Inclusive Design of Digital Health Solutions for Older Adults

Digital health solutions utilize evidence-based approaches for prevention, treatment, and health promotion. To minimize inequalities, they must be accessible and comprehensible for diverse user groups. The project by Kerstin Denecke and Beatrice Kaufmann develops design heuristics for digital solutions specifically for older adults.

Health Literacy and Digital Health Interventions

Health literacy is the ability to understand and use health information to make informed decisions and manage one’s well-being. With increasing digitalization in healthcare, digital health literacy is becoming increasingly important. This includes the ability to use digital tools and data to access and understand health information.

Older adults in particular face challenges such as cognitive impairments, physical limitations, and limited digital competencies. These factors can significantly impair their ability to effectively use digital health services. Currently, there is a lack of specific guidelines for designing digital health interventions tailored to the needs of older adults. Digital health interventions can be apps or web platforms that implement evidence-based interventions, such as elements of cognitive behavioral therapy. While medical research is increasingly moving toward personalized medicine, digital health interventions only offer generic “one-size-fits-all” solutions.

A new thematic field project by researchers from the Institute of Patient-centered Digital Health and the Institute of Design Research aims to develop design standards that consider these limitations. This should make health information and services more accessible and usable for older users, promoting their health literacy and ability to manage their health independently. But which design elements in digital health interventions make them accessible and inclusive for older adults? This is where inclusive design comes in. Inclusive design refers to creating products or services with the goal of making them accessible to the broadest possible user group, regardless of their abilities, limitations, or social backgrounds.

Learning from Interactions Between Healthcare Professionals and Patients

In preliminary work, we gathered information through literature reviews on how healthcare professionals consider health literacy in their interaction with patients (see Figure 1), which technologies and strategies can contribute to inclusive design, and what experiences and guidelines for inclusive design of such solutions are documented (Denecke et al. 2024). Guidelines for medical communication emphasize that health information should be adapted to patients’ knowledge, needs, and level of understanding. Plain language and clear content structuring help promote understanding (Coleman 2020). The teach-back method, where patients repeat received information in their own words, is a proven tool to ensure content comprehension (Coleman 2020). A respectful and safe environment, along with memory aids such as written summaries or visual aids, additionally support information intake and retention. The use of various teaching methods such as videos, graphics, or audio formats helps accommodate different health literacy levels and cognitive abilities of patients (Lyles 2022).

User-Centered Design and User Involvement

Best practices for inclusive design emphasize the relevance of user-centered design (Eichner 2024). User-centered design requires active user involvement during the development phase to align solutions with their specific needs and contexts. Only through this approach can the provision of information and interaction be iteratively tested and adjusted to improve usability. Clear and logical workflows in interacting with the solution, along with appropriate guidance where necessary, support finding relevant information or functionalities in a digital solution. The ability to specify preferences can help personalize digital service offerings.

Towards Design Heuristics

This initial information will be further developed in our project and ultimately result in heuristics for the inclusive design of digital health interventions for older adults. Our goal is to develop design heuristics, recommendations, and best practices to improve the accessibility, usability, and user experience of digital health interventions specifically for older adults. This should enable the aging population to navigate digital health solutions independently.

Many technologies are already available that support the implementation of inclusive design. Artificial intelligence methods can prepare content in a personalized way and provide it at the right time in a digital health solution. The “right time” is derived from the behavior or needs of the user. The project will additionally compile such technological possibilities for implementing various design heuristics. Ultimately, these efforts are the foundation for creating additional access to health services, which can improve health outcomes and quality of life for the older population.

Figure 1: Initial recommendations for inclusive design of digital health applications.

References

Coleman, C. Health Literacy and Clear Communication Best Practices for Telemedicine. HLRP: Health Literacy Research and Practice 2020, 4, doi:10.3928/24748307-20200924-01.

Denecke, K., Kaufmann, B., Reichenpfader, D., Petersen, C. (2024). How to Consider Health Literacy in Digital Health Interventions?. In: Stephanidis, C., Antona, M., Ntoa, S., Salvendy, G. (eds) HCI International 2024 Posters. HCII 2024. Communications in Computer and Information Science, vol 2119. Springer, Cham.

Eichner, J.; Dullabh, P. Accessible Health Information Technology (Health IT) for Populations With Limited Literacy: A Guide

for Developers and Purchasers of Health IT.; 2007; Vol. AHRQ Publication No. 08-0010-EF, MD Agency for Healthcare Research and Quality.

Lyles, Courtney R.; Aguilera Adrian; Nguyen O; Sarkar, Urmimala: Bridging the Digital Health Divide Series. California Health Care Foundation, 2022. https://www.chcf.org/publication/bridging-digital-health-divide-series/ (letzter Zugriff: 8.12.2024.

Mallon, C. Inclusive Design’s next wave breaks for mental health, Microsoft, 7.Mai 2024; https://microsoft.design/articles/inclusive-designs-next-wave-breaks-for-mental-health/ (letzter Zugriff: 09.12.2024);

Murugesu, L.; Heijmans, M.; Rademakers, J.; Fransen, M.P. Challenges and Solutions in Communication with Patients with Low Health Literacy: Perspectives of Healthcare Providers. PLoS One 2022, 17, e0267782, doi:10.1371/journal.pone.0267782.