JMIR Publications

ABSTRACT

Background:

Electronic health (eHealth) interventions have become an interest to the field of mental health due to their increased coordination and integration of different elements of care in treating and preventing mental ill-health in patients with somatic illnesses. However, poor usability, learnability, and user engagement might affect the effectiveness of the eHealth intervention. Identifying different sociodemographic characteristics that might be associated with higher perceived usability can help in improving the usability of these e-health interventions.

Objective:

This study aimed to identify sociodemographic characteristics that might be associated with the perceived usability of the NEVERMIND e-health system, comprised of a mobile application and a sensorized shirt, developed to reduce co-morbid depressive symptoms in patients with breast and prostate cancer.

Methods:

The study included a total of 129 patients with a diagnosis of breast (n=80) or prostate cancer (n=49) who received the NEVERMIND system. Sociodemographic data on age, sex, marital status, completed level of education, and employment status were collected at baseline. Usability outcomes included the System Usability Scale (SUS), a subjective measure that covers different aspects of the system usability, the Mobile Application Rating Scale: user version (uMARS), a user experience questionnaire, and a usage index, an indicator calculated from the number of days patients used the NEVERMIND system during the study period.

Results:

The analysis was based on 108 patients (68 breast cancer and 40 prostate cancer patients) who used the NEVERMIND system for an average of 12-weeks and completed the study. The overall mean SUS score at 12-weeks was 73.4, which indicates that the NEVERMIND system has good usability with no statistical differences among different sociodemographic characteristics. The global uMARS score was 3.8, and females scored the app higher than males ( coefficient= 0.16; p=.03, 95% CI 0.02 - 0.3) after adjusting for other covariates. No other sociodemographic characteristics were associated with a higher uMARS score. There was a statistical difference in the usage of the NEVERMIND system between females and males. Females had significant lower usage (β coefficient= -0.13; p=.04, 95% CI -0.25 to -0.01) after adjusting for other covariates.

Conclusions:

The findings suggest that the NEVERMIND system has good usability according to the SUS and uMARS scores. There was a higher favourability of the mobile application among females compared to males. However, males had significantly higher usage of the NEVERMIND system. No other usability differences were found among the other sociodemographic groups indicating that the NEVERMIND system does not suffer from the ‘digital divide’ where certain sociodemographic characteristics are more associated with higher usability.