2009 Conference Presentation

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2009 HESCA Conference Presentation

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2009 Conference Presentation

  1. 1. INShape Indiana: A Case Study in Evaluating Health Web Site Usability<br />Peter J. Ellery & Jane Ellery<br />Fisher Institute for Wellness and Gerontology<br />1<br />2009 Health Sciences Communications Association Conference - St. Louis, MO<br />
  2. 2. Salutogenesis: A Theoretical Approach to Understanding Usability<br />2009 Health Sciences Communications Association Conference - St. Louis, MO<br />2<br />
  3. 3. Using a Theoretical Foundation in the Designing of Health Information Websites<br /><ul><li>“There is nothing more practical than a good theory” – Kurt Lewin, social psychologist
  4. 4. “The problem, however, is that bright ideas, as long as they are unintegrated into a good theory … are not very helpful. More significantly, a good theory will give birth to productive ideas. “ – Aaron Antonovsky, social psychologist
  5. 5. A theoretical framework is practical because it organizes and directs thinking toward solutions.</li></ul>2009 Health Sciences Communications Association Conference - St. Louis, MO<br />3<br />
  6. 6. 2009 Health Sciences Communications Association Conference - St. Louis, MO<br />4<br />Do you have the time and resources needed to cope with the problems you face on a daily basis?<br />Salutogenesis: Perceiving Life as Meaningful, Manageable, and Comprehensible<br />Is the information you receive ordered, consistent, structured, and clear? Does it conform with the way you understand the world to be?<br />Is what you do adding value and meaning to your life? <br />Meaningful<br />Comprehensible<br />
  7. 7. 2009 Health Sciences Communications Association Conference - St. Louis, MO<br />5<br />General Resistance Resources/Deficits Contribute to our Sense of Coherence<br /><ul><li>Properties of a person, a collective, or a situation that facilitate successful coping with the inherent stressors of human existence
  8. 8. The one quality GRRs have in common… they all foster repeated life experiences that help one see the world as ‘making sense,’ cognitively, instrumentally and emotionally
  9. 9. General examples: Wealth, ego strength, cultural stability, environment, support structure </li></ul>GRRs give rise to or reinforces a strong Sense of Coherence<br />
  10. 10. 2009 Health Sciences Communications Association Conference - St. Louis, MO<br />Does the information on your website improve the life of your client base in a way that they can appreciate? <br />Incorporating User Sense of Coherence into the Design of Health Information Websites<br />Does your client base have the knowledge, skills and means to effectively access and use the information offered on the website?<br />What should a health information website contain and how should it look and work so that my client base keeps coming back and using it?<br />Comprehensibility<br />Is the information being offered presented in a way that the client base can readily understand and assimilate?<br />6<br />
  11. 11. 2009 Health Sciences Communications Association Conference - St. Louis, MO<br />7<br /><ul><li>Access to a computer and the Internet
  12. 12. Existing level of knowledge related to the content presented
  13. 13. Level of comfort navigating websites
  14. 14. Willingness to download files
  15. 15. Likely security level for Internet browsing
  16. 16. Choice of web browsing software
  17. 17. Other software already loaded
  18. 18. Education level
  19. 19. Literacy level
  20. 20. Time
  21. 21. Availability of technical assistance
  22. 22. Others?
  23. 23. Once the information is received… do your clients have the resources to use the information?</li></ul>Incorporating General Resistance Resources/Deficits into the Design of Health Information Websites<br />What resources do my clients have, and what deficits do they have, related to using the website and taking action on the information presented?<br />
  24. 24. INShape Indiana: Website Usability from an Individual Perspective<br />2009 Health Sciences Communications Association Conference - St. Louis, MO<br />8<br />
  25. 25. 2009 Health Sciences Communications Association Conference - St. Louis, MO<br />9<br />Program Overview<br /><ul><li>Indiana State Government supported health and wellness program that is promoted through Indiana businesses and organizations.
  26. 26. Primarily a web-based health and wellness promotion program that also utilizes motivational/informational emails to participants.
