Initial User Testing Research Articles

Development and preliminary evaluation of the Child Feeding Guide website and app: A tool to support caregivers with promoting healthy eating in children

Background: Fussy eating in young children is very common, with at least 50% of parents reporting having a fussy child. Eating behaviours established early in life tend to remain throughout childhood and into adulthood, so ensuring that children develop healthy eating behaviours from their earliest years is vital. Fussy children often refuse to eat healthy foods, like fruit and vegetables, but favour high-calorie foods instead. Diets low in fruit and vegetables have been linked to a number of preventable health conditions, such as diabetes and cancers, as well as to overweight and obesity. Fussy child eating behaviours can also cause anxiety and stress in caregivers, which can perpetuate the problem. Despite an abundance of available support for introducing complementary foods, practical advice about child feeding once weaning has occurred is lacking. Moreover, caregivers find available resources about feeding young children and promoting healthy eating to be “too basic” and have called for evidence-based, credible resources to help them manage children’s difficult or fussy eating behaviours. Empowering caregivers to effectively manage fussy eating behaviours and improve health in their children will likely prevent these eating behaviours from becoming engrained and reduce the number of children eating unhealthy or limited diets. Aim: To address the lack of child feeding support for caregivers by developing an evidence-based, credible and accessible support resource to promote healthy eating habits in young children and healthy feeding practices in caregivers. Method: Following a review of the literature and consultation with caregivers, the Child Feeding Guide was developed. The Child Feeding Guide is a website and free mobile app which offers information, advice and tools to help caregivers manage fussy eating behaviours. An online format was used to ensure the Child Feeding Guide is accessible and that a diverse range of caregivers can benefit from it. Health professionals and caregivers with young children were asked to use the newly-developed Child Feeding Guide and provide feedback on its usability, content, appearance and novelty. Results: Over 85% of health professionals agreed that the Child Feeding Guide contains useful information, is a beneficial resource, and is easy to use. 95% would recommend it to the families that they work with. 80% of caregivers reported that using it helped them to better understand their children’s eating behaviour. Caregivers commented that using the Child Feeding Guide had made them aware of how their feeding behaviours can inadvertently affect their child. Other features of the Child Feeding Guide were identified as beneficial, such as: the provision of advice alongside practical and realistic methods for improving mealtimes; tips for not using food for rewards or for comfort; information on common feeding pitfalls. Caregivers also reported finding the Child Feeding Guide novel, interesting and educational, and easy to use. Conclusions: Preliminary user feedback suggests that the Child Feeding Guide is filling a critical gap in available support resources. Caregivers and health professionals report that it is easy to use, helpful and accessible. While initial user testing of the Child Feeding Guide confirms its value, further formal testing of this resource is required prior to wider-scale roll-out.

Applying User Input to the Design and Testing of an Electronic Behavioral Health Information System for Wraparound Care Coordination.

Health information technology (HIT) and care coordination for individuals with complex needs are high priorities for quality improvement in health care. However, there is little empirical guidance about how best to design electronic health record systems and related technologies to facilitate implementation of care coordination models in behavioral health, or how best to apply user input to the design and testing process. In this paper, we describe an iterative development process that incorporated user/stakeholder perspectives at multiple points and resulted in an electronic behavioral health information system (EBHIS) specific to the wraparound care coordination model for youth with serious emotional and behavioral disorders. First, we review foundational HIT research on how EBHIS can enhance efficiency and outcomes of wraparound that was used to inform development. After describing the rationale for and functions of a prototype EBHIS for wraparound, we describe methods and results for a series of six small studies that informed system development across four phases of effort-predevelopment, development, initial user testing, and commercialization-and discuss how these results informed system design and refinement. Finally, we present next steps, challenges to dissemination, and guidance for others aiming to develop specialized behavioral health HIT. The research team's experiences reinforce the opportunity presented by EBHIS to improve care coordination for populations with complex needs, while also pointing to a litany of barriers and challenges to be overcome to implement such technologies.

