Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: May 2, 2020
Open Peer Review Period: May 2, 2020 - May 11, 2020
Date Accepted: Jun 14, 2020
Date Submitted to PubMed: Jul 14, 2020
(closed for review but you can still tweet)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
User-dependent Usability and Feasibility of a Swallowing Training mHealth App for Older Adults: A Preliminary Quantitative and Qualitative Study
ABSTRACT
Background:
Swallowing difficulties (i.e., dysphagia) are common among older adults, with a 13%-54% prevalence rate. Adequate interventional efforts to improve the swallowing function of the elderly would reduce morbidity and improve their health-related quality of life outcomes. Mobile health (mHealth) apps may alleviate dysphagia symptoms by providing the maximum intensity and frequency of training programs without the high costs and the need for regular clinic visits.
Objective:
This pilot study aimed to assess the usability of swallowing training apps by quantitatively and qualitatively evaluating older adults’ self-reported data, taking into consideration their educational attainment and exposure to mobile technology. For this purpose, we conducted surveys and brief interviews while utilizing a swallowing intervention app developed by us. By doing so, we could identify and resolve individual-specific usability issues in order to improve future implementation of the app protocol for older persons with swallowing difficulties.
Methods:
A total of 11 participants (10 women; aged 75.7±3.93 years) from two district-run senior welfare centers took part in this study. Based on their total number of years of education and smart device usage, the participants were divided into two groups: the high-potential group and low-potential group. To investigate the usability of the app at initial- and post-intervention stages, we used mixed methods, consisting of both quantitative (i.e., System Usability Scale (SUS), modified Computer Self-Efficacy Scale (mCSES) surveys) and qualitative (i.e., interview) approaches.
Results:
Quantitative results of the SUS and mCSES revealed that the high-potential group was more inclined to adopt and learn new technology than the low-potential group. In addition, the low-potential group’s usability scores were within the “marginal acceptability” range even after the completion of an 8-week intervention program. Qualitative analyses via semi-structured interviews yielded promising outcomes regarding app acceptability, training program utilization, emotional response, and learning experience.
Conclusions:
To the best of the authors’ knowledge, this usability and feasibility study is the first on swallowing training apps to improve the swallowing function of older adults. Considering several issues, such as user characteristics, pre-training education, and the intensity and innate characteristics of the intervention program, future research is warranted.
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