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Capturing Usability Problems for People Living With Dementia by Applying the DEMIGNED Principles in Usability

Thomas Engelsma1,2,3, Simone Heijmink1, Heleen M A Hendriksen4,5

  • 1eHealth Living & Learning Lab Amsterdam, Department of Medical Informatics, Amsterdam UMC, location University of Amsterdam, Amsterdam, Netherlands.

JMIR Human Factors
|July 31, 2024
PubMed
Summary

The DEMIGNED principles effectively identified 79.6% of usability issues in a mobile website for memory clinic patients. This approach helps improve digital health accessibility for individuals with cognitive decline, reducing digital health inequities.

Keywords:
dementiadesign principlesdigital healthmemory clinicmobile phoneusability evaluation

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Area of Science:

  • Digital Health
  • Human-Computer Interaction
  • Gerontology

Background:

  • Dementia-related impairments create significant barriers to accessing and using digital health technologies (DHTs), exacerbating digital health inequities.
  • The DEMIGNED principles, derived from literature, offer guidance for designing and evaluating DHTs tailored to individuals with cognitive decline.
  • This population, including those with subjective cognitive decline (SCD), mild cognitive impairment (MCI), and dementia, is rapidly growing.

Purpose of the Study:

  • To apply DEMIGNED principles within usability evaluation methods for a mobile website serving memory clinic patients.
  • To identify usability problems encountered by individuals with SCD, MCI, or dementia on this mobile website.
  • To assess the validity of usability problems identified by DEMIGNED principles during expert testing of mobile DHTs.

Main Methods:

  • A heuristic evaluation was performed using DEMIGNED principles as domain-specific guidelines, involving 3 double experts and 2 usability engineering experts.
  • Think-aloud sessions were conducted with 7 patients from a memory clinic, including individuals with SCD, MCI, and dementia.
  • Usability problems identified during heuristic evaluation were compared against those encountered during patient think-aloud sessions.

Main Results:

  • Heuristic evaluation identified 36 unique usability problems.
  • Think-aloud sessions with 7 patients revealed 181 usability problem encounters, mapping to 144 (79.6%) of the heuristically identified problems.
  • An additional 10 unique usability problems were identified through user testing, with common issues including search functionality, content organization, scrolling, information overload, and unclear feedback.

Conclusions:

  • Applying DEMIGNED principles in expert testing successfully captured a significant majority (79.6%) of usability problem encounters during user testing of a mobile website for memory clinic patients.
  • The study demonstrated that 50% of unique usability problems identified through heuristic evaluation were also observed in user testing.
  • Further research is recommended to explore the applicability of DEMIGNED principles to other DHT functionalities to enhance digital health accessibility and reduce inequities for this demographic.