JMIR Publications

ABSTRACT

Background:

: Dementia-related impairments can cause complex barriers to access, use, and adopt digital health technologies. These barriers can contribute to digital health inequities. Therefore, literature-based design principles called DEMIGNED have been developed to support the design and evaluation of digital health technologies for this rapidly increasing population.

Objective:

This study aims to (1) apply these principles in usability testing to capture usability problems on a mobile website providing information resources for people visiting a memory clinic, including those living with dementia and (2) further validate the relevance of DEMIGNED principles and the applicability specifically for mobile websites as a means of providing digital health technology.

Methods:

A heuristic evaluation approach was conducted with the DEMIGNED principles serving as domain-specific guidelines with two usability experts, one domain expert and two double experts (experienced both in usability and dementia). Second, think-aloud sessions were conducted with memory clinic patients living with subjective cognitive decline, mild cognitive impairment, or dementia.

Results:

The heuristic evaluation resulted in 36 unique usability problems. Seven people visiting a memory clinic participated in a think aloud session: four with subjective cognitive decline, one with mild cognitive impairment and two with dementia. The analysis of the think-aloud sessions revealed 181 usability problem encounters. One hundred forty-four of these could be mapped on 18 usability problems identified in the heuristic evaluation. The remaining 37 encounters from the user-testing revealed another ten unique usability problems. Usability problems frequently encountered in the think aloud sessions encompassed difficulties with utilizing the search function, discrepancies between the user’s expectations and the content organization, the need for scrolling, information overload and unclear system feedback.

Conclusions:

By applying the DEMIGNED principles in expert-testing, evaluators were able to capture ~80% of usability problems encountered in user testing of a mobile website for people visiting a memory clinic, including people living with dementia. Future research should look into the applicability of the DEMIGNED principles for other digital health functionalities, to increase accessibility of digital health and decrease digital health inequity for this complex and rapidly increasing population.