Think Aloud Testing of a Smartphone App for Lifestyle Change Among Persons at Risk of Type 2 Diabetes: Usability Study.

BACKGROUND: Type 2 diabetes mellitus (DM2) is a leading cause of morbidity and mortality worldwide and is considered a global epidemic. Despite the growing evidence on the effectiveness of mobile health interventions in the management of DM2, the evidence on the effect of mobile health interventions in prevention of DM2 is sparse. Therefore, we have developed an app aiming to promote initiation of behavioral change and adherence to healthy behavior. Before commencing a small-scale randomized controlled trial to assess the feasibility of using an app for initiation and adherence of healthy behavior in people at risk of DM2, testing the usability of the app in the target population is warranted. OBJECTIVE: The aim of this study was to assess the usability of an app among people at risk of DM2. METHODS: A qualitative study with the use of a think aloud (TA) procedure was conducted from April to November 2022. The TA procedure consisted of 10 problem-solving tasks and a semistructured interview which was carried out after the tasks. These interviews served to gain more in-depth knowledge of the users experience of the problem-solving tasks. The TA-sessions and the postactivity interviews were recorded and transcribed verbatim, and the data were coded and analyzed following the principles of thematic analysis. RESULTS: In total, 7 people at risk of DM2 with a median age of 66 (range 41-75) years participated in this study. The analysis resulted in the following themes: (1) user interface design; and (2) suggestions for improvements of the functionality of the app. CONCLUSIONS: Overall, the participants were satisfied with the usability of the app. Through the TA-sessions, real time perspective on the appeal, relevance, and utility of the app were gained. Only minor changes to the functionality of the prototype app were reported as necessary to improve the usability of the app. Points of guidance from the participants in this study have been adopted and incorporated into the final design of the app now being assessed for feasibility in a small-scale randomized controlled trial.

Experience with the use of a digital sleep diary in symptom management by individuals with insomnia -a pilot mixed method study.

Background: Insomnia is the most common sleep disorder. The recommended treatment is cognitive behavioural therapy for insomnia (CBTi). A sleep diary is a core tool in CBTi. We have developed a digital sleep diary with a standardised feedback function. Aim: To study feasibility of the digital sleep diary in participants of the Akershus Sleep Apnea (ASAP) cohorts with difficulties falling asleep or maintaining sleep. To describe sleep diary engagement and explore experiences with the digital sleep diary with potential influences in insomnia symptom management. Material and methods: Twenty participants were recruited from the ASAP. All filled out a digital sleep diary up to 12 weeks. Treatment options provided were a self-help book (N = 11) or electroencephalography neurofeedback (N = 9) in addition to the sleep diary standardised feedback function. We collected quantitative data from the sleep diary reports and we sub-divided insomnia by sleep onset insomnia and non-sleep onset insomnia. Finally, we performed qualitative interviews. Results: The median number of entries to the sleep diary was 81 (25th quartile: 26, 75th quartile 84). In the qualitative analysis, we identified two main themes; "structure and overview" and "usability and digital features". Conclusion: The sleep diary was found to be feasible when distributed in combination with a self-help book or electroencephalography neurofeedback. The qualitative results emphasised the importance of a timely graphical overview and visualisations of self-recorded sleep.

Technology Acceptance and Quality of Life among Older People Using a TUI Application.

Good quality of life is important for healthy ageing. Studies have shown that although information and communication technology can improve older people's quality of life, their technology acceptance level is rather low. Tangible user interfaces (TUIs) enable people to interact with the digital world through everyday physical objects, thus offering more intuitive digital environments for older people. In this study, we employ a TUI prototype to investigate the relationship between older people's technology acceptance and quality of life, the changes in these outcome measures after using TUI, and the associations between them. The TUI prototype, Tangible Cup was used by 20 older participants over a period of three months. Data were collected using the technology acceptance model (TAM) questionnaire, the older people's quality of life (OPQOL) questionnaire and semi-structured interviews. The results showed some positive changes in technology acceptance after the use of Tangible Cup. However, no change in the quality of life was found. While statistically significant correlations between the change in technology acceptance and the change in quality of life were observed, limitations such as small sample size and participants not accurately representing the target population should be noted. Thus, further research is needed to better understand the associations between the change in technology acceptance and the change in quality of life.