Health Information Technology Usability Evaluation Research Articles

A Mobile Sexual Health App on Empowerment, Education, and Prevention for Young Adult Men (MyPEEPS Mobile): Acceptability and Usability Evaluation.

BackgroundHIV incidence among young adult men who have sex with men (MSM), particularly among black and Latino men, continues to rise. As such, continued HIV prevention interventions for young MSM of color are of utmost importance. Male Youth Pursuing Empowerment, Education and Prevention around Sexuality (MyPEEPS) Mobile is a comprehensive HIV prevention and sexual health education smartphone app initially created to promote sexual health and HIV prevention among adolescent sexual minority young men aged 13 to 18 years.ObjectiveThe objective of this study was to critically appraise the acceptability and usability of MyPEEPS Mobile for young adult MSM aged 19 to 25 years.MethodsStudy participants used the mobile app, completed usability questionnaires and in-depth interviews, and reported their experience using the app. Analysis of interview data was guided by the Unified Theory of Acceptance and Use of Technology (UTAUT) to better understand the usability and acceptability of this intervention for young adults. Interview data were coded using the following constructs from the UTAUT model: performance expectancy, effort expectancy, and social influence.ResultsA total of 20 young adult MSM (n=10 in Chicago, Illinois, and n=10 in New York, New York) were enrolled in the study. Participants reported that MyPEEPS Mobile was free of functional problems (Health Information Technology Usability Evaluation Scale scores and Post-Study System Usability Questionnaire scores consistent with high usability), easy to use, and useful, with an engaging approach that increased acceptability, including the use of avatars and animation, and inclusive representation of the diverse identities by race and ethnicity, gender identity, and sexual orientation. Recommended areas for improving MyPEEPS Mobile for the target demographic included more adult-oriented graphics, advanced educational content, scenarios for youth with more sexual experience, and search function to increase accessibility of key content.ConclusionsOverall, young adult MSM aged 19 to 25 years described the MyPEEPS Mobile as educational, informative, and usable for their sexual health education and HIV prevention needs, and they provided actionable recommendations to optimize its use and applicability for this age group.

Use, Perceived Usability, and Barriers to Implementation of a Patient Safety Dashboard Integrated within a Vendor EHR.

Preventable adverse events continue to be a threat to hospitalized patients. Clinical decision support in the form of dashboards may improve compliance with evidence-based safety practices. However, limited research describes providers' experiences with dashboards integrated into vendor electronic health record (EHR) systems. This study was aimed to describe providers' use and perceived usability of the Patient Safety Dashboard and discuss barriers and facilitators to implementation. The Patient Safety Dashboard was implemented in a cluster-randomized stepped wedge trial on 12 units in neurology, oncology, and general medicine services over an 18-month period. Use of the Dashboard was tracked during the implementation period and analyzed in-depth for two 1-week periods to gather a detailed representation of use. Providers' perceptions of tool usability were measured using the Health Information Technology Usability Evaluation Scale (rated 1-5). Research assistants conducted field observations throughout the duration of the study to describe use and provide insight into tool adoption. The Dashboard was used 70% of days the tool was available, with use varying by role, service, and time of day. On general medicine units, nurses logged in throughout the day, with many logins occurring during morning rounds, when not rounding with the care team. Prescribers logged in typically before and after morning rounds. On neurology units, physician assistants accounted for most logins, accessing the Dashboard during daily brief interdisciplinary rounding sessions. Use on oncology units was rare. Satisfaction with the tool was highest for perceived ease of use, with attendings giving the highest rating (4.23). The overall lowest rating was for quality of work life, with nurses rating the tool lowest (2.88). This mixed methods analysis provides insight into the use and usability of a dashboard tool integrated within a vendor EHR and can guide future improvements and more successful implementation of these types of tools.

Information visualizations of symptom information for patients and providers: a systematic review.

To systematically synthesize the literature on information visualizations of symptoms included as National Institute of Nursing Research common data elements and designed for use by patients and/or healthcare providers. We searched CINAHL, Engineering Village, PsycINFO, PubMed, ACM Digital Library, and IEEE Explore Digital Library to identify peer-reviewed studies published between 2007 and 2017. We evaluated the studies using the Mixed Methods Appraisal Tool (MMAT) and a visualization quality score, and organized evaluation findings according to the Health Information Technology Usability Evaluation Model. Eighteen studies met inclusion criteria. Ten of these addressed all MMAT items; 13 addressed all visualization quality items. Symptom visualizations focused on pain, fatigue, and sleep and were represented as graphs (n = 14), icons (n = 4), and virtual body maps (n = 2). Studies evaluated perceived ease of use (n = 13), perceived usefulness (n = 12), efficiency (n = 9), effectiveness (n = 5), preference (n = 6), and intent to use (n = 3). Few studies reported race/ethnicity or education level. The small number of studies for each type of information visualization limit generalizable conclusions about optimal visualization approaches. User-centered participatory approaches for information visualization design and more sophisticated evaluation designs are needed to assess which visualization elements work best for which populations in which contexts.

A multi-level usability evaluation of mobile health applications: A case study.

