Paula J. Edwards

Older adults and visual impairment: what do exposure times and accuracy tell us about performance gains associated with multimodal feedback?

This study examines the effects of multimodal feedback on the performance of older adults with different visual abilities. Older adults possessing normal vision (n=29) and those who have been diagnosed with Age-Related Macular Degeneration (n=30) performed a series of drag-and-drop tasks under varying forms of feedback. User performance was assessed with measures of feedback exposure times and accuracy. Results indicated that for some cases, non-visual (e.g. auditory or haptic) and multimodal (bi- and trimodal) feedback forms demonstrated significant performance gains over the visual feedback form, for both AMD and normally sighted users. In addition to visual acuity, effects of manual dexterity and computer experience are considered.

Toward achieving universal usability for older adults through multimodal feedback

This experiment examines the effect of combinations of feedback (auditory, haptic, and/or visual) on the performance of older adults completing a drag-and-drop computer task. Participants completed a series of drag-and-drop tasks under each of seven feedback conditions (3 unimodal, 3 bimodal, 1 trimodal). Performance was assessed using measures of efficiency and accuracy. For analyses of results, participants were grouped based on their level of computer experience. All users performed well under auditory-haptic bimodal feedback and experienced users responded well to all multimodal feedback. Based on performance benefits for older adults seen in this experiment, future research should extend investigations to effectively integrate multimodal feedback into GUI interfaces in order to improve usability for this growing and diverse user group.

The effects of multimodal feedback on older adults' task performance given varying levels of computer experience

This experiment examines the effect that computer experience and various combinations of feedback (auditory, haptic, and/or visual) have on the performance of older adults completing a drag-and-drop task on a computer. Participants were divided into three computer experience groups, based on their frequency of use and breadth of computer knowledge. Each participant completed a series of drag-and-drop tasks under each of seven feedback conditions (three unimodal, three bimodal, one trimodal). Performance was assessed using measures of efficiency and accuracy. Experienced users responded well to all multimodal feedback while users without experience responded well to auditory-haptic bimodal, but poorly to haptic-visual bimodal feedback. Based on performance benefits for older adults seen in this experiment, future research should extend investigations to effectively integrate multimodal feedback into GUI interfaces in order to improve usability for this growing and diverse user group.

Isolating the effects of visual impairment: exploring the effect of AMD on the utility of multimodal feedback

This study examines the effects of multimodal feedback on the performance of older adults with an ocular disease, Age-Related Macular Degeneration (AMD), when completing a simple computer-based task. Visually healthy older users (n = 6) and older users with AMD (n = 6) performed a series of drag-and-drop tasks that incorporated a variety of different feedback modalities. The user groups were equivalent with respect to traditional visual function metrics and measured subject cofactors, aside from the presence or absence of AMD. Results indicate that users with AMD exhibited decreased performance, with respect to required feedback exposure time. Some non-visual and multimodal feedback forms show potential as solutions to enhance performance, for those with AMD as well as for visually healthy older adults.

Multimodal Feedback as a Solution to Ocular Disease-Based User Performance Decrements in the Absence of Functional Visual Loss

This study examines effects of the most common cause of blindness in persons over the age of 55 in the United States, age-related macular degeneration (AMD), on the performance of older adults when completing a simple computer-based task. Older users with normal vision (n = 6) and with AMD (n = 6) performed a series of drag-and-drop tasks that incorporated a variety of different feedback modalities. The user groups were equivalent with respect to traditional visual function parameters (i.e., visual acuity, contrast sensitivity, and color vision) and measured subject cofactors, aside from the presence or absence of AMD (i.e., drusen and retinal pigment epithelial mottling). Task performance was assessed with measures of time (trial time and feedback exposure time) and accuracy (error frequency). Results indicate that users with AMD exhibited decreased performance with respect to required feedback exposure time, total trial time, and errors committed. Some nonvisual and multimodal feedback forms show potential as solutions for enhanced performance, for those with AMD as well as for visually healthy older adults.

