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Optimizing Usability of Digital Health Interventions for Nondigitally Native Adults: A Framework-Based Approach to
Abby L Cheng1, Christine Y Gou1, Adriana Martin1
1Division of Musculoskeletal Physical Medicine and Rehabilitation, Department of Orthopaedic Surgery, Washington University in St. Louis, Campus Box MSC 8233-0004-05, 660 S Euclid Ave, St. Louis, MO, 63110, United States, 1 314-747-8489.
JMIR Human Factors
|August 11, 2026
Summary
Older adults need user-friendly digital health tools. This study identified key usability improvements, like clear instructions and reduced notifications, to enhance engagement with mental health apps for chronic pain management.
Area of Science:
- Digital Health
- Human-Computer Interaction
- Gerontology
Background:
- Widespread adoption of health technology among non-digital natives necessitates tailored design.
- Digital health interventions often overlook usability needs of middle-aged and older adults, especially those with multiple conditions.
- The intersection of mental health and chronic pain presents a key opportunity for digital health interventions in non-digital natives.
Purpose of the Study:
- Identify actionable, usability-focused features for digital health interventions.
- Adapt interventions for non-digitally native adults, considering their preferences and multimorbidity.
- Explore general usability adaptations and just-in-time adaptive interventions (JITAIs).
Main Methods:
- Qualitative usability study of a mental health app (Wysa for Chronic Pain).
- Participants: 45+ years old with moderate depression/anxiety and frequent pain.
- Frameworks used: Framework for Reporting Adaptations and Modifications to Evidence-based Implementation Strategies, Nahum-Shani's pragmatic framework for JITAI development, and the Behavioral Integration Technology model.
Main Results:
- Participants (n=42, mean age 57) emphasized clear, step-by-step instructions and minimized navigation burden.
- Requests included better onboarding and customized user experiences based on usage patterns.
- A key JITAI opportunity was reducing notifications to prevent fatigue and disengagement.
Conclusions:
- Actionable insights can improve digital health intervention usability and engagement for all ages.
- Findings are generalizable to digital health interventions for older adults with multimorbidity and potential physical/cognitive challenges.
- The integrated framework-based process can optimize existing digital health interventions.
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