JMIR Publications

ABSTRACT

Background:

Few studies evaluate the usability of mobile-phone assessments in older adults.

Objective:

The aim of this study was to identify design-based barriers and facilitators to mobile app survey completion among two samples of older adults; those in the Framingham Heart Study and a more diverse sample from a hospital-based setting.

Methods:

We used mixed methods to identify challenging and beneficial features of the mobile app in participants from the electronic Framingham Heart Study (eFHS, n=15, mean age 72 years, 40% women, 100% non-Hispanic and White) and among participants recruited from a hospital-based setting (n=15, mean age 71 years, 47% women, 20% Hispanic and 53% non-White). A variety of app-based measures with different response formats were tested including self-reported surveys, pictorial assessments (to indicate body pain sites), and cognitive testing tasks (e.g., Trail Making Test (TMT) and Stroop). Participants completed each measure using a think-aloud protocol, while being audio- and video-recorded with a qualitative interview conducted at the end of the session. Recordings were coded for participant usability errors by two pairs of coders. Participants completed the Mobile App Rating Scale (MARS) to assess the app (response range 1=inadequate to 5= excellent).

Results:

In eFHS participants, the average total MARS score was 7.6 (SD=1.1), with no significant differences in the hospital-based sample. In general participants were pleased with the app and found it easy to use. A large minority had at least one navigational issue, most committed only once. Most older adults did not have difficulty completing the self-reported multiple choice measures unless it included lengthy instructions but participants had usability issues with the Stroop and TMT.

Conclusions:

Our methods and results help guide app development and app-based survey construction for older adults, while also giving consideration to sociodemographic differences.