Limits...
User-centered design of a web-based self-management site for individuals with type 2 diabetes - providing a sense of control and community.

Yu CH, Parsons JA, Hall S, Newton D, Jovicic A, Lottridge D, Shah BR, Straus SE - BMC Med Inform Decis Mak (2014)

Bottom Line: Based on these results, revisions were made to the website.Revisions to the website were made based on results from this testing.We identified five themes concerning participants' experiences of health care and related unmet needs: 1) Desire for information and for greater access to timely and personalized care to gain a sense of control of their disease; 2) Desire for community (sharing experiences with others) to fulfill practical and emotional needs; 3) Potential roles of an online self-management website in self-empowerment, behavior change, self-management and health care delivery; 4) Importance of a patient-centered perspective in presenting content (e.g. common assumptions, medical nomenclature, language, messaging, sociocultural context); 5) Barriers and facilitators to use of a self-management website (including perceived relevance of content, incorporation into usual routine, availability for goal-directed use, usability issues).

View Article: PubMed Central - HTML - PubMed

Affiliation: Li Ka Shing Knowledge Institute, St, Michael's Hospital, 30 Bond Street, Toronto, ON M5B 1 W8, Canada. yuca@smh.ca.

ABSTRACT

Background: To design and test a web-based self-management tool for patients with type 2 diabetes for its usability and feasibility.

Methods: An evidence-based, theory-driven website was created for patients with type 2 diabetes. Twenty-three patients with type 2 diabetes aged ≥ 25 years were recruited from 2 diabetes care centers in Toronto, Canada. We employed focus group methodology to assess acceptability, sustainability, strengths and weaknesses of the self-management website. Based on these results, revisions were made to the website. Three cycles of individual usability testing sessions using cognitive task analysis were conducted with patients with type 2 diabetes. Revisions to the website were made based on results from this testing.

Results: We identified five themes concerning participants' experiences of health care and related unmet needs: 1) Desire for information and for greater access to timely and personalized care to gain a sense of control of their disease; 2) Desire for community (sharing experiences with others) to fulfill practical and emotional needs; 3) Potential roles of an online self-management website in self-empowerment, behavior change, self-management and health care delivery; 4) Importance of a patient-centered perspective in presenting content (e.g. common assumptions, medical nomenclature, language, messaging, sociocultural context); 5) Barriers and facilitators to use of a self-management website (including perceived relevance of content, incorporation into usual routine, availability for goal-directed use, usability issues).

Conclusions: Participants outlined a series of unmet health care needs, and stated that they wanted timely access to tailored knowledge about their condition, mechanisms to control and track their disease, and opportunities to share experiences with other patients. These findings have implications for patients with type 2 diabetes of diverse ages, socioeconomic backgrounds, and disease severity, as well as to the design of other computer-based resources for chronic disease management.

Show MeSH

Related in: MedlinePlus

Evidence-based and theory-driven framework was used for intervention development.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
getmorefigures.php?uid=PMC4222757&req=5

Figure 2: Evidence-based and theory-driven framework was used for intervention development.

Mentions: Our objective was to create an evidence-based, theory-informed self-contained website focused on facilitating the management of diabetes including optimising vascular risk factors. Figure 2 depicts our evidence-based and theory-driven framework that was used for intervention development. Details regarding systematic reviews of diabetes-related electronic tools [11] and behavior change websites [17], the theory of self-efficacy [18], the Health Information Model [19], as well as their application to our website development are described elsewhere [16]. We selected self-management tools known to be effective, relevant and usable [11]. Though multiple theories could guide this work, we selected self-efficacy, a theory that has not only been validated in predicting and promoting patient behavior change but has also been demonstrated to improve clinical outcomes in diabetes care [20-27]. Guided by this theoretical framework, sources and mediators of self-efficacy were integrated into website format and tool selection. Feedback, goal-setting, peer story-telling, and monitoring tools were incorporated. In order to complement patient health-information-seeking behavior [19] we sent automated emails with selected content (such as tailored reminders to complete a self-management log, or new content on the website), optimized search algorithms to enable self-directed information retrieval, and included tools to facilitate communication with health care providers (HCPs). Our overarching design goal was to tailor the website to patient characteristics, include their age, computer familiarity, behavioral characteristics (stage of change, self-efficacy, self-care) and stage of disease. To achieve this, we created a combination of tag-based and hierarchical organization; in other words, we presented a combination of “look around yourself” and guided “step by step” approaches. We included features such as definitions under a mouse hover mode, and links to additional definitions such as levels of evidence. We clustered our content in the areas of knowledge, behavior change, skill development and reinforcing/supporting resources. Throughout the website, we chose labels and titles carefully so that it would be clear and understandable. Figure 3a depicts how the system looked before any user evaluation was done. The iterative design began in this phase where the designers met with human factors specialists and content experts to iteratively refine the website based on discussion of user needs and tasks.