Like life itself: blurring the distinction between fiction and reality in the Four Broken Hearts transmedia storyworld

Transgressing the boundaries of the real and the virtual, the temporal and the spatial and the personal and the political, Four Broken Hearts (FBH) is a hybrid storyworld encompassing film, live performance, location-based experiences and social media. The project is scheduled for launch early next year and is currently a work-in-progress undergoing initial user testing. The story of FBH is being told by taking each of the classic elements of fiction – character, setting, exposition, climax and denouement – and bringing them ‘to life’ in the medium that conveys them to the highest degree of mimesis: characters are built and explored through social media, setting is experienced through location-based storytelling, the backstory is fleshed out using film and the climax is performed as an immersive drama. By taking advantage of what each medium does best while complementing the other mediums, FBH is presented in the form of a rich transmedia experience that allows audiences to explore the storyworld across many different platforms while still tying it all together within a cohesive narrative. This paper presents an investigation of the project's narrative outputs produced so far and will be followed by two additional articles over the next six months that will cover the results of the project's public launch and focus group analysis.

IBM Secure Enterprise Desktop

Using software-only approaches makes it is practically impossible to completely secure software applications, as well as corporate information, against determined cyber-criminals. Therefore, in an era where any general-purpose operating system (OS) with end-user access can be hacked, we propose using dedicated security hardware to ensure that only authorized people obtain access to sensitive information. The fundamental principle involves booting the end-user computer from such a trusted mobile device without trusting any software installed on the computer. The device establishes a secure connection to the back-end infrastructure to provide access to the user's OS, e.g., through a remote terminal access or provisioned on the local computer. The solution is very simple to operate, as many corporate employees are not necessarily IT (information technology) savvy. In this paper, we discuss the combination of our dedicated tamper-resistant security boot-token operating user credentials with known defense mechanisms, such as OS virtualization, trusted boot, establishment of client-side and server-side authenticated secure channels to trustworthy back-ends, and client-side storage encryption. This novel combination forms an easy-to-use and highly mobile security solution that addresses security challenges of the BYOD (bring-your-own-device) approach. As a proof point for the latter claims, we report on initial real-world usability tests.

Obstacle detection system for visually impaired persons: Initial design and usability testing

People with visual impairment have problems detecting obstacles when walking. New technologies have been used to improve their mobility. This paper presents an obstacle detection system that is compact, flexible and wearable. It utilizes ultrasonic sensors to detect obstacles and provide auditory feedback. The system is composed of two separate parts that communicate wirelessly. One part can be conveniently fitted on the users' footwear, and the other part on the ear, for audio cue. It is calibrated such that the user gets an idea of the distance from obstacles. Usability test results show that users can navigate around obstacles with minimal training.

Happy Measure

The authors present a vision based augmented reality system called Happy Measure to facilitate the measurement, 3D modeling, and visualization of furniture and other objects using a smartphone or mobile device equipped with a camera. They also study the concomitant interaction metaphors that enable interactive 3D model capture and manipulation in augmented environments. The proposed system allows for interactive measurement of an object’s size and the creation of primitive based 3D models from a single photograph. The appearance of the furniture (color textured model) is captured by the system using the underlying (or multiple) images taken by the user. This allows the user to capture textured 3D models of furniture or other objects and manipulate them virtually for visualization purposes. The authors compare two interaction metaphors used to capture 3D textured models of object to ensure easy interaction while still obtaining accurate measurements in a user test. Results suggest that one is superior in terms of measurement accuracy and also subjective user experience as it allows for continuous touch interaction on the whole screen. Virtually placing a modeled object in another location is another aspect of the presented system and the authors explore a novel interaction paradigm to perform this task along with initial user tests.

Development of a bedside sensory testing kit for the neurologic classification of patients with osteoarthritis

Quantitative sensory testing is useful in clinical trials of osteoarthritis (OA) to determine the degree of peripheral and/or central sensitization present, and predict treatment response that may assist in selecting pain treatments. No standardized, comprehensive OA sensory assessment easily performed at the bedside exists. Thus we developed a simple Bedside Sensory Testing Kit for OA (BSTK-OA) to classify OA patients based on mechanisms of pain. Initial usability testing involved 22 OA subjects and was well tolerated.

Service Oriented Architecture to Support Mexican Secondary Education through Mobile Augmented Reality

This paper proposes a mobile augmented reality system that allows Mexican secondary education students to access additional educational contents related to their textbooks. Our system recognizes the images printed in the book as part of regular taught topics and shows multimedia contents that complement the topics covered in the book. These contents are generated through a service-oriented architecture. Initial usability testing of our augmented reality system showed a user satisfaction of 97%.