  27. 27. The program currently has a participant database for over 63,000 “Hoosiers” of which approximately 70% are female participants.</li></li></ul><li>2009 Health Sciences Communications Association Conference - St. Louis, MO<br />10<br />Research Questions<br />The purpose of this study was to determine the usability of the website. This usability evaluation was based on the following questions:<br /><ul><li>How meaningful is the website and information found on it?
  28. 28. Is the website and its information valuable to the user?
  29. 29. How manageable is the website?
  30. 30. How difficult is it for the user to access and understand the website and information on it?
  31. 31. How comprehensible is the website?
  32. 32. Does the website and information conform to the users current lifestyle?
  33. 33. Which specific aspects of the website and its contents do users like and dislike?</li></li></ul><li>2009 Health Sciences Communications Association Conference - St. Louis, MO<br />11<br />Study Design<br />The study utilized a qualitative research approach involving:<br /><ul><li>The interviewing of subjects while performing tasks on the INShape Indiana website;
  34. 34. ASL eye tracking technology to monitor user eye movement around the web pages;
  35. 35. Morae Usability software to capture subject voice and facial expression while the website is being used; and,
  36. 36. An “Orientation to the Website” survey designed to determine the participants receptiveness to the web site. It should be noted that this survey is still under development and that the results are designed to provide a measure of user’s website experience for each of the first 3 research questions being pursued in this study.</li></li></ul><li>2009 Health Sciences Communications Association Conference - St. Louis, MO<br />12<br />ASL Eye Tracking Data Collection<br /><ul><li>Applied Science Laboratories (ASL) provides desktop equipment that allows the eyes to be tracked while the subject is looking at a screen.
  37. 37. This equipment allows us to determine:
  38. 38. Where the user looks on the screen to try and complete a task
  39. 39. The gaze path the user has as they try and complete a task, and
  40. 40. The time spent looking at different parts of the web page while completing tasks.</li></li></ul><li>2009 Health Sciences Communications Association Conference - St. Louis, MO<br />13<br />MORAE Website Usability Analysis Software<br /><ul><li>The TechSmith MORAE usability software allows for the analysis of a web site in terms of:
  41. 41. What participants are doing when they are given a task on the website
  42. 42. Which web links are used most often, and
  43. 43. How participants feel from verbal comments, facial expressions and body language that are all captured on video.</li></li></ul><li>2009 Health Sciences Communications Association Conference - St. Louis, MO<br />14<br />Subject Selection and Characteristics<br /><ul><li>16 volunteer subjects participated in the study.
  44. 44. Group demographics and characteristics included:
  45. 45. All were Ball State University employees currently enrolled in INShape Indiana
  46. 46. 3 to 1 Female to Male ratio (which was representative of the INShape Indiana Membership gender makeup)
  47. 47. A variety of education levels
  48. 48. 3 (Some College Education); 4 (Bachelors Degree); & 9 (Graduate or Terminal Degree)
  49. 49. A variety of age levels
  50. 50. 3 (18-24); 4 (25-34); 3 (35-44); 0 (45-54); & 6 (55 and older)
  51. 51. A variety of computer use and weekly internet access time
  52. 52. 2 (2 to 3 times per week); 3 (4 to 5 times per week); & 11 (everyday)
  53. 53. All but one had been to the website prior to the study</li></li></ul><li>2009 Health Sciences Communications Association Conference - St. Louis, MO<br />15<br />Interview Task List<br /><ul><li>The participants in the study were asked to complete tasks and provide their thoughts and opinions related to different aspects of the website.
  54. 54. Tasks and activities were developed based on the following website sections:
  55. 55. The landing page or initial “home” page for the website
  56. 56. Signing up and the support information section of the website
  57. 57. The tools and resources section of the website
  58. 58. The current program support information
  59. 59. Participants completed tasks and activities that were considered typical and common to users of this kind of website.</li></li></ul><li>2009 Health Sciences Communications Association Conference - St. Louis, MO<br />16<br />Subscription and Supporting Information <br />Section Activities<br /><ul><li>Subjects were then asked to:
  60. 60. Join INShape Indiana and subscribe to the email list using the e-mail address subject@assessment.com. Now unsubscribe from the list.
