Aloud Study

Background Health information is increasingly presented on the Internet. Several Web design guidelines for older Web users have been proposed; however, these guidelines are often not applied in website development. Furthermore, although we know that older individuals use the Internet to search for health information, we lack knowledge on how they use and evaluate Web-based health information. Objective This study evaluates user experiences with existing Web-based health information tools among older (≥ 65 years) cancer patients and survivors and their partners. The aim was to gain insight into usability issues and the perceived usefulness of cancer-related Web-based health information tools. Methods We conducted video-recorded think-aloud observations for 7 Web-based health information tools, specifically 3 websites providing cancer-related information, 3 Web-based question prompt lists (QPLs), and 1 values clarification tool, with colorectal cancer patients or survivors (n=15) and their partners (n=8) (median age: 73; interquartile range 70-79). Participants were asked to think aloud while performing search, evaluation, and application tasks using the Web-based health information tools. Results Overall, participants perceived Web-based health information tools as highly useful and indicated a willingness to use such tools. However, they experienced problems in terms of usability and perceived usefulness due to difficulties in using navigational elements, shortcomings in the layout, a lack of instructions on how to use the tools, difficulties with comprehensibility, and a large amount of variety in terms of the preferred amount of information. Although participants frequently commented that it was easy for them to find requested information, we observed that the large majority of the participants were not able to find it. Conclusions Overall, older cancer patients appreciate and are able to use cancer information websites. However, this study shows the importance of maintaining awareness of age-related problems such as cognitive and functional decline and navigation difficulties with this target group in mind. The results of this study can be used to design usable and useful Web-based health information tools for older (cancer) patients.

Exergaming: Meaningful Play for Older Adults?

Dutch historian Johan Huizinga [1] viewed games as a fundamental aspect of life. As long ago as 1938, he observed that, next to “homo faber” (man the maker), there is also the concept of “homo ludens” (man the player). The aim of this paper is to explore what we can learn from previously conducted empirical studies about the motivation and capability of older adults to use exergames. We were guided by the following questions. To which extent: (1) Are older adults motivated to play exergames and why is this the case?, (2) Are older adults able to play exergames and why is this the case? and (3) Can the voices of the older players be heard in the empirical studies on exergaming in later life? We conducted a narrative literature review to gain insight, not only into the factors relating to older adults’ engaging in exergames, but also into the ways older adults themselves experience playing such games. To avoid a mainly functionalist perspective on play, we will also include hedonic aspects of playing exergames.

Visual Ageism in the Media

Researchers have long used content analysis techniques to document the frequency of stereotypical representations in the media, but the interest in studying ageism in the media is relatively recent. We approach older people’s representation in the media by considering visual aspects—depictions in visual documents, such as photos and video materials—with a focus on television programs and print and television advertisements. We introduce the concept of “visual ageism”: the social practice of visually underrepresenting older people or misrepresenting them in a prejudiced way. According to previous studies, over time, media representations of older people have moved from visual under- and misrepresentation (negative images) to more positive depictions. Our review of empirical studies conducted since 1950 in Europe and North America reveals that print and television advertisements started the transition towards a more positive visual representation of older people during the last decade of the twentieth century; followed by television programs some years later. This is probably due to the increase in third age rhetoric in the media, picturing younger-old adults as healthy and as potential consumers. Our analysis also shows that the older-old (fourth age) group continues to be underrepresented in the visual media. Finally, we suggest ways of reducing visual ageism by adopting a design for dynamic diversity approach.