Supporting Cancer Patients in Illness Management: Usability Evaluation of a Mobile App

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Abstract

Background

Mobile phones and tablets currently represent a significant presence in people’s everyday lives. They enable access to different information and services independent of current place and time. Such widespread connectivity offers significant potential in different app areas including health care.

Objective

Our goal was to evaluate the usability of the Connect Mobile app. The mobile app enables mobile access to the Connect system, an online system that supports cancer patients in managing health-related issues. Along with symptom management, the system promotes better patient-provider communication, collaboration, and shared decision making. The Connect Mobile app enables access to the Connect system over both mobile phones and tablets.

Methods

The study consisted of usability tests of a high fidelity prototype with 7 cancer patients where the objectives were to identify existing design and functionality issues and to provide patients with a real look-and-feel of the mobile system. In addition, we conducted semistructured interviews to obtain participants’ feedback about app usefulness, identify the need for new system features and design requirements, and measure the acceptance of the mobile app and its features within everyday health management.

Results

The study revealed a total of 27 design issues (13 for mobile apps and 14 for tablet apps), which were mapped to source events (ie, errors, requests for help, participants' concurrent feedback, and moderator observation). We also applied usability heuristics to identify violations of usability principles. The majority of violations were related to enabling ease of input, screen readability, and glanceability (15 issues), as well as supporting an appropriate match between systems and the real world (7 issues) and consistent mapping of system functions and interactions (4 issues). Feedback from participants also showed the cancer patients’ requirements for support systems and how these needs are influenced by different context-related factors, such as type of access terminal (eg, desktop computer, tablet, mobile phone) and phases of illness. Based on the observed results, we proposed design and functionality recommendations that can be used for the development of mobile apps for cancer patients to support their health management process.

Conclusions

Understanding and addressing users’ requirements is one of the main prerequisites for developing useful and effective technology-based health interventions. The results of this study outline different user requirements related to the design of the mobile patient support app for cancer patients. The results will be used in the iterative development of the Connect Mobile app and can also inform other developers and researchers in development, integration, and evaluation of mobile health apps and services that support cancer patients in managing their health-related issues.

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Most cited references 79

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eHealth Literacy: Extending the Digital Divide to the Realm of Health Information

Efrat Neter, Esther Brainin (2012)

Background eHealth literacy is defined as the ability of people to use emerging information and communications technologies to improve or enable health and health care. Objective The goal of this study was to explore whether literacy disparities are diminished or enhanced in the search for health information on the Internet. The study focused on (1) traditional digital divide variables, such as sociodemographic characteristics, digital access, and digital literacy, (2) information search processes, and (3) the outcomes of Internet use for health information purposes. Methods We used a countrywide representative random-digital-dial telephone household survey of the Israeli adult population (18 years and older, N = 4286). We measured eHealth literacy; Internet access; digital literacy; sociodemographic factors; perceived health; presence of chronic diseases; as well as health information sources, content, search strategies, and evaluation criteria used by consumers. Results Respondents who were highly eHealth literate tended to be younger and more educated than their less eHealth-literate counterparts. They were also more active consumers of all types of information on the Internet, used more search strategies, and scrutinized information more carefully than did the less eHealth-literate respondents. Finally, respondents who were highly eHealth literate gained more positive outcomes from the information search in terms of cognitive, instrumental (self-management of health care needs, health behaviors, and better use of health insurance), and interpersonal (interacting with their physician) gains. Conclusions The present study documented differences between respondents high and low in eHealth literacy in terms of background attributes, information consumption, and outcomes of the information search. The association of eHealth literacy with background attributes indicates that the Internet reinforces existing social differences. The more comprehensive and sophisticated use of the Internet and the subsequent increased gains among the high eHealth literate create new inequalities in the domain of digital health information. There is a need to educate at-risk and needy groups (eg, chronically ill) and to design technology in a mode befitting more consumers.

