The importance of co-design and usability evaluation in shaping the design of the app for the home care workforce

A guest blog by Dr Amanda Adams, Post-Doctoral Research Associate, ELDAC

The development of digital products, resources, and systems for use by the aged care sector has seen the rapid uptake of co-design as an approach to creating and customising technological solutions for the workforce. At the centre of co-design is the collaboration of stakeholders, partners, and end-users to create or adapt technological designs to support the needs and requirements of the intended audience [1]. Features of the design, such as content, resources, interactives, and visuals, are provided to the development team from the collaborator's perspective based on personal experiences and knowledge.

However, the co-design approach cannot guarantee either the intended users’ user experience or whether the proposed design can be easily used within real-world contexts. [2] For example, the question of whether ‘end-users can use the design to find, use or apply information to solve a problem or improve practice or increase their knowledge,’ can only be answered by evaluating the design's usability.

Shaping the interactive design of the Home Care App with the help of the home care workforce

Using a user-centred design approach to development, ELDAC’s Technology and Innovations team have created the Home Care App with the assistance of representatives from organisations within the home care sector.

Our design and development process began with two rounds of co-design interviews with home care workers and managers. The first round of interviews looked at the app's feasibility in supporting the end of life care provided in a home care setting. In these interviews, we invited participants to identify the types of content, information and resources that would be helpful to home care workers. The second round of interviews invited feedback on the type of language and the features the app end-users would find useful to support their practice. We also asked participants to complete a card sorting activity to understand the app's information architecture, helping us structure content and information flow across the screens.

The design was then tested by five home care workers and managers who completed usability testing of our production prototype. The participants completed task-based activities that were contextualised to real-world scenarios. By observing and listening to their interactions, the project team were able to identify areas commonly known as ‘pinch and pain points’ within the prototype interface.

Usability testing is equally important as co-design

‘Pinch and pain points’ are areas of the interface directly impacting end-user interactions with aspects of the information, navigation, menu, or interactives. [3] ‘Pain points’ are severe errors impacting user interactions and ‘pinch points’ are areas of design that create a barrier to use that sometimes can be overcome by more experienced or tech-savvy app users. For example, our usability testing participants discovered our app's pain points were a lack of navigational cues, information flow across and down screens, and issues with customisation of their experience when using our interactive activities successfully.

Without undertaking usability testing to explore how people will use the Home Care App in real life, we cannot shape the design to support the diversity in how individuals find and use digital information. [4] For example, we know individuals with limited technical abilities or confidence using technology, people with varying levels of physical ability or those who are neurodiverse, may use the app. Other end-users may have English as a second or third language or have low literacy and experience difficulties using digital interfaces. These issues can also be compounded by a person's age, gender, cultural or social background, socioeconomic status or education level and geographic location.

As a result of involving home care workers and managers in the co-designing process and evaluating the usability of this design before release, we have created a resource with an interface that can support the diversity of individuals with different informational needs and technical abilities. Furthermore, our app interface’s ability to support all home care workers (regardless of their level of technical skill, language proficiency or digital capabilities) to improve their end of life care will depend on their access to quality evidence-based information to inform their end of life and palliative care practice.

For more information about how you can download the Home Care App, please visit our Home Care App project page.

References

1. Ostlund B, Fischer B, Marshall N, et al. Using academic work places to involve older people in the design of digital applications. Presentation of a methodological framework to advance co-design in later life. In: Gao, Q., Zhou, J. (eds) HCII 2020, LNCS 12207, p45-58. https:/(1)/doi.org/10.1007/978-3-030-50252-2_4.

2. Tremblay M, Latulippe K, Guay M, Provencher V, Giguère A, Poulin V, et al. Usability of a co-designed eHealth prototype for caregivers: Combination study of three frameworks. JMIR Hum Factors. 2021;8(3):e26532. doi: 10.2196/26532

3. Qi W, Xue J. Visual design of smartphone app interface based on user experience. Comput. Aided. Des. Appl. 2020;17:89-99.

4. Sarkar U, Gourley GI, Lyles CR, Tieu L, Clarity C, Newmark L, et al. Usability of commercially available mobile applications for diverse patients. J Gen Inter Med. 2016;31(12):1417-26. doi: 10.1007/s11606-016-3771-6.

 

Dr Amanda Adams
Post-Doctoral Research Associate, ELDAC