International Journal of Medical Informatics
Volume 79, Issue 8 , Pages 565-575 , August 2010

Web-based education for low-literate parents in Neonatal Intensive Care Unit: Development of a website and heuristic evaluation and usability testing

  • Jeungok Choi

      Affiliations

    • School of Nursing, University of Massachusetts Amherst, 024 Skinner Hall, 651 North Pleasant Street, Amherst, MA, USA
    • Corresponding Author InformationCorresponding author. Tel.: +1 413 545 5689; fax: +1 413 577 2550.
    • ,
  • Suzanne Bakken

      Affiliations

    • School of Nursing, Department of Biomedical Informatics, Columbia University, New York, NY, USA

Received 11 October 2009 ,Revised 22 April 2010 ,Accepted 9 May 2010.

References 

  1. Kutner M, Greenberg E, Jin Y, Paulsen C. The Health Literacy of America's Adults: Results From the 2003 National Assessment of Adult Literacy (NCES 2006-483). U. S. Department of Education. Washington, DC: National Center for Education; 2006;
  2. Williams MV, Davis T, Parker RM, Weiss BD. The role of health literacy in patient–physician communication. Fam. Med. 2002;34(May (5)):383–389
  3. Baker DW, Gazmararian JA, Williams MV, Scott T, Parker RM, Green D, et al. Health literacy and use of outpatient physician services by medicare managed care enrollees. J. Gen. Intern. Med. 2004;19(March (3)):215–220
  4. Berkman ND, Dewalt DA, Pignone MP, Sheridon SL, Lohr KN, Lux L, et al. Literacy and health outcomes. Evid. Rep. Technol. Assess. (Summ.). 2004;87(January):1–8
  5. Gordon MM, Hampson R, Capell HA, Madhok R. Illiteracy in rheumatoid arthritis patients as determined by the rapid estimate of adult literacy in medicine (REALM) score. Rheumatology (Oxford). 2002;41(July (7)):750–754
  6. Lindau ST, Basu A, Leitsch SA. Health literacy as a predictor of follow-up after an abnormal pap smear: a prospective study. J. Gen. Intern. Med. 2006;21(August (8)):829–834
  7. Davis TC, Williams MV, Marin E, Parker RM, Glass J. Health literacy and cancer communication. CA Cancer J. Clin. 2002;52(May–June (3)):134–149
  8. Davis TC, Fredrickson DD, Arnold C, Murphy PW, Herbst M, Bocchini JA. A polio immunization pamphlet with increased appeal and simplified language does not improve comprehension to an acceptable level. Patient Educ. Couns. 1998;33(January (1)):25–37
  9. Doak CC, Doak LG, Root JH. Teaching Patients with Low Literacy Skills. 2nd ed.. Philadelphia: J.B. Lippincott; 1996;212 pp.
  10. Doak CC, Doak LG, Friedell GH, Meade CD. Improving comprehension for cancer patients with low literacy skills: strategies for clinicians. CA Cancer J. Clin. 1998;48(May–June (3)):151–162
  11. Mayer RE. Multimedia aids to problem-solving transfer. Int. J. Educ. Res. 1999;31:611–623
  12. Mayer RE. Instructional technology. In:  Durso F editors. Handbook of Applied Cognition. Chichester, England: Wiley; 1999;p. 551–570
  13. In:  Sharp H,  Rogers Y,  Preece J editor. Interaction Design: Beyond Human–Computer Interaction. 2nd ed.. New York, NY: John Wiley & Sons, Inc.; 2007;
  14. Dix A, Finlay J, Abowd GD, Beale R. Human–Computer Interaction. 3rd ed.. England: Prentice Hall; 2004;
  15. In:  Nielsen J,  Mack RL editor. Usability Inspection Methods. New York: John Wiley & Sons; 1994;
  16. Zhang J, Johnson TR, Paige DL, Kubose T. Using usability heuristics to evaluate patient safety of medical devices. J. Biomed. Inform. 2003;36(February–April (1/2)):23–30
  17. Graham MJ, Kubose TK, Jordan D, Zhang J, Johnson TR. Heuristic evaluation of infusion pumps: implications for patient safety in intensive care units. Int. J. Med. Inform. 2004;73(November (11/12)):771–779
  18. Gazmararian JA, Baker DW, Williams MV, Parker RM, Scott TL, Green DC, et al. Health literacy among medicare enrollees in a managed care organization. JAMA. 1999;281(February (6)):545–551
  19. Michielutte R, Bahnson J, Dignan MB, Schroeder EM. The use of illustrations and narrative text style to improve readability of a health education brochure. J. Cancer Educ. 1992;7(3):251–260
  20. Leiner M, Handal G, Williams D. Patient communication: a multidisciplinary approach using animated cartoons. Health Educ. Res. 2004;19(October (5)):591–595
  21. Morrow DG, Hier CM, Menard WE, Leirer VO. Icons improve older and younger adults’ comprehension of medication information. J. Gerontol. B Psychol. Sci. Soc. Sci. 1998;53(July (4)):P240–P254
  22. Dowse R, Ehlers M. Medicine labels incorporating pictograms: do they influence understanding and adherence?. Patient Educ. Couns. 2005;58(July