Margaux M. Price

Age-Sensitive Design of Online Health Information: Comparative Usability Study

Background Older adults’ health maintenance may be enhanced by having access to online health information. However, usability issues may prevent older adults from easily accessing such information. Prior research has shown that aging is associated with a unique pattern of cognitive changes, and knowledge of these changes may be used in the design of health websites for older adults. Objective The goal of the current study was to examine whether older adults use of a health information website was affected by an alternative information architecture and access interface (hierarchical versus tag-based). Methods Fifty younger adults (aged 18-23) and 50 older adults (aged 60-80) navigated a health information website, which was organized hierarchically or used tags/keywords, to find answers to health-related questions while their performance was tracked. We hypothesized that older adults would perform better in the tag-based health information website because it placed greater demands on abilities that remain intact with aging (verbal ability and vocabulary). Results The pattern of age-related differences in computer use was consistent with prior research with older adults. We found that older adults had been using computers for less time (F 1,98= 10.6, P= .002) and used them less often (F 1,98= 11.3, P= .001) than younger adults. Also consistent with the cognitive aging literature, younger adults had greater spatial visualization and orientation abilities (F 1,98= 34.6, P< .001 and F 1,98= 6.8, P= .01) and a larger memory span (F 1,98= 5.7, P= .02) than older adults, but older adults had greater vocabulary (F 1,98= 11.4, P= .001). Older adults also took significantly more medications than younger adults (F 1,98= 57.7, P< .001). In the information search task, older adults performed worse than younger adults (F 1,96= 18.0, P< .001). However, there was a significant age × condition interaction indicating that while younger adults outperformed older adults in the hierarchical condition (F 1,96= 25.2, P< .001), there were no significant age-related differences in the tag-based condition, indicating that older adults performed as well as younger adults in this condition. Conclusions Access to online health information is increasing in popularity and can lead to a more informed health consumer. However, usability barriers may differentially affect older adults. The results of the current study suggest that the design of health information websites that take into account age-related changes in cognition can enhance older adults’ access to such information.

Aggregate gaze visualization with real-time heatmaps

A GPU implementation is given for real-time visualization of aggregate eye movements (gaze) via heatmaps. Parallelization of the algorithm leads to substantial speedup over its CPU-based implementation and, for the first time, allows real-time rendering of heatmaps atop video. GLSL shader colorization allows the choice of color ramps. Several luminance-based color maps are advocated as alternatives to the popular rainbow color map, considered inappropriate (harmful) for depiction of (relative) gaze distributions.

Older adults' perceptions of usefulness of personal health records

Electronic personal health records (PHRs) have the potential to both make health information more accessible to patients and function as a decision-support system for patients managing chronic conditions. Age-related changes in cognition may make traditional strategies of integrating and understanding existing (i.e., paper-based) health information more difficult for older adults. The centralized and integrated nature of health information, as well as the long-term tracking capabilities present in many PHRs, may be especially beneficial for older patients’ management of health. However, older adults tend to be late adopters of technology and may be hesitant to adopt a PHR if the benefits are not made clear (perceived usefulness). Toward the design of a useful PHR, a needs analysis was conducted to determine how people currently manage their health information, what they perceive as useful, and to identify any unmet needs. This paper describes two qualitative studies examining the health information needs of both younger and older adults. The first study used a 2-week diary methodology to examine everyday health questions or concerns, while the second study examined maintenance of health information and perceptions of PHRs through the use of a three-part interview. User’s perceptions of the usefulness of PHRs are provided as recommendations for the design of e-health technology, especially those targeted for older adult healthcare consumers. The results suggest that both older and younger adults would deem a PHR useful if it provides memory support in the form of reminders, provides tools to aid in comprehension of one’s health concerns, is interactive and provides automatic functions, and is highly accessible to authorized users, yet one’s information is kept secure and private.