Primary care providers as partners in long-term follow-up of pediatric cancer survivors

PurposeTo develop a model of shared healthcare delivery that includes primary care providers (PCP) and ensures best practice in follow-up of pediatric cancer survivors.MethodStructured interviews with healthcare professionals (HCPs) were used to ascertain familiarity and confidence in providing care to survivors. Partnerships were made with HCP societies, and survivor care lectures were given at HCP meetings. HCP’s preferences for ongoing continuing education (CE) opportunities were ascertained. Cancer SurvivorLinkTM, a web-based tool, was developed to allow patients to securely store their healthcare documents and share them electronically with registered HCPs. Educational material developed for Cancer SurvivorLinkTM includes CE modules and QuickFacts—concise summaries of late effects. Website utilization was monitored utilizing Google Analytics.ResultsHCPs described moderate to very low familiarity with survivor care, but high interest in online CE learning. Thirty-one lectures were given to HCP groups to increase awareness. Preferred types of ongoing CE were: lectures, online text, and video modules. CE material was developed based on feedback from HCPs and website utilizations and includes 19 QuickFacts and 5 CE modules. During the first year, the website had 471 unique visitors and 1,129 total visits. QuickFacts received 345 views with Neurocognitive, Survivor Care 101, and Endocrine being most visited, and 49 CME modules have been completed.ConclusionsPCPs are interested in partnering in models of shared care for pediatric cancer survivors. Effective educational initiatives include lectures within HCP’s professional education constructs and web-based CE opportunities. PCP involvement in survivor care alleviates some barriers to care such as geographic distance to the the cancer center and ensures that more pediatric cancer survivors receive recommended coordinated surveillance for late effects of cancer therapy.

Understanding users with Diabetic Retinopathy: factors that affect performance in a menu selection task

This paper examines factors that affect performance on a basic menu selection task by users who are visually healthy and users with Diabetic Retinopathy (DR) in order to inform better interface design. Linear and logistic regression models were used to examine various contextual factors that influenced task efficiency (time) and accuracy (errors). Interface characteristics such as multimodal feedback, Windows® accessibility settings, and menu item location were investigated along with various visual function and participant characteristics. Results indicated that Windows® accessibility settings and other factors, including age, computer experience, visual acuity, contrast sensitivity, and menu item location, were significant predictors of task performance.

Empirical validation of the Windows® accessibility settings and multimodal feedback for a menu selection task for users with Diabetic Retinopathy

This study investigates the effectiveness of two design interventions, the Microsoft® Windows® accessibility settings and multimodal feedback, aimed at the enhancement of a menu selection task, for users with diabetic retinopathy (DR) with stratified levels of visual dysfunction. Several menu selection task performance measures, both time- and accuracy-based, were explored across different interface conditions and across groups of participants stratified by different degrees of vision loss. The results showed that the Windows® accessibility settings had a significant positive impact on performance for participants with DR. Moreover, multimodal feedback had a negligible effect for all participants. Strategies for applying multimodal feedback to menu selection are discussed, as well as the potential benefits and drawbacks of the Windows® accessibility settings.

Strategic design for users with diabetic retinopathy: factors influencing performance in a menu-selection task

This paper examines factors that affect performance of a basic menu selection task by users who are visually healthy and users with Diabetic Retinopathy (DR) in order to inform better interface design. Interface characteristics such as multimodal feedback, Windows® accessibility settings, and menu item location were investigated. Analyses of Variance (ANOVA) were employed to examine the effects of interface features on task performance. Linear regression was used to further examine and model various contextual factors that influenced task performance. Results indicated that Windows® accessibility settings significantly improved performance of participants with more progressed DR. Additionally, other factors, including age, computer experience, visual acuity, and menu location were significant predictors of the time required for subjects to complete the task.

Implementing a Pharmacy System: Facilitators and Barriers

To describe facilitators and barriers to the implementation of an inpatient pharmacy system at two pediatric hospitals. Interviews, pre- and post-implementation, were conducted with pharmacy and clinical managers. Key findings from the pre-implementation survey were included in the post-implementation survey to further assess facilitators and barriers to the adoption of a pharmacy system. The majority of pharmacy participants and all clinical leaders believed that project goals were being met. Pharmacist’s described staff readiness-to-change as the most significant facilitator to adoption and concerns with the usability of information in the pediatric drug file as the most significant barrier. Clinical managers described system training and education as the most significant facilitator to adoption and adjustment to new work processes as the most significant barrier. We described major facilitators and barriers to the adoption of an inpatient pharmacy system at two pediatric hospitals. Strategies identified by our informants to overcome barriers may promote successful pharmacy implementations at other pediatric facilities.