Improving Meaningful Access of Internet Health Information for Older Adults

There has been enormous growth in the development of consumer-oriented health information technology (IT) applications designed to support tasks such as the exchange of health information, communication, health decisionmaking, and disease management. Many older adults have less experience with computers and the Internet than other age groups and thus obtaining health information from this source may be challenging for them. Studies have shown that older adults use less-efficient search strategies and have less success finding specific information than do younger adults. Given the aging population and that older adults represent a large segment of the consumer health population, it is important to identify ways to reduce barriers to their access and use of health IT applications.

This study refined a set of tools to help health care consumers, particularly older adults, complete Internet-based health management tasks, and evaluated the usability and efficiency of the tools.

The specific aims of this project were to:

• Refine, through a user-centered iterative design process, a set of software aiding tools so that they can be used by health consumers, particularly older adults, in the performance of Internet-based health management tasks.
• Evaluate the feasibility, acceptability, and usability of these tools among adult health consumers and the impact of the use of these tools on the performance of Internet-based health management tasks.

The study had two phases. The first involved adapting four specific tools designed to aid health information-seeking tasks on the Internet. Focus groups with older adults were held to learn about perceived benefits and concerns of the tools. Potential usability problems were identified by a task-analysis study.

In the second phase, a randomized trial was conducted in which the intervention group had access to the adapted tools, while the control group did not. All participants had prior computer and Internet experience and were required to complete two brief Internet search tests, one easy and the other more complex, before they could be part of the study. Participants were randomly assigned to one of four conditions and asked to complete a set of defined information-seeking tasks. Those who used the tools were asked to rate their potential usefulness and usability.

Participants found the tools to be useful and of potential value in aiding their information seeking activities. However, performance was generally lower among those who used the tools than those that did not. Training was conducted immediately before the participants performed the tasks, and the study team hypothesized that the users focused more on how to use the tool itself than on completing the task. While repeated use of the tools over time may lead to improved performance, the study data suggested that the tools as designed may be too complex from a usability standpoint for older adults. All participants, irrespective of task, showed an increase in health knowledge following completion of the tasks, indicating that engaging in Internet information-seeking activities may enhance an individual’s overall health knowledge.

The study team concluded that if the tools become publically available, training and instructional support materials are critical. The project team developed recommendations for the redesign of the tools and hope to see the refined tools evaluated with a larger sample over an extended period of time.