Usability of iSupport Swiss, a World Health Organization Digital Intervention for Caregivers of People With Dementia:...

Dementia presents a pressing public health challenge, with informal caregivers (ICs) playing a pivotal role in supporting people with dementia. Digital interventions, such as the World Health Organization (WHO) iSupport, offer scalable, self-guided psychosocial and educational support for caregivers. However, effective implementation relies on strong usability, particularly for older adults with varying levels of digital literacy.

This study aimed to evaluate the usability of the desktop version of iSupport Swiss, a WHO culturally adapted digital intervention for ICs of people with dementia in the Italian-speaking region of Switzerland.

We conducted a mixed methods usability study at the Università della Svizzera italiana. Participants (formal caregivers and ICs) completed a pretest questionnaire to collect sociodemographic data and digital health literacy measures via the Italian version of the eHealth Literacy Scale, 11 structured usability tasks, a posttest System Usability Scale, and a semistructured interview. Task performance was observed and analyzed, including completion rates and qualitative feedback obtained through the think-aloud technique. Interviews were analyzed using thematic analysis.

Twelve caregivers (10 ICs and 2 formal caregivers) took part in the study. Most participants showed high digital proficiency (Italian version of the eHealth Literacy Scale: mean 31.17, SD 5.84) and completed most tasks successfully or with minimal support. The mean System Usability Scale score was 71.5 (SD 12.27), indicating good usability. Website features were rated positively, especially information quality (mean 4.58/5, SD 0.51) and quantity (mean 4.42/5, SD 0.51), though ease of navigation scored lower (mean 3.42/5, SD 1.00). Qualitative interviews revealed 5 core dimensions: content quality and relevance, credibility of the source, navigation and usability, interactivity, and emotional impact. Suggestions included clearer language switching, improved navigation cues, and more personalized feedback in exercises.

iSupport Swiss demonstrated overall good usability among caregivers, supporting its further implementation. Key areas for refinement include navigation clarity and user-tailored feedback. Participants appreciated the emotional resonance and credibility of the program, underlining its potential to enhance caregiver self-efficacy and early help-seeking. Usability testing proved essential in identifying both functional and affective dimensions of user experience. Future work should extend to broader and more diverse populations, incorporate real-world usage settings, and examine long-term engagement to optimize adoption and impact. Successful use and further development of iSupport, beyond the specific Swiss context, could contribute to expanding the availability of accessible and appropriate resources for ICs, ultimately helping to reduce caregiver burden and alleviate its impact on social and health care systems globally.