Document Type


Degree Name



Department of Medical Informatics and Clinical Epidemiology


Oregon Health & Science University


Throughout the developed world, population aging requires increasing numbers of friends and family members to serve as informal caregivers of older adults. Currently, due to factors such as reduced fertility rates, and increased numbers of women in the workforce, demand far outweighs supply. Many researchers have suggested that using information technology to bridge the caregiver -care recipient divide may be a promising means of addressing these issues. In this dissertation we discuss the user-centered design of information technology tools for informal caregivers, specifically those that do not live in the same home as their older adult loved ones.

Study 1 - Before designing any caregiver tools, we felt it was most appropriate to better understand the information needs of caregivers. As such, we conducted semi-structured needs assessment interviews via Skype with 10 remote caregivers of older adults. To facilitate the discussion, we presented basic mockup screenshots of a potential website for caregivers. Through this process we identified important functional requirements and design implications for our caregiver tool. Findings included high interest in information regarding medication regimens and adherence, calendaring, and cognitive health. Usage was estimated as at least once per week, with many subjects desiring the ability to access the information from a smartphone

Study 2 - We developed a high fidelity interactive prototype of a smartphone app for caregivers. We then took a rapid, agile approach to usability testing in which 15 users were recruited to participate in three iterative rounds of testing. Users were asked to “think aloud“ while using the app to participate in five different caregiving scenarios. At the conclusion of each round of testing, problems were classified as either ”resolve” or “wait and see”. Solutions were developed to address any problem marker for resolution while “wait and see” items were used as special areas of focus for subsequent rounds of usability testing. Overall, usability of our caregiver application was high, with all users able to properly navigate through the app without any guidance/training. 34 unique usability problems were identified with a large majority of problems based upon poor labeling, unclear interaction styles, and inappropriately sized or placed user interface elements.

Study 3 - We used an insight based evaluation methodology to ensure that caregivers could properly interpret the graphs used in our caregiving app. We recorded 15 caregivers “thinking aloud” while they explored 10 different graphs depicting health activity data (e.g. medication adherence, sleep and exercise). Recordings were then used to identify individual insights made by each caregiver. And sets were then rated according to value and correctness. Our analysis showed that chart complexity significantly impacted both the number and quality of insights gained, with ~4 insights being elicited per minute. Lessons learned from this process included the importance of displaying longitudinal graphs when long-term problems are detected and short closely zoomed graphs when recent problems have occurred.

The findings of these 3 studies combine to provide important, user-derived findings that inform the design of more appropriate tools for caregivers around the world.




School of Medicine



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