Viola Voncken*, Maastricht University, Maastricht, Netherlands Huibert Tange*, Maastricht University, Maastricht, Netherlands Albine Moser, Maastricht University, Maastricht, Netherlands Hein De Vries, Maastricht University, Maastricht, Netherlands Trudy Van Der Weijden*, Maastricht University, Maastricht, Netherlands Track: Research Presentation Topic: Usability and human factors on the web Presentation Type: Poster presentation Submission Type: Single Presentation Building: MECC Room: Trajectum Last modified: 2010-07-21

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Background
Maintaining a healthy lifestyle is important for chronic patients. General practitioners emphasize this importance and offer lifestyle enhancement programs for diabetes, COPD, and heart failure. Chronic patients, on the other hand, increasingly find support on the internet. However, many “best practices” derived from online communities are neither consistent with the medical guidelines nor applicable to their own situation. This prompted us to develop and evaluate a web-based tailored feedback program that is consistent with the medical guidelines for COPD. We here report the adaptation of the program and a usability study.

Objectives
To adapt an existing computer tailored feedback program for the general population to COPD patients. To evaluate the usability of the program with COPD patients as test users.

Methods
To adjust the program the lifestyle guidelines for COPD were compared with the guidelines used in the program. Further, the feedback style was made suitable for COPD patients. Finally, a medication adherence module was developed and integrated in the program, next to the existing modules for physical activity and smoking cessation. In order to develop this module a literature overview and ten interviews with COPD patients were performed and compared with the literature.
During the second phase of the study we conducted a usability study with an iterative design, containing three series of individual tests with COPD-patients in a controlled setting. Each participant worked with the program and performed two tasks. The first task was to fill out the health risk appraisal questionnaire. The second task was to complete one of the feedback modules. Users were encouraged to think aloud during the tasks. Screen display and mouse clicks, participants’ verbal comments, and nonverbal reactions were all captured. Data were analyzed using content analysis, a qualitative research method. After the first series of four participants, data were analyzed and the results were used for program refinement. Thereafter, this process was repeated twice, with two participants per series.

Results
Phase 1: The lifestyle guidelines for COPD were similar to the guidelines used in the program. The feedback style was more focused to COPD patients. The results of the literature overview were compatible with the results of the interviews and were usable for the development of the medication adherence module.
Phase 2: The results from the first test series of the usability study revealed some serious issues for improvement, particularly in the content of the physical activity module. Results from the second series showed fewer problems to be solved. During the last series no more issues were found.

Conclusions
A computer-tailored feedback program for the general population cannot be used straightforward for patients with COPD. Exploratory interviews and usability testing help to make it fit.