  61. 61. Go to, and review a physical activity or tobacco cessation resource of interest to you from this website.
  62. 62. Go to, and read, an INShape Success Story that interests you.
  63. 63. Again, opinions and suggestions were sought both during the activities and upon completions of the tasks.</li></li></ul><li>2009 Health Sciences Communications Association Conference - St. Louis, MO<br />17<br />Tools and Resources Section Activities<br /><ul><li>Subjects were asked to complete the following tasks and provide their opinions and suggestions on their experience in this process.
  64. 64. Can you find a Calorie Counter on this website? Now, find out how many grams of fat are in the Chicken and Broccoli Pasta dish from Ruby Tuesdays (Answer = 80 grams).
  65. 65. Can you find the information available on this website describing how to create an exercise program for older adults?
  66. 66. Find an INShape Indiana partner listed on the website that interests you and click on their link. Have a quick look around the site you are now at and tell us what you think of the website you have been taken to.</li></li></ul><li>2009 Health Sciences Communications Association Conference - St. Louis, MO<br />18<br />Program Support Section Activities<br /><ul><li>Finally, subjects were asked to provide their thoughts on the program support materials offered through the website.
  67. 67. In this section, they were asked to:
  68. 68. Find and read the Week 6 Ready, Set Walk newsletter.
  69. 69. Find and view the First Lady Cheri DanielsWeek 7 Walking Tip video.</li></li></ul><li>2009 Health Sciences Communications Association Conference - St. Louis, MO<br />19<br />Home/Landing Page Activities<br /><ul><li>Subjects were directed to the website address www.in.gov/inshape/ . This address was designated the “landing page” for the purposes of this study.
  70. 70. Subjects were then asked to provide their thoughts on the number of links on the page, the layout of the page, whether or not the information being offered was of interest to them, and whether or not the information provided was useful/valuable.</li></li></ul><li>2009 Health Sciences Communications Association Conference - St. Louis, MO<br />20<br />What the Subjects Were Looking At …<br /><ul><li>Links to the left and right were readily noticed;
  71. 71. And, the central image does draw viewer attention.
  72. 72. However, the web page content did not appear to catch the subject’s attention very much.</li></li></ul><li>2009 Health Sciences Communications Association Conference - St. Louis, MO<br />21<br />What the Subjects Were Looking At …<br /><ul><li>Links to the left and right were readily noticed;
  73. 73. And, the central image does draw viewer attention.
  74. 74. However, the web page content did not appear to catch the subject’s attention very much.</li></li></ul><li>2009 Health Sciences Communications Association Conference - St. Louis, MO<br />22<br />What the Subjects Were Looking At …<br /><ul><li>Links to the left and right were readily noticed;
  75. 75. And, the central image does draw viewer attention.
  76. 76. However, the web page content did not appear to catch the subject’s attention very much.</li></li></ul><li>2009 Health Sciences Communications Association Conference - St. Louis, MO<br />23<br />The Landing Page<br /><ul><li>Resources offered are valuable. For example, Talk to a Nutritionist is “good because my husband is a diabetic and I can ask questions”.
  77. 77. Good to have the FAQ’s quickly accessible here.
  78. 78. Information offered is valuable and relevant
  79. 79. Remove it from the .gov portion of the site. Too much information and too confusing.
  80. 80. Too many links and some are confusing or do not appear related to the site itself.
  81. 81. Some did not identify with the image of the Governor</li></li></ul><li>2009 Health Sciences Communications Association Conference - St. Louis, MO<br />24<br />Landing Page Recommendations<br /><ul><li>Have ad links and other .gov links open in a new page so that the user can always return to the original window and website screen.
  82. 82. Section headers could all be links, and would be better as “roll over” links as this would reduce screen clutter.
  83. 83. FAQs are helpful but could be put in the left verticalnavigation bar to reduce clutter and increase screen space.</li></li></ul><li>2009 Health Sciences Communications Association Conference - St. Louis, MO<br />25<br />Comments and Suggestions for the Subscription and Supporting Information Section Activities<br /><ul><li>Unsubscribing was difficult. Separate it from the subscription process.
