Usability Testing of an Online Self-management Program for Adolescents With Juvenile Idiopathic Arthritis

Background A new bilingual (English and French) Internet-based self-management program, Teens Taking Charge: Managing Arthritis Online, for adolescents with arthritis and their parents was developed following a needs assessment. Objectives This study explored the usability (user performance and satisfaction) of the self-management program for youth with juvenile idiopathic arthritis (JIA) and their parents to refine the health portal prototype. Methods A qualitative study design with semi-structured, audio taped interviews and observation by a trained observer was undertaken with two iterative cycles to determine the usability (ease of use, efficiency, errors, and user satisfaction) of the user interface and content areas of the intervention. A purposive sample of English-speaking (n = 11; mean age = 15.4, standard deviation [SD] 1.7) and French-speaking (n = 8; mean age = 16.0, SD 1.2) adolescents with JIA and one of their respective parents/caregivers were recruited from 2 Canadian tertiary care centers. Descriptive statistics and simple content analyses were used to organize data into categories that reflected the emerging usability themes. Results All of the participants had access to a computer/Internet at home; however, adolescents were more comfortable using the computer/Internet than their parents. Adolescents and parents provided similar as well as differing suggestions on how the website user interface could be improved in terms of its usability (navigation; presentation and control usage errors; format and layout; as well as areas for further content development). There were no major differences in usability issues between English- and French-speaking participants. Minor changes to the website user interface were made and tested in a second cycle of participants. No further usability problems were identified in the second iterative cycle of testing. Teens and parents responded positively to the appearance and theme of the website (ie, promoting self-management) and felt that it was easy to navigate, use, and understand. Participants felt that the content was appropriate and geared to meet the unique needs of adolescents with JIA and their parents as well as English- and French-speaking families. Many participants responded that the interactive features (discussion board, stories of hope, and video clips of youth with JIA) made them feel supported and “not alone” in their illness. Conclusions We describe the usability testing of a self-management health portal designed for English- and French-speaking youth with arthritis and their parents, which uncovered several usability issues. Usability testing is a crucial step in the development of self-management health portals to ensure that the various end users (youth and parents) have the ability to access, understand, and use health-related information and services that are delivered via the Internet and that they are delivered in an efficient, effective, satisfying, and culturally competent manner.

[1]  J. McDonagh,et al.  Health-related quality of life in adolescents with juvenile idiopathic arthritis. , 2006, Arthritis and rheumatism.

[2]  J. Stinson,et al.  Surfing for Juvenile Idiopathic Arthritis: Perspectives on Quality and Content of Information on the Internet , 2009, The Journal of Rheumatology.

[3]  Huong Q. Nguyen,et al.  Internet-based patient education and support interventions: a review of evaluation studies and directions for future research , 2004, Comput. Biol. Medicine.

[4]  C. Wright,et al.  Self-management approaches for people with chronic conditions: a review. , 2002, Patient education and counseling.

[5]  M. Cheang,et al.  Epidemiology of chronic arthritis in childhood. , 1996, Seminars in arthritis and rheumatism.

[6]  M. Sandelowski.  Focus on Research Methods Whatever Happened to Qualitative Description? , 2022 .

[7]  J. Powell,et al.  Empirical studies assessing the quality of health information for consumers on the world wide web: a systematic review. , 2002, JAMA.

[8]  M. Rapoff.  Assessing and enhancing adherence to medical regimens for juvenile rheumatoid arthritis. , 2002, Pediatric annals.

[9]  A. Martini,et al.  Relative responsiveness of condition specific and generic health status measures in juvenile idiopathic arthritis , 2005, Annals of the rheumatic diseases.

[10]  Jessica Holt,et al.  A systematic review of internet-based self-management interventions for youth with health conditions. , 2009, Journal of pediatric psychology.

[11]  D. Cox,et al.  Internet interventions: In review, in use, and into the future. , 2003 .

[12]  Jeremy C Wyatt,et al.  Evaluation of ehealth systems and services , 2004, BMJ : British Medical Journal.

[13]  Richard Coyne,et al.  Models, Metaphors and the Hermeneutics of Designing , 1992 .

[14]  Leanne M. Currie,et al.  Evaluation frameworks for nursing informatics , 2005, Int. J. Medical Informatics.

[15]  E. Badley,et al.  Unmet service needs of children with rheumatic diseases and their parents in a metropolitan area. , 1996, The Journal of rheumatology.

[16]  Jennifer N Stinson,et al.  Asking the experts: exploring the self-management needs of adolescents with arthritis. , 2008, Arthritis and rheumatism.

[17]  K. Shaw,et al.  Consulting the 'experts': children's and parents' perceptions of psycho-educational interventions in the context of juvenile chronic arthritis. , 1999, Health education research.

[18]  J. Klein,et al.  Health information-seeking behaviour in adolescence: the place of the internet. , 2005, Social science & medicine.

[19]  J. Peters,et al.  Introducing touchscreens to black and ethnic minority groups--a report of processes and issues in the Three Cities project. , 2003, Health information and libraries journal.

[20]  M. White,et al.  Receiving social support online: implications for health education. , 2001, Health education research.

[21]  Claudia Pagliari,et al.  Design and Evaluation in eHealth: Challenges and Implications for an Interdisciplinary Field , 2007, Journal of medical Internet research.

[22]  LeAdelle Phelps,et al.  Chronic health-related disorders in children: Collaborative medical and psychoeducational interventions. , 2006 .

[23]  U. Reinhardt,et al.  Health care spending and use of information technology in OECD countries. , 2006, Health affairs.

[24]  André Kushniruk,et al.  Evaluation in the design of health information systems: application of approaches emerging from usability engineering , 2002, Comput. Biol. Medicine.

[25]  A M Wichansky,et al.  Usability testing in 2000 and beyond , 2000, Ergonomics.

[26]  J. Campinha-Bacote.  The Process of Cultural Competence in the Delivery of Healthcare Services: A Model of Care , 2002, Journal of transcultural nursing : official journal of the Transcultural Nursing Society.