JMIR Publications

ABSTRACT

Background:

Home modifications provided by occupational therapists (OTs) are effective in improving daily activity performance and reducing fall risk among community-dwelling older adults. However, the prevalence of home modification is low. One reason is the lack of a centralized database of OTs who provide home modifications.

Objective:

To develop and test the usability of a mobile application directory of OTs who provide home modifications in the US.

Methods:

In Phase 1, a prototype was developed by identifying OTs who provide home modifications through keyword web searches. Referral information was confirmed by phone or email. In Phase 2, community-dwelling older adults over the age of 65 and OTs currently working in the US were purposefully recruited to participate in a single usability test of the mobile app, Home Maddirs. Participants completed the System Usability Scale (SUS) and semi-structured interview questions. Interview data were coded and themes derived using a grounded theory approach

Results:

In Phase 1, referral information for 101 OTs across 49 states were confirmed. In Phase 2, six OTs (mean clinical experience ± SD: 4.3 ± 1.6 years) and six older adults (mean age ± SD: 72.8 ± 5.0 years) participated. The mean SUS score for OTs was 91.7 ± 8.0 (out of 100), indicating good usability. The mean SUS score for older adults was 71.7 ± 27.1, indicating considerable variability in usability. Additionally, the SUS scores indicated the app is acceptable to OTs and may be acceptable to some older adults. For OTs, self-reported barriers to acceptability and usability included the need for more information on the scope of referral services. For older adults, barriers included high cognitive load, lack of operational skills, and the need to accommodate sensory changes. For both groups, facilitators of acceptability and usability included perceived usefulness, social support, and multiple options to access information.

Conclusions:

Home Maddirs demonstrates good preliminary acceptability and usability to OTs. Older adults’ perceptions regarding acceptability and usability varied considerably, partly based on prior experience using mobile apps. Results will be used to make improvements to this promising new tool for increasing older adults’ access to home modifications.