User-centered design of a web-based self-management site for individuals with type 2 diabetes - providing a sense of control and community.

Yu CH, Parsons JA, Hall S, Newton D, Jovicic A, Lottridge D, Shah BR, Straus SE - BMC Med Inform Decis Mak (2014)

Evidence-based and theory-driven framework was used for intervention development.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4222757&req=5

Figure 2: Evidence-based and theory-driven framework was used for intervention development.
Mentions: Our objective was to create an evidence-based, theory-informed self-contained website focused on facilitating the management of diabetes including optimising vascular risk factors. Figure 2 depicts our evidence-based and theory-driven framework that was used for intervention development. Details regarding systematic reviews of diabetes-related electronic tools [11] and behavior change websites [17], the theory of self-efficacy [18], the Health Information Model [19], as well as their application to our website development are described elsewhere [16]. We selected self-management tools known to be effective, relevant and usable [11]. Though multiple theories could guide this work, we selected self-efficacy, a theory that has not only been validated in predicting and promoting patient behavior change but has also been demonstrated to improve clinical outcomes in diabetes care [20-27]. Guided by this theoretical framework, sources and mediators of self-efficacy were integrated into website format and tool selection. Feedback, goal-setting, peer story-telling, and monitoring tools were incorporated. In order to complement patient health-information-seeking behavior [19] we sent automated emails with selected content (such as tailored reminders to complete a self-management log, or new content on the website), optimized search algorithms to enable self-directed information retrieval, and included tools to facilitate communication with health care providers (HCPs). Our overarching design goal was to tailor the website to patient characteristics, include their age, computer familiarity, behavioral characteristics (stage of change, self-efficacy, self-care) and stage of disease. To achieve this, we created a combination of tag-based and hierarchical organization; in other words, we presented a combination of “look around yourself” and guided “step by step” approaches. We included features such as definitions under a mouse hover mode, and links to additional definitions such as levels of evidence. We clustered our content in the areas of knowledge, behavior change, skill development and reinforcing/supporting resources. Throughout the website, we chose labels and titles carefully so that it would be clear and understandable. Figure 3a depicts how the system looked before any user evaluation was done. The iterative design began in this phase where the designers met with human factors specialists and content experts to iteratively refine the website based on discussion of user needs and tasks.

Bottom Line: Based on these results, revisions were made to the website.Revisions to the website were made based on results from this testing.We identified five themes concerning participants' experiences of health care and related unmet needs: 1) Desire for information and for greater access to timely and personalized care to gain a sense of control of their disease; 2) Desire for community (sharing experiences with others) to fulfill practical and emotional needs; 3) Potential roles of an online self-management website in self-empowerment, behavior change, self-management and health care delivery; 4) Importance of a patient-centered perspective in presenting content (e.g. common assumptions, medical nomenclature, language, messaging, sociocultural context); 5) Barriers and facilitators to use of a self-management website (including perceived relevance of content, incorporation into usual routine, availability for goal-directed use, usability issues).

View Article: PubMed Central - HTML - PubMed

Affiliation: Li Ka Shing Knowledge Institute, St, Michael's Hospital, 30 Bond Street, Toronto, ON M5B 1 W8, Canada. yuca@smh.ca.

ABSTRACT

Background: To design and test a web-based self-management tool for patients with type 2 diabetes for its usability and feasibility.

Methods: An evidence-based, theory-driven website was created for patients with type 2 diabetes. Twenty-three patients with type 2 diabetes aged ≥ 25 years were recruited from 2 diabetes care centers in Toronto, Canada. We employed focus group methodology to assess acceptability, sustainability, strengths and weaknesses of the self-management website. Based on these results, revisions were made to the website. Three cycles of individual usability testing sessions using cognitive task analysis were conducted with patients with type 2 diabetes. Revisions to the website were made based on results from this testing.

Results: We identified five themes concerning participants' experiences of health care and related unmet needs: 1) Desire for information and for greater access to timely and personalized care to gain a sense of control of their disease; 2) Desire for community (sharing experiences with others) to fulfill practical and emotional needs; 3) Potential roles of an online self-management website in self-empowerment, behavior change, self-management and health care delivery; 4) Importance of a patient-centered perspective in presenting content (e.g. common assumptions, medical nomenclature, language, messaging, sociocultural context); 5) Barriers and facilitators to use of a self-management website (including perceived relevance of content, incorporation into usual routine, availability for goal-directed use, usability issues).

Conclusions: Participants outlined a series of unmet health care needs, and stated that they wanted timely access to tailored knowledge about their condition, mechanisms to control and track their disease, and opportunities to share experiences with other patients. These findings have implications for patients with type 2 diabetes of diverse ages, socioeconomic backgrounds, and disease severity, as well as to the design of other computer-based resources for chronic disease management.

Show MeSH
Related in: MedlinePlus