JMIR Publications

ABSTRACT

Background:

To allow non-occupational therapist healthcare workers to make bathroom adaptation recommendations for older adults, a paper form clinical algorithm (Algo) is used in Quebec (Canada). Integrated knowledge transfer process around Algo suggested an electronic version of this decision support system (e- DSS) to be used by older adults and their caregivers in search of information and solutions for their autonomy and safety in the bathroom.

Objective:

1 - To create an e-DSS for the self-selection of bathroom assistive technology by community-dwelling older adults and their caregivers. 2 – To assess usability with lay users and experts to improve the design accordingly.

Methods:

A user-centered design method was achieved. The process started with 7 semi-structured interviews (members of healthcare interdisciplinary teams, assistive technology providers, community resources) and 4 focus groups of older adults (n=6, n=2) and caregivers (n=3, n=2). Thematic content transcript analysis was carried out to create a prototype. Think aloud and observation methods with a clinical expert (n=1), research experts (n=3), occupational therapists (n=3), older adults (n=3), and caregivers (n=3) provided information on the e-DSS’s usability throughout of the prototype design.

Results:

In addition to guidelines for senior friendly website, four specific criteria for the prototype of the electronic Algo (Hygiene 2.0) were suggested: target (safety, confidentiality, well-being and autonomy); engage; ease of use (simplify, clarify, use images); broadcast. For example, users first pay attention to the images and their details suggesting pictures can be used to depict safe postures, illustrate questions embedded in the decision support tool and demonstrate the context of use of assistive technology.

Conclusions:

The user-centered design of Hygiene 2.0 [1] has allowed to create a web application (app), soon-to-be available also in a mobile app format. This app will better respond to the users’ needs, promoting the actual use of the e-DSS and therefore the appropriate selection of assistive technology by older adults or their caregivers. Indeed, each iteration brought more insight into the different users’ realities and considered the users’ input throughout the design process.