Heuristic evaluation and usability testing of a functional dementia stages app for Hispanic family caregivers

Abstract

AbstractBackgroundHispanic family caregivers of persons with Alzheimer’s disease and other dementias are not getting the anticipatory guidance they need about how functional abilities will change as dementia progresses. Existing informational resources are overwhelming to navigate and written at a high reading level. Furthermore, professional assessment of functional abilities is not universally available. Innovative, tailored approaches are needed. Our aim was to develop and test a mobile application, the Interactive Functional Assessment Staging Navigator (I‐FASTN), to support Hispanic family caregivers’ assessment of care recipients’ functional stage of dementia in either English or Spanish.MethodWe conducted heuristic evaluation with informatics experts (N = 5, English only) and usability testing with caregivers (n = 10 English, n = 10 Spanish). Participants attempted a series of tasks with the app using a think‐aloud protocol and then rate the usability of the app using mobile app heuristics (experts) and two usability instruments (caregivers). Sessions were recorded and transcribed. For heuristic evaluation, we tabulated the number of usability problems by category: cosmetic, minor, major, and catastrophic. For usability testing, recordings, notes, and transcripts were content analyzed to extract usability problems, suggestions for improvement, desired app features, and other feedback.ResultRefinements to the app were made after each of the five evaluations to address the problems encountered. Caregivers’ mean usability scores were high (4.6 and 4.7 out of 5.0), reflecting good usability overall. Chief usability problems were a confusing tutorial and difficulty finding the app’s side menu. These will be addressed by creating a video tutorial and moving all menu items to the home screen. The app was very well received by caregivers, who indicated that the concise, illustrated content met their informational needs. However, analog alternatives are still needed by caregivers unaccustomed to using apps as they had difficulty moving on from even the simplest screens (see Figure 1a).ConclusionCaregivers are not receiving informational support in a way that meets their needs. The focus should be on providing concise information that addresses the practical aspects of caregiving, tailored to the care recipient’s functional stage.