To report a methodological approach for the development of a usable mHealth application (app). This work was guided by a 3-level stratified view of health information technology (IT) usability evaluation framework. We first describe a number of methodologies for operationalizing each level of the framework. Following the description of each methodology, we present a case study which illustrates the use of our preferred methodologies for the development of a mHealth app. At level 1 (user-task), we applied a card sorting technique to guide the information architecture of a mobile HIV symptom self-management app, entitled mVIP. At level 2 (user-task-system), we conducted a usability evaluation of mVIP in a laboratory setting through end-user usability testing and heuristic evaluation with informatics experts. At level 3 (user-task-system-environment), usability of mVIP was evaluated in a real-world setting following the use of the app during a 3-month trial. The 3-level usability evaluation guided our work exploring in-depth interactions between the user, task, system, and environment. Integral to the findings from the 3-level usability evaluation, we iteratively refined the app's content, functionality, and interface to meet the needs of our intended end-users. The stratified view of the health IT usability evaluation framework is a useful methodological approach for the design, development, and evaluation of mHealth apps. The methodological recommendations for using the theoretical framework can inform future usability studies of mHealth apps.

Health Information Technology Usability Evaluation Scale (Health-ITUES) for Usability Assessment of Mobile Health Technology: Validation Study.

BackgroundMobile technology has become a ubiquitous technology and can be particularly useful in the delivery of health interventions. This technology can allow us to deliver interventions to scale, cover broad geographic areas, and deliver technologies in highly tailored ways based on the preferences or characteristics of users. The broad use of mobile technologies supports the need for usability assessments of these tools. Although there have been a number of usability assessment instruments developed, none have been validated for use with mobile technologies.ObjectiveThe goal of this work was to validate the Health Information Technology Usability Evaluation Scale (Health-ITUES), a customizable usability assessment instrument in a sample of community-dwelling adults who were testing the use of a new mobile health (mHealth) technology.MethodsA sample of 92 community-dwelling adults living with HIV used a new mobile app for symptom self-management and completed the Health-ITUES to assess the usability of the app. They also completed the Post-Study System Usability Questionnaire (PSSUQ), a widely used and well-validated usability assessment tool. Correlations between these scales and each of the subscales were assessed.ResultsThe subscales of the Health-ITUES showed high internal consistency reliability (Cronbach alpha=.85-.92). Each of the Health-ITUES subscales and the overall scale was moderately to strongly correlated with the PSSUQ scales (r=.46-.70), demonstrating the criterion validity of the Health-ITUES.ConclusionsThe Health-ITUES has demonstrated reliability and validity for use in assessing the usability of mHealth technologies in community-dwelling adults living with a chronic illness.

Examining construct and predictive validity of the Health-IT Usability Evaluation Scale: confirmatory factor analysis and structural equation modeling results.

In a previous study, we developed the Health Information Technology Usability Evaluation Scale (Health-ITUES), which is designed to support customization at the item level. Such customization matches the specific tasks/expectations of a health IT system while retaining comparability at the construct level, and provides evidence of its factorial validity and internal consistency reliability through exploratory factor analysis. In this study, we advanced the development of Health-ITUES to examine its construct validity and predictive validity. The health IT system studied was a web-based communication system that supported nurse staffing and scheduling. Using Health-ITUES, we conducted a cross-sectional study to evaluate users' perception toward the web-based communication system after system implementation. We examined Health-ITUES's construct validity through first and second order confirmatory factor analysis (CFA), and its predictive validity via structural equation modeling (SEM). The sample comprised 541 staff nurses in two healthcare organizations. The CFA (n=165) showed that a general usability factor accounted for 78.1%, 93.4%, 51.0%, and 39.9% of the explained variance in 'Quality of Work Life', 'Perceived Usefulness', 'Perceived Ease of Use', and 'User Control', respectively. The SEM (n=541) supported the predictive validity of Health-ITUES, explaining 64% of the variance in intention for system use. The results of CFA and SEM provide additional evidence for the construct and predictive validity of Health-ITUES. The customizability of Health-ITUES has the potential to support comparisons at the construct level, while allowing variation at the item level. We also illustrate application of Health-ITUES across stages of system development.

Review of health information technology usability study methodologies

Usability factors are a major obstacle to health information technology (IT) adoption. The purpose of this paper is to review and categorize health IT usability study methods and to provide practical guidance on health IT usability evaluation. 2025 references were initially retrieved from the Medline database from 2003 to 2009 that evaluated health IT used by clinicians. Titles and abstracts were first reviewed for inclusion. Full-text articles were then examined to identify final eligibility studies. 629 studies were categorized into the five stages of an integrated usability specification and evaluation framework that was based on a usability model and the system development life cycle (SDLC)-associated stages of evaluation. Theoretical and methodological aspects of 319 studies were extracted in greater detail and studies that focused on system validation (SDLC stage 2) were not assessed further. The number of studies by stage was: stage 1, task-based or user–task interaction, n=42; stage 2, system–task interaction, n=310; stage 3, user–task–system interaction, n=69; stage 4, user–task–system–environment interaction, n=54; and stage 5, user–task–system–environment interaction in routine use, n=199. The studies applied a variety of quantitative and qualitative approaches. Methodological issues included lack of theoretical framework/model, lack of details regarding qualitative study approaches, single evaluation focus, environmental factors not evaluated in the early stages, and guideline adherence as the primary outcome for decision support system evaluations. Based on the findings, a three-level stratified view of health IT usability evaluation is proposed and methodological guidance is offered based upon the type of interaction that is of primary interest in the evaluation.