Iterative refinement of a tailored system for self-care management of depressive symptoms in people living with HIV/AIDS through heuristic evaluation and end user testing

Abstract

Background: HIV TIDES -tailored interventions for self-care management of depressive symptoms for people living with HIV/AIDS (PLWHA) -provides assessment of depression and tailored education on self-care strategies to decrease the risk of developing clinical depressive disorders. The iterative refinement of the prototype is an important process during system development to ensure that the design of the system is easy to use and useful. Methods:The heuristic evaluation and usability testing methodologies were used to guide the iteration of the HIV TIDES. Results:The system's compliance with the majority of usability concepts and current standards was confirmed by three experts on human-computer interaction in the heuristic evaluation. However, a number of usability problems were identified. Refinements were made based on experts' recommendations prior to the usability testing. The usability testing included six PLWHA with various levels of computer experience. Data from this iterative testing informed the refinement of key pages and the development of new features. Conclusions:The final version of HIV TIDES consists of 73 messages. The average readability level of the messages is 6.0 based on the Flesch-Kincaid Grade Level and the average word count is 103.Keywords depressive symptom; HIV/AIDS; tailoring; self-care management; heuristic evaluation; usability testing Summary Points:What was known before the study?• Usability evaluation is a necessary step for improving system ease of use and usefulness during the system development process.• Heuristic evaluation with usability experts provides efficient feedback at a relatively low cost in the early stages of system development.Correspondent: Tsai-Ya Lai Mail Code 6 630 West 168 th Street New York, NY 10032 Office: 212−305−6451 E-mail: TL105@columbia.edu. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. • Usability testing explores sustainability problems from the perspective of system end users. NIH Public AccessAuthor Manuscript Int J Med Inform. Author manuscript; available in PMC 2008 October 1.What has the study added to the body of knowledge?• In order to evaluate a tailoring system, testing scenarios should be carefully designed to reflect all functions that were included in the system. • Discussion with experts at the end of the heuristic evaluation session is a critical step prioritizing the usability problems and exploring possible solutions for system iterations.• The involvement of PLWHA with various computer backgrounds in the usability testing enhances the likelihood that the system fits the needs of a...

It Feels Like I'm Managing Myself

“…However, there are currently very few PHI tools dedicated to HIV. TIDES [11], an application developed in academia, is designed to provide targeted interventions to HIV+ people to support self-care and avoid depression. A solution from industry, myHIV (www.tht.org.uk/myhiv), can be used to set up reminders to take pills and record lab results.…”

“…First, being diagnosed as HIV+, as well as taking ARV drugs, can have negative effects on a person's mental health. Because depression is a significant factor related to ARV non-compliance [11], it is important to maintain a positive mental wellbeing. Second, it is important for people living with HIV to maintain a stable and healthy body-mass index; being over-weight or underweight means poorer increases in CD4 over time.…”

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A Mobile Health Intervention for HIV Prevention Among Racially and Ethnically Diverse Young Men: Usability Evaluation (Preprint)

“…We employed two usability evaluation methods most commonly used in usability studies (i.e., a heuristic evaluation and end-user testing) to capture different usability perspectives from experts and endusers. [33] Similar to prior research, usability experts were more likely to identify usability problems related to general interface features working in a natural and logical order, [34,35] whereas end-users identified those related to impact on task performance interacting with the app. [16] For example, contrary to feedback received from experts in the heuristic evaluation regarding the usability factor Match between System and the Real World, our end-users did not identify the natural/logical order of response options as a problem.…”