Development, implementation and initial evaluation of narrative virtual patients for use in vocational mental health nurse training

Simulation techniques such as virtual patients (VPs) are valuable tools for teaching and learning a range of clinical proficiencies. Compared with other forms of simulation, however, the reported use of VPs within nursing is limited. Descriptions of simple, low cost methods for the development of VP devices could help facilitate their wider implementation and use in nursing education and training. In order to encourage broader use of VP technologies within nursing, this paper aims to expand current knowledge of VP creation by reference to the development of two virtual mental health patients produced for a multilingual e-learning course for European mental health nurses. Focusing on narrative VPs, the paper provides a brief overview of various types and potential uses of VP techniques, along with central elements of good practice in VP development. The five phase development framework used in the creation of the two VPs is presented. Processes detailed include the design and construction of case scenarios and multimedia components, in addition to initial usability and validity testing. VPs like those described here are a relatively inexpensive way of integrating virtual simulation technology into nursing education, particularly within online, blended and/or cross-cultural learning environments.

Anonymized, genotype‐directed online nutrition guidance

Unaided tailoring of individual food selections to multiple genotype‐directed nutrient intake targets greatly exceeds the abilities of lay consumers and dietetic professionals alike. Previous draft versions provided proof‐of‐concept for computer‐assisted menu planning (http://www.nim.unc.edu/nutrition/guidance.html). Added functionalities and an expanded food database have now improved usability and consumer choice.The personal target sets depend on user characteristics and genetic data. The user never enters personally identifying information, DNA samples are identified by code.The algorithmic core calculates and ranks the sum of normalized parabolic distance functions relative to personal target sets of individually selectable nutrients and food groups in a potential menu. The program offers an initial choice of well‐matched daily meal plans. The user can then make unlimited modifications by replacing, adding or deleting items. Real‐time displays of color‐coded lists, which show alternative foods ranked by goodness‐of‐fit, make finding acceptable choices easy.Initial user tests indicate that this online tool effectively supports personalized meal planning based on complex genotype patterns.

Designing and evaluating UbiBall: a ubiquitous computing game for children

This paper provides an overview of a recent project called UbiBall – a ubiquitous exergame game developed by researchers at the Victoria University of Wellington, New Zealand. We survey the emerging field of exergaming, cover the design goals and processes and summarise the results obtained from our initial user testing. UbiBall features a ubiquitous computing ball outfitted with a microcontroller. The microcontroller emits sound and light in accordance with the various ways it is interacted with. It also data logs the play activity to a file, which then acts as a bridge between two modes of gameplay, one that is physical and active, and another that is a screen-based game. Ultimately, the game provided a fun and particularly active example of mobile exergaming for the children participants who tested the system.

Development of an Interactive Game-Based Rehabilitation Tool for Dynamic Balance Training

Conventional physical therapy techniques have been shown to improve balance, mobility, and gait following neurological injury. Treatment involves training patients to transfer weight onto the impaired limb to improve weight shift while standing and walking. Visual biofeedback and force plate systems are often used for treatment of balance and mobility disorders. Researchers have also been exploring the use of video game consoles such as the Nintendo Wii Fit as rehabilitation tools. Case studies have demonstrated that the use of video games may have promise for balance rehabilitation. However, initial usability studies and anecdotal evidence suggest that the current commercial games are not compatible with controlled, specific exercise required to meet therapy goals. Based on focus group data and observations with patients, a game has been developed to specifically target weight shift training using an open source game engine and the Nintendo Wii Fit Balance Board. The prototype underwent initial usability testing with a sample of clinicians and with persons with neurological injury. Overall, feedback was positive, and areas for improvement were identified. This preliminary research provides support for the development of a game that caters specifically to the key requirements of balance rehabilitation.

Patient-Centered Design of an Information Management Module for a Personally Controlled Health Record