  84. 84. Add headlines to your stories to draw reader’s attention
  85. 85. INShape Partners is confusing. Consider offering activities and events related to programs being conducted.
  86. 86. Good information that is relevant to the user related to tobacco cessation, nutrition and physical activity.
  87. 87. Having the opportunity to ask questions for themselves and for others is a good feature.</li></li></ul><li>2009 Health Sciences Communications Association Conference - St. Louis, MO<br />26<br />Comments Regarding the Tools and Resources Section Activities<br /><ul><li>Having a resource like a calorie counter for restaurant food is good.
  88. 88. Showing of partners is good if they are directly supporting programs (e.g., discounts on activity equipment).
  89. 89. Older information is very helpful. Could use more images and how to information.
  90. 90. No one could find the calorie counter and it needs to be easy to read and understand. Put the link in the Nutrition section at the top … not in Nutrition under Family Wellness
  91. 91. Partner page appears to be more about advertising than useful links for the user.</li></li></ul><li>2009 Health Sciences Communications Association Conference - St. Louis, MO<br />27<br />Comments Regarding the Program <br />Support Section Activities<br /><ul><li>The video is cute and short, fun to watch and I would come back to it.
  92. 92. The newsletter and video are easy to access and view.
  93. 93. I find the newsletter and videos motivating. Both help and are a real incentive to keep me going toward my goals.
  94. 94. Seems geared to beginners. Perhaps they could list different information based on ability level.
  95. 95. Watching the video may not be a good use of time.
  96. 96. There appears to be a lot of scrolling to read information and some appears disjointed. Perhaps offer less information or smaller chunks of it.</li></li></ul><li>2009 Health Sciences Communications Association Conference - St. Louis, MO<br />28<br />Review of Comments and Conclusions<br /><ul><li>Unsubscribe needs to be a stand alone link on the web site.
  97. 97. Easy to wander into other sections on the government side of the site.
  98. 98. Partner page appears to be more about advertising than useful links for the user.
  99. 99. Well organized with good information but too much on the landing page.
  100. 100. The calorie counter, newsletter and videos and the website overall is supportive.
  101. 101. Links, photos and information all need to be relevant to the user. For example, “What’s happening in my County?”</li></li></ul><li>INShape Indiana: Website Usability from a Group Perspective<br />2009 Health Sciences Communications Association Conference - St. Louis, MO<br />29<br />
  102. 102. 2009 Health Sciences Communications Association Conference - St. Louis, MO<br />30<br />Toward a Macro Scale Quantitative <br />Assessment Tool<br /><ul><li>Adapted from Antonovsky’s Orientation Toward Life Survey.
  103. 103. Comprised of rating items (1 to 5) using statements related to the meaningfulness, manageability and comprehensibility of the website.
  104. 104. Administered on-line to users of the INShape Indiana website and completed by almost 400 participants.
  105. 105. Responses were used to reduce the number of survey items and begin the validity and reliability testing process. </li></li></ul><li>2009 Health Sciences Communications Association Conference - St. Louis, MO<br />31<br />Toward a Macro Scale Quantitative <br />AssessmentTool<br /><ul><li>Preliminary analysis suggests a one factor structure consistent with Antonovsky’s suggestion that “Meaningfulness,” “Manageability,” and “Comprehensibility” are interconnected and may be more appropriately viewed as the single factor “Sense of Coherence.”</li></li></ul><li>2009 Health Sciences Communications Association Conference - St. Louis, MO<br />32<br />Implications<br /><ul><li>Formulating a theoretical framework is essential as we work toward a common understanding of “usability.”
  106. 106. A theoretical framework can provide developers with an understanding of “how well” users relate to websites, and may even offer a rationale as to “why and how” web design strategies work.
  107. 107. Media is a tool that has the potential to “help people function optimally in their current environment;” as such, a salutogenic/sense of coherence framework may provide an important starting point in this process. </li>

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