Accepted for/Published in: JMIR Human Factors
Date Submitted: Nov 1, 2021
Date Accepted: Jan 20, 2022
Accordons-nous, A Mobile Application for Advance Care Planning and Advance Directives: Development and Usability Test
ABSTRACT
Background:
Advance Care Planning (ACP), including Advance Directives (AD) are important tools to allow patients to express their preferences for care, in the event that they are no longer able to express themselves. We developed Accordons-nous, a smartphone application that informs patients about ACP and AD, facilitates communication on these sensitive topics, and helps patients to express their values and preferences for care.
Objective:
Our first objective was to conduct a usability test of this application. The second was to collect users’ critical opinion on the usability and relevance of the tool.
Methods:
We conducted a usability test by means of a think aloud method asking 10 representative patients to complete seven browsing tasks. We double coded the filmed sessions to obtain descriptive data on task completion (with or without help), time spent, number of clicks, and type of problems encountered. We assessed the severity of problems encountered and identified the modifications needed in order to address those problems. We evaluated the readability of the application with the test Scolarius, a French equivalent of the Flesch Reading Ease test. By means of a post-test questionnaire, we asked participants to assess the application’s usability (SUS - System Usability Scale), relevance (MARS - Mobile Application Rating Scale, section F), and whether they would recommend the application to target groups: patients, health professionals, and patients’ caring relatives.
Results:
Participants succeeded the seven think aloud tasks in 80% of the cases without help from the experimenter, in 16% with some help, and failed in 4% of the cases. The analysis of failures and difficulties encountered revealed a series of major usability problems that could all be addressed with minor modifications to the application. Accordons-nous obtained high scores on readability (overall score of 87.4 on Scolarius test, corresponding to elementary school level), usability (85.3/100 on SUS test), relevance (4.3/5 on MARS, section F), and overall subjective endorsement on three “I would recommend” questions (4.7/5).
Conclusions:
This usability test helped us to make the final changes to our application before official launching.
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