BackgroundThe development of health information technologies should be informed by iterative experiments in which qualitative and quantitative methodologies provide a deeper understanding of the abilities, needs, and goals of the target audience for a personal health application.ObjectiveOur objective was to create an interface for parents of children with attention-deficit hyperactivity/disorder (ADHD) to enter disease-specific information to facilitate data entry with minimal task burden.MethodsWe developed an ADHD-specific personal health application to support data entry into a personally controlled health record (PCHR) using a three-step, iterative process: (1) a needs analysis by conducting focus groups with parents of children with ADHD and an heuristic evaluation of a prerelease version of a PCHR, (2) usability testing of an initial prototype personal health application following a “think aloud” protocol, (3) performance testing of a revised prototype, and (4) finalizing the design and functionality of the ADHD personal health application. Study populations for the three studies (focus groups and two usability testing studies) were recruited from organizations in the greater Boston area. Study eligibility included being an English- or Spanish-speaking parent who was the primary caretaker of a school-age child with ADHD. We determined subjects’ health literacy using the Test of Functional Health Literacy in Adults (TOFHLA). We assessed subjects’ task burden using the National Aeronautics and Space Administration (NASA) Task Load Index. To assess the impact of factors associated with the time spent entering data, we calculated Pearson correlation coefficients (r) between time on task and both task burden and subject characteristics. We conducted t tests to determine if time on task was associated with successful task completion.ResultsThe focus groups included three cohorts: 4 Spanish-speaking parents with diverse health literacy, 4 English-speaking parents with lower health literacy, and 7 English-speaking parents with higher health literacy. Both the initial usability testing cohort (n = 10) and the performance-testing cohort (n = 7) included parents of diverse health literacy and ethnicity. In performance testing, the prototype PCHRs captured patient-specific data with a mean time on task of 11.9 minutes (SD 6.5). Task burden experienced during data entry was not associated with successful task completion (P = .92). Subjects’ past computer experience was highly correlated with time on task (r = .86, P = .01), but not with task burden (r = .18, P = .69). The ADHD personal health application was finalized in response to these results by (1) simplifying the visual environment, (2) including items to support users limited by health literacy or technology experience, and (3) populating the application’s welcome screen with pictures of culturally diverse families to establish a personal family-oriented look and feel.ConclusionsOur patient-centered design process produced a usable ADHD-specific personal health application that minimizes the burden of data entry.

Special issue on personal interactive (TV) environments

Today’s changing TV environments require to consider the related shifts in user needs and behaviours. The demand for being mobile and having personalized access to information and entertainment anywhere and anytime for example, clearly shows that developers of interactive TV services find themselves confronted with new exciting challenges. Thus, both traditional broadcast TV and interactive TV need to understand the users in such a networked multimedia world. In this special issue topical research on interactivity, multimediality, personalization, and recommendation systems from both a technical and a user-centred viewpoint is presented. A combination of innovative systems, developed architectures, applied algorithms, and methodologies will be discussed. Moreover, new interaction concepts supporting personalized consumption and exchange of TV content for multi-user environments will be investigated and new concepts evolving from Web 2.0 for mobile networks will be highlighted. All articles underline the important challenges for the future development and design of personalized and interactive TV based systems and services. In the first article, Pablo Cesar, Dick C.A. Bulterman, and Jack Jansen present a TV viewing system which uses secondary screens for content control, enrichment and sharing. The system allows the users to control the viewed content (to choose the content and the device), add, e.g. a voice annotation to the content and share the annotation and the selected part of the content with others. The article also summarizes initial business analysis and user testing results. Elena Vildjiounaite et al. and Regina Bernhaupt et al. in their following two articles also address this need for more

Project Blacklight: a next generation library catalog at a first generation university

PurposeThis paper sets out to provide an overview of the open source online public access catalog (OPAC) software known as Blacklight. It includes a discussion of the reasons why the University of Virginia decided to create the Blacklight project, rationale behind design decisions, an overview of the technologies used, and some examples of interface designs and object behaviors.Design/methodology/approachDesign approaches discussed include open source methodologies, model/view/controller development patterns, and strategies for efficient staff training and utilization.FindingsThe Blacklight project is not yet complete, but initial usability testing is favorable. The project shows particular promise among previously underserved populations such as music researchers, and for previously under‐used collections.Practical implicationsLibraries who are considering de‐coupling their OPAC from their Integrated Library System will find useful information about this process as undertaken by the University of Virginia, as well as more information about Blacklight, and more information about whether Blacklight might be a good fit for their library.Originality/valueBlacklight is an open source OPAC system that is particularly well suited to large libraries with diverse collections. It is the only open source OPAC system with a focus on creating customized interfaces for specific populations.