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Mapping mHealth Research: A Decade of Evolution

Maddalena Fiordelli, Nicola Diviani, Peter J. Schulz (2013)

Background For the last decade, mHealth has constantly expanded as a part of eHealth. Mobile applications for health have the potential to target heterogeneous audiences and address specific needs in different situations, with diverse outcomes, and to complement highly developed health care technologies. The market is rapidly evolving, making countless new mobile technologies potentially available to the health care system; however, systematic research on the impact of these technologies on health outcomes remains scarce. Objective To provide a comprehensive view of the field of mHealth research to date and to understand whether and how the new generation of smartphones has triggered research, since their introduction 5 years ago. Specifically, we focused on studies aiming to evaluate the impact of mobile phones on health, and we sought to identify the main areas of health care delivery where mobile technologies can have an impact. Methods A systematic literature review was conducted on the impact of mobile phones and smartphones in health care. Abstracts and articles were categorized using typologies that were partly adapted from existing literature and partly created inductively from publications included in the review. Results The final sample consisted of 117 articles published between 2002 and 2012. The majority of them were published in the second half of our observation period, with a clear upsurge between 2007 and 2008, when the number of articles almost doubled. The articles were published in 77 different journals, mostly from the field of medicine or technology and medicine. Although the range of health conditions addressed was very wide, a clear focus on chronic conditions was noted. The research methodology of these studies was mostly clinical trials and pilot studies, but new designs were introduced in the second half of our observation period. The size of the samples drawn to test mobile health applications also increased over time. The majority of the studies tested basic mobile phone features (eg, text messaging), while only a few assessed the impact of smartphone apps. Regarding the investigated outcomes, we observed a shift from assessment of the technology itself to assessment of its impact. The outcome measures used in the studies were mostly clinical, including both self-reported and objective measures. Conclusions Research interest in mHealth is growing, together with an increasing complexity in research designs and aim specifications, as well as a diversification of the impact areas. However, new opportunities offered by new mobile technologies do not seem to have been explored thus far. Mapping the evolution of the field allows a better understanding of its strengths and weaknesses and can inform future developments.

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Heuristic evaluation of user interfaces

Jakob Nielsen, Rolf Molich (1990)

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Author and article information

Contributors

Jelena Mirkovic:

Center for Shared Decision Making and Collaborative Care ResearchOslo University HospitalForskningsveien 2bOslo, 0373Norway47 4634386947 23075450Jelena.Mirkovic@rr-research.no

ORCID: http://orcid.org/0000-0001-6828-1230

Journal

Journal ID (nlm-ta): JMIR Mhealth Uhealth

Journal ID (iso-abbrev): JMIR Mhealth Uhealth

Journal ID (publisher-id): JMU

Title: JMIR mHealth and uHealth

Publisher: JMIR Publications Inc. (Toronto, Canada )

ISSN (Electronic): 2291-5222

Publication date Collection: Jul-Sep 2014

Publication date (Electronic): 13 August 2014

Volume: 2

Issue: 3

Electronic Location Identifier: e33

Affiliations

[1] ¹Center for Shared Decision Making and Collaborative Care Research Oslo University Hospital OsloNorway

[2] ²Department of Biomedical Informatics College of Health Solutions Arizona State University Scottsdale, AZUnited States

Author notes

Corresponding Author: Jelena Mirkovic Jelena.Mirkovic@ 123456rr-research.no

Author information

Jelena Mirkovic http://orcid.org/0000-0001-6828-1230

David R Kaufman http://orcid.org/0000-0001-9968-9968

Cornelia M Ruland http://orcid.org/0000-0001-6521-4884

Article

Publisher ID: v2i3e33

DOI: 10.2196/mhealth.3359

PMC ID: 4147703

PubMed ID: 25119490

SO-VID: 304c6917-32cc-4f7c-8de4-019658e2a34a

License:

This is an open-access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR mhealth and uhealth, is properly cited. The complete bibliographic information, a link to the original publication on http://mhealth.jmir.org/, as well as this copyright and license information must be included.

History

Date received : 28 February 2014

Date revision requested : 06 June 2014

Date revision received : 23 June 2014

Date accepted : 07 July 2014

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