How is Prospective Memory Used to Complete Instrumental Activities of Daily Living? Examining the Topic Through Focus Groups with Older Adults: Pilot Results

A key goal of many older adults is to maintain an independent lifestyle, but in order to live independently in the community, it is necessary that older adults are able to perform instrumental activities of daily living (IADLs). Many IADLs require the use of prospective memory (PM), however the research documenting the specific PM tasks people encounter when performing IADLs is scant. The current paper describes a proposed study and lessons learned from a pilot study aimed at narrowing the gap in the literature, by identifying common PM tasks older adults encounter when performing IADLs. Specifically, we aim to 1) identify PM tasks older adults must remember and those they forget when performing IADLs, 2) describe the nature of the PM tasks, 3) pinpoint memory aids that are used to help remember the PM tasks, and 4) offer human factors design recommendations based on our findings to help improve memory aids and decrease forgetting.

How Does Anthropomorphism Affect User’s Trust, Compliance, and Performance On a Decision Making Automation Task?

Automation is becoming increasingly prevalent, as new technology develops to replace tasks humans once performed. Users‘ adoption of the technology depends on several factors, particularly how much they trust the automation. One important, yet understudied factor that may influence trust in automation is how ‘humanlike’ the interface is, or how anthropomorphic the features of the computer are. The current study seeks to examine the effect of anthropomorphic automation on user‘s trust, compliance, and performance on a challenging diabetes related decision-making task. We hypothesize that anthropomorphic automation will engender more social responses (e.g., trust), which would affect compliance and performance.

Examining Non-Critical Health Information Seeking: A Needs Analysis for Personal Health Records

Keeping track of health information may be burdensome for older adults who may be more likely to have health concerns and questions than other age groups. The management of their health information may be aided by web-based health information management tools (e.g., personal health records). However, it is currently not known what kinds of health information potential users seek and need or want to manage. The current study examined the health information needs of both older and younger adults, to better understand how e-health technology can aid health information management. Seventeen younger and twenty-four older adults kept a health diary for a two-week period, making one entry for each health concern or question they had and how they solved it.

Effects of Information Visualization on Older Adults’ Decision-Making Performance in a Medicare Plan Selection Task: A Comparative Usability Study

Background Technology gains have improved tools for evaluating complex tasks by providing environmental supports (ES) that increase ease of use and improve performance outcomes through the use of information visualizations (info-vis). Complex info-vis emphasize the need to understand individual differences in abilities of target users, the key cognitive abilities needed to execute a decision task, and the graphical elements that can serve as the most effective ES. Older adults may be one such target user group that would benefit from increased ES to mitigate specific declines in cognitive abilities. For example, choosing a prescription drug plan is a necessary and complex task that can impact quality of life if the wrong choice is made. The decision to enroll in one plan over another can involve comparing over 15 plans across many categories. Within this context, the large amount of complex information and reduced working memory capacity puts older adults’ decision making at a disadvantage. An intentionally designed ES, such as an info-vis that reduces working memory demand, may assist older adults in making the most effective decision among many options. Objective The objective of this study is to examine whether the use of an info-vis can lower working memory demands and positively affect complex decision-making performance of older adults in the context of choosing a Medicare prescription drug plan. Methods Participants performed a computerized decision-making task in the context of finding the best health care plan. Data included quantitative decision-making performance indicators and surveys examining previous history with purchasing insurance. Participants used a colored info-vis ES or a table (no ES) to perform the decision task. Task difficulty was manipulated by increasing the number of selection criteria used to make an accurate decision. A repeated measures analysis was performed to examine differences between the two table designs. Results Twenty-three older adults between the ages of 66 and 80 completed the study. There was a main effect for accuracy such that older adults made more accurate decisions in the color info-vis condition than the table condition. In the low difficulty condition, participants were more successful at choosing the correct answer when the question was about the gap coverage attribute in the info-vis condition. Participants also made significantly faster decisions in the info-vis condition than in the table condition. Conclusions Reducing the working memory demand of the task through the use of an ES can improve decision accuracy, especially when selection criteria is only focused on a single attribute of the insurance plan.

Information Visualizations as Complex Decision Support Systems

Older adults are faced with complex decision tasks that impose high working memory demands. A representative task is choosing a prescription drug plan from a multitude of options that must be evaluated along many factors. The combined effect of the quantity of complex information, and reduced working memory capacity puts older adults at a disadvantage. However, research with younger adults suggests that the working memory burden of decision tasks can be reduced using well-designed graphic decision aids. The current study examines the feasibility of using information visualizations as a decision support system for complex decision tasks. Findings from this study will be used to make recommendations for visualizations as complex decision support systems.