Black Skin Dermatology Online, from the project to the website: a needed collaboration between North and South

Whereas teledermatology is an emerging discipline, to date, no teledermatology service has been developed, which is specifically dedicated to black skins. To create and develop a teledermatology service that provides a complete range of communication, information, telediagnosis and teaching services. A multilingual clinical description of the lesion was provided for each photograph using a five-level disease classification from the 10th revised International Classification of Diseases. In parallel, a usability study to assess and improve the functionality of the platform was also conducted. A web prototype has been developed which integrates image acquisition, submission, clinical description, translation as well as validation, security and data protection aspects and almost 2000 images were obtained from which 600 have been integrated in the 'store and forward' telemedicine system (http://www.black-skin.org). Initial usability tests with native French medical students show good perceived usefulness, perceived usability and internal consistency (Cronbach's alpha = 0.80 and 0.84). The Black Skin project (North and South collaboration project) offers possibilities for continuous medical education (pedagogical cases), teleteaching (educational quiz) or asking for a second opinion ('Ask a specialist' item).

Predicting Cognitive Readiness of Deploying Military Medical Teams

Cognitive readiness can be defined as “possessing the psychological (mental) and sociological (social) knowledge, skills, and attitudes (KSAs) that individuals and team members need to sustain competent professional performance and mental wellbeing in the dynamic, complex, and unpredictable environments of military operations.” Determining if medical personnel are cognitively ready to perform their job poses a considerable challenge to the research community both in terms of understanding what is meant by being cognitively ready and in terms of developing methods to actually assess it. Accordingly, as part of a government-sponsored research program, we set out to gain a better understanding of what is meant by being “cognitively ready” for military medical teams as well as develop a tool for predicting cognitive readiness. In this paper, we describe the design, development, and initial user testing of our Medical Cognitive REadiness Survey Tool (M-CREST).

A development environment for distributed synchronous collaborative programming

While collaborative approaches in the classroom have been shown to be highly beneficial for students of computer science, obstacles inherent in today's academic environment often prevent collocated collaborative approaches from being implemented. One solution to the collocation problem may lie with tools that facilitate distributed collaboration. This paper presents R IPPLE (Remote Interactive Pair Programming and Learning Environment), a development environment for distributed synchronous collaborative programming. R IPPLE is an open source software tool. Initial user tests demonstrate positive responses from students, and the potential for long term learning, motivation, and retention benefits is significant. In addition to its benefits for students, R IPPLE is a tool for computing education researchers who wish to collect data on collaborative programming.

Initial Usability Testing of Navigation and Interaction Methods in Virtual Environments: Developing Usable Interfaces for Brain Injury Rehabilitation

It is speculated that virtual environments (VE) might be used as a training tool in brain injury rehabilitation. The rehabilitation process often involves practicing so-called instrumental activities of daily living (IADL), such as shopping, cooking, and using a telephone. If a brain injury patient is to practice such activities in a VE, the patient must be able to navigate the viewpoint and interact with virtual objects in an understandable way. People with brain injury may be less tolerant to a poor interface and a VE might therefore become unusable due to, for example, an unsuitable input device. In this paper we present two studies aimed to do initial usability testing of VE interaction methods on people without experience of 3D computer graphics. In the first study four navigation input device configurations were compared: the IntelliKeys keyboard and the Microsoft Sidewinder joystick, both programmed with two and three degrees of freedom (DOF). The purpose of the second study was to evaluate a method for interaction with objects, and to find a sufficiently usable input device for this purpose. The keyboard was found to be more suitable for navigation tasks in which the user wants to give the viewpoint a more advantageous position and orientation for carrying out a specific task. No big differences could be found between two and three DOFs. The method for interaction with objects was found to work sufficiently well. No difference in performance could be found between mouse and touch screen, but some evidence was found that they affect the usability of the VE interface in different ways.

Text-Free User Interfaces for Illiterate and Semiliterate Users

We describe work toward the goal of a user interface designed such that even novice, illiterate users require absolutely no intervention from anyone at all to use. Our text-free user interface is based on many hours of ethnographic design conducted in collaboration with a community of illiterate domestic labourers in three Bangalore slums. An ethnographic design process was used to understand what kind of application subjects would be interested in, how they respond to computing technology, and how they react to specific UI elements. We built two applications using these principles, one for job search for domestic labourers, and another for a generic map that could be used for navigating a city. The resulting designs are based on key lessons that we gained through the design process. The paper describes the design process, the design principles which evolved out of the process, the final application design, and results from initial user testing. Our results confirm previous work that emphasizes the need for semi-abstracted graphics and voice feedback, but we additionally find that some aspects of design for illiterate users that have been previously overlooked (such as a consistent help feature). Results also show that the text-free designs are strongly preferred over standard text-based interfaces by the communities which we address, and that they are potentially able to bring even complex computer functions within the reach of users who are unable to read.