JMIR Publications

ABSTRACT

Background:

With the increase in the elderly population and the popularization of mobile devices, older adults have become potential users of mobile health applications (mHealth apps). Usability is a key factor affecting the acceptance of mHealth apps, but traditional usability evaluation methods may not be suitable for use in this population because of aging barriers. Recent literature reviews of usability evaluations have not focused on this group. In the context of the rapidly increasing rate of mHealth apps every year, it is essential to gain insight into the usability evaluation methods of mHealth apps for the elderly.

Objective:

The objectives of this study were to identify, explore, and summarize the current state of the literature on the usability evaluation of mHealth apps for older adults and to incorporate these methods into the appropriate evaluation stage.

Methods:

The Arksey and O’Malley framework was used to map the relevant literature published between January 2000 and December 2020. Electronic searches were conducted in 10 databases. Inclusion criteria were articles focused on the usability evaluation of mHealth apps designed for older adults. The included studies were organized by the abductive approach: they were classified according to the mHealth app usability evaluation framework in the deductive phase, and the suitability of evaluation methods for use among the elderly in the inductive phase was analyzed.

Results:

Ninety-six articles met the inclusion criteria. Research activity increased steeply after 2013 (n=92). The distribution of the articles in the framework was as follows: combining the components (n=61), integrating the system into the setting (n=30), and routine use (n=19). Wellness management (n=40) was the most frequently used function. The ratios of satisfaction, learnability, operability, and understandability measures were significantly related to the different stages of evaluation (P＜0.05). The methods used for usability evaluation were questionnaire (n=68), interview (n=36), concurrent thinking aloud (n=25), performance metrics (n=25), behavioral observation log (n=14), screen recording (n=3), eye tracking (n=1), retrospective thinking aloud (n=1), and feedback log (n=1). The System Usability Scale (SUS) was the most frequently used questionnaire (n=40). Thirty-two studies developed their own evaluation tool to assess unique design features for the elderly. The proportion of evaluation methods used in each stage was also different.

Conclusions:

In the past five years, the number of studies in the field of usability evaluation of mHealth apps for the elderly has increased rapidly. Apps are often used as an auxiliary means of self-management to help the elderly manage wellness and disease. According to the three stages of the mHealth app usability evaluation framework, the critical measures and evaluation methods are inconsistent. Future research should focus on adapting usability evaluation methods to the elderly by improving traditional tools or introducing automated evaluation tools.