User-centred design of a mobile self-management solution for Parkinson's disease

ABSTRACT

Parkinson's disease (PD) is a highly prevalent and disabling condition, requiring frequent medication adjustments. In parallel, non-adherence to medical treatment might lead to severe consequences. Therefore, a solution to monitor PD symptoms, allowing neurologists to make informed decisions about medication adjustments, and one which could promote medical treatment adherence would be beneficial for both the patient and the medical doctor. In this paper we present the rationale and user-centred process for the design of four smartphone applications for the self-management of PD. We present the methods for evaluation and the results of usability tests. The results show that user-centred methods were efficient and that people with PD were able to achieve high task completion rates on usability tests with three of the applications for PD self-management. Future work should focus on detailed improvement of touch screen sensitivity to optimize error prevention.

References

1. Wirdefeldt, K., Adami, H. O., Cole, P., Trichopoulos, D., and Mandel, J. 2011. Epidemiology and etiology of Parkinson's disease: A review of the evidence. European Journal of Epidemiology 26, Suppl 1 (June 2011), S1--58.
2. Massano, J. and Bhatia, K. P. 2012. Clinical approach to Parkinson's disease: Features, diagnosis, and principles of management. Cold Spring Harbor Perspectives in Medicine 2, 6, a008870.
3. Correia de Barros, A., Duarte, C., and Cruz, J. B. 2011. The influence of context on product judgement -- Presenting assistive products as consumer goods. International Journal of Design 5, 3, 99--112.
4. Holman, H. and Lorig, K. 2004. Patient self-management: A key to effectiveness and efficiency in care of chronic disease. Public Health Reports 119, 239--243.
5. Gauffin, L. and Lundman, M. 2003. Towards improved user participation. In Proceedings of the AAATE Conference (Dublin, Ireland).
6. Council of the European Union, Conclusions on a future smart regulation agenda with a strong end-user focus, 2012.
7. Orwat, C., Graefe, A., and Faulwasser, T. 2008. Towards pervasive computing in health care - A literature review. BMC Medical Informatics and Decision Making 8, 26.
8. Sánchez, M. A., Beato, E., Salvador, D., and Martín, A. 2011. Mobile assistant for the elder (MASEL): A practical application for smart mobility. Advances in Intelligent and Soft Computing 89, 325--331.
9. Krishna, S., Boren, S. A., and Balas, E. A. 2009. Healthcare via cell phones: A systematic review. Telemedicine and e-health 15, 3, 231--240.
10. Kauw-A-Tjoe, R., Thalen, J., Marin-Perianu, M., and Havinga, P. 2007. SensorShoe: Mobile gait analysis for Parkinson's disease patients. In UbiComp 2007 Workshop Proceedings (Innsbruck, Austria, September 16--19, 2007).
11. Memedi, M., Westin, J., Nyholm, D., Dougherty, M., and Groth, T. 2011. A web application for follow-up of results from a mobile device test battery for Parkinson's disease patients. Biomedicine104, 2, 219--226.
12. van Dulmen, S., Sluijs, E., van Dijk, L., de Ridder, D., Heerdink, R., and Bensing, J. 2007. Patient adherence to medical treatment: A review of reviews. BMC Health Services Research 7, 55 (April 17).
13. Vermeire, E., Hearnshaw, H., Van Royen, P., and Denekens, J. 2001. Patient adherence to treatment: Three decades of research. A comprehensive review. Journal of Clinial Pharmacy and Therapeutics 26, 331--342.
14. The Center for Universal Design. 1997. The principles of universal design (Version 2.0), Raleigh, NC: NC State University.
15. Chen, K. B., Savage, A. B., Chourasia, A. O., Wiegmann, D. A., and Sesto, M. E. 2013. Touch screen performance by individuals with and without motor control disabilities. Applied Ergonomics 44, 297--302.
16. Fisk, A. D., Rogers, W. A., Charness, N., Czaja, S. J., and Sharit, J. 2009. Designing for older adults: Principles and creative human factors approaches. Boca Raton, CRC Press.
17. Pak, R. and McLaughlin, A. 2011. Designing displays for older adults. Boca Raton, CRC Press.
18. Cunningham, L. M., Finlay, D. D., Moore, G., and Craig, D. 2009. A review of assistive technologies for people with Parkinson's disease. Technology and Health Care 17, 3, 269--279.
19. Keates, S. and Trewin, S. 2005. Effect of age and Parkinson's disease on cursor positioning using a mouse. In Proceedings of the 7th International ACM SIGACCESS Conference on Assistive Technologies (Baltimore, USA, October 09--12, 2005). ASSETS 05, ACM, New York, NY, 68--75. DOI = http://dl.acm.org/citation.cfm?id=1090800
20. Maziewski, P., Suchomski, P., Kostek, B., and Czyzewski, A. 2009. An intuitive graphical user interface for the Parkinson's disease patients. In Proceedings of the 4th International IEEE/EMBS Conference on Neural Engineering.
21. Johnson, C. M., Johnson, T. R., and Zhang, J. 2005. A user-centered framework for redesigning health care interfaces. Journal of Biomedical Informatics 38, 75--87.
22. Gould, J. D., and Lewis, C. 1985. Designing for usability: key principles and what designers think. Communications of the ACM, 28, 3 (March 1985). ACM, New York, NY, 300--311. DOI=http://dx.doi.org/10.1145/3166.3170
23. De Vito Dabbs, A., Myers, B. A., Mc Curry, K. R., Dunbar-Jacob, J., Hawkins, R. P., Begey, A., and Dew, M. A. 2009. User-centered design and interactive health technologies for patients. Computers, Informatics, Nursing 27, 3, 175.
24. Eisma, R., Dickinson, A., Goodman, J., Syme, A., Tiwari, L., and Newell, A. F. 2004. Early user involvement in the development of information technology-related products for older people. Universal Access in the Information Society 3, 2, 131--140.
25. Lindsay, S. 2011. Engaging older adults and people with dementia in the design of digital technologies. Doctoral thesis. School of Computing Science, Newcastle University.
26. McNaney, R., Lindsay, S., Ladha, K., Ladha, C., Schofield, G., Ploetz, T., Hammerla, N., Jackson, D., Walker, R., Miller, N., and Olivier, P. 2011. Cueing for drooling in Parkinson's disease. In Proceedings of the SIGCHI Conference on Human Factors in Computing Systems (Vancouver, Canada, May 07--12, 2011). CHI'11. ACM, New York, NY, 619--622. DOI=http://dx.doi.org/10.1145/1978942.1979030
27. Edwards, M., Quinn, N., and Bahtia, K. 2008. Parkinson's disease and other movement disorders (Oxford specialist handbooks in neurology). Oxford, Oxford University Press.
28. Jankovic, J. 2008. Parkinson's disease: clinical features and diagnosis. Journal of Neurology, Neurosurgery and Psychiatry 79, 4, 368--376.
29. Bonnet, A. M., Jutras, M. F., Czernecki, V., Corvol, J. C., and Vidailhet, M. 2012. Nonmotor symptoms in Parkinson's disease in 2012: relevant clinical aspects. Parkinson's Disease, 2012(2012).
30. Zesiewicz, T. A., Sullivan, K. L., and Hauser, R. A. 2006. Nonmotor symptoms of Parkinson's disease. Expert Rev Neurother. 6, 12 (Dec. 2006), 1811--1822.
31. Dubois, B. and Pillon, B. 1996. Cognitive deficits in Parkinson's disease. J Neurol, 244, 1 (1996), 2--8.
32. Kelly, V. E., Eusterbrock, A. J., and Shumway-Cook, A. 2012. A review of dual-task walking deficits in people with Parkinson's disease: Motor and cognitive contributions, mechanisms, and clinical implications. Parkinson's Disease, 2012, Article ID 918719.
33. Rubin, J. and Chisnell, A. L. 2008. Handbook of usability testing: How to plan, design and conduct effective tests. Indianapolis, Wiley Publishing, Inc.
34. Silva, P. A. and Nunes, F. 2010. 3 x 7 usability testing guidelines for older adults. In MexIHC 2010.
35. Frost, J. H. and Massagli, M. P. 2008. Social Uses of Personal Health Information Within PatientsLikeMe, an Online Patient Community: What Can Happen When Patients Have Access to One Another's Data. J Med Internet Res. 13, 3, e15.
36. Little, M., Wicks, P., Vaughan, T., and Pentland, A. 2013. Quantifying short-term dynamics of Parkinson's disease using self-reported symptom data from an internet social network. J Med Internet Res 15, 1, e20.
37. Ascertaining Barriers for Compliance. 2012. Ascertaining barriers for compliance: Policies for safe, effective and cost-effective use of medicines in Europe - Final report of the ABC Project. Lodz.
38. Correia de Barros, A. and Leitão, R. 2013. Young practitioners' challenges, experience and strategies in usability testing with older adults. In Assistive Technology: From Research to Practice -- AAATE 2013, P. Encarnação, L. Azevedo, G. J. Gelderblom, and N-E Mathiassen, Eds. IOS Press, Amsterdam, 787--792.
39. Nielsen, J. 2000. Why you only need to test with five users. Retrieved October 18, 2013, from Nielsen Norman Group: http://www.nngroup.com/articles/why-you-only-need-to-test-with-5-users/
40. Schmettow, M. 2012. Sample size in usability studies. Communications of the ACM, 55, 4 (April 2012). ACM, New York, NY, 64--70. DOI=http://dx.doi.org/10.1145/2133806.2133824

Index Terms

• Human-centered computing

  • Accessibility

  • Human computer interaction (HCI)

    • Empirical studies in HCI

    • Interaction devices

      • Touch screens

    • Interaction paradigms

      • Graphical user interfaces

  • Interaction design

    • Interaction design process and methods

      • User centered design