Accessibility of mHealth Self-Care Apps for Individuals with Spina Bifida.

As the smartphone becomes ubiquitous, mobile health is becoming a viable technology to empower individuals to engage in preventive self-care. An innovative mobile health system called iMHere (Internet Mobile Health and Rehabilitation) has been developed at the University of Pittsburgh to support self-care and adherence to self-care regimens for individuals with spina bifida and other complex conditions who are vulnerable to secondary complications. The goal of this study was to explore the accessibility of iMHere apps for individuals with spina bifida. Six participants were asked to perform tasks in a lab environment. Though all of the participants were satisfied with the iMHere apps and would use them again in the future, their needs and preferences to access and use iMHere apps differed. Personalization that provides the ability for a participant to modify the appearance of content, such as the size of the icons and the color of text, could be an ideal solution to address potential issues and barriers to accessibility. The importance of personalization--and potential strategies--for accessibility are discussed.

[1]  Sarah M. Greene,et al.  Finding common ground: patient-centeredness and evidence-based chronic illness care. , 2005, Journal of alternative and complementary medicine.

[2]  H. Becker,et al.  Health promotion practices in women with multiple sclerosis: increasing quality and years of healthy life. , 2001, Physical medicine and rehabilitation clinics of North America.

[3]  Sethuraman Panchanathan,et al.  A demonstration of phototacs: a simple image-based phone dialing interface for people with cognitive or visual impairments , 2008, Assets '08.

[4]  Stephen A. Brewster,et al.  Maximising screen-space on mobile computing devices , 1999, CHI Extended Abstracts.

[5]  Julio Abascal,et al.  Universal access to mobile telephony as a way to enhance the autonomy of elderly people , 2001, WUAUC'01.

[6]  Morten Hertzum,et al.  The Evaluator Effect: A Chilling Fact About Usability Evaluation Methods , 2001, Int. J. Hum. Comput. Interact..

[7]  James R. Lewis,et al.  Sample sizes for usability tests: mostly math, not magic , 2006, INTR.

[8]  Akhila Kosaraju,et al.  Use of mobile phones as a tool for United States health diplomacy abroad. , 2010, Telemedicine journal and e-health : the official journal of the American Telemedicine Association.

[9]  Sj Wu,et al.  A Projection of Chronic Illness Prevalence and Cost Inflation , 2000 .

[10]  Richard E. Ladner,et al.  Freedom to roam: a study of mobile device adoption and accessibility for people with visual and motor disabilities , 2009, Assets '09.

[11]  S. Lindgren,et al.  Health promotion for people with disabilities: development and evaluation of the Living Well with a Disability program. , 2006, Health education research.

[12]  Jakob Nielsen,et al.  Determining Usability Test Sample Size , 2006 .

[13]  Murni Mahmud,et al.  A study of the use of mobile phones by older persons , 2006, CHI Extended Abstracts.

[14]  Stephen A. Brewster,et al.  Overcoming the Lack of Screen Space on Mobile Computers , 2002, Personal and Ubiquitous Computing.

[15]  Jacob O. Wobbrock,et al.  Slide rule: making mobile touch screens accessible to blind people using multi-touch interaction techniques , 2008, Assets '08.

[16]  Thomas Bodenheimer,et al.  Improving primary care for patients with chronic illness: the chronic care model, Part 2. , 2002, JAMA.

[17]  H. Holman,et al.  Chronic disease--the need for a new clinical education. , 2004, JAMA.

[18]  V. Nelson,et al.  Assessment of a Holistic Wellness Program for Persons with Spinal Cord Injury , 2003, American journal of physical medicine & rehabilitation.

[19]  K. Lorig,et al.  Self-management education: History, definition, outcomes, and mechanisms , 2003, Annals of behavioral medicine : a publication of the Society of Behavioral Medicine.

[20]  T. Seekins,et al.  Working well with a disability: health promotion as a means to employment. , 2012, Rehabilitation psychology.

[21]  Tetsuya Watanabe,et al.  A Survey on the Use of Mobile Phones by Visually Impaired Persons in Japan , 2008, ICCHP.

[22]  Noreen M Clark,et al.  Management of chronic disease by patients. , 2003, Annual review of public health.

[23]  Dongsoo Han,et al.  THE-MUSS: Mobile U-Health Service System , 2008, BIOSTEC.

[24]  Brad E Dicianno,et al.  Hospitalizations of adults with spina bifida and congenital spinal cord anomalies. , 2010, Archives of physical medicine and rehabilitation.

[25]  Lijing Ouyang,et al.  Health care expenditures of children and adults with spina bifida in a privately insured U.S. population. , 2007, Birth defects research. Part A, Clinical and molecular teratology.

[26]  Bambang Parmanto,et al.  iMHere: A Novel mHealth System for Supporting Self-Care in Management of Complex and Chronic Conditions , 2013, JMIR mHealth and uHealth.

[27]  Bambang Parmanto,et al.  VISYTER: versatile and integrated system for telerehabilitation. , 2010, Telemedicine journal and e-health : the official journal of the American Telemedicine Association.

[28]  Stephen A. Brewster,et al.  Gestural and audio metaphors as a means of control for mobile devices , 2002, CHI.

[29]  Steven Dow,et al.  Mobile ADVICE: an accessible device for visually impaired capability enhancement , 2003, CHI Extended Abstracts.

[30]  Patrick Baudisch,et al.  Blindsight: eyes-free access to mobile phones , 2008, CHI.

[31]  T. Seekins,et al.  Disability and health behavior change. , 2011, Disability and health journal.

[32]  Rosalind W. Picard,et al.  Wireless Technologies, Ubiquitous Computing and Mobile Health: Application to Drug Abuse Treatment and Compliance with HIV Therapies , 2010, Journal of Medical Toxicology.

[33]  A. Barton.  Using mobile health technology to enhance patient-centered care. , 2010, Clinical nurse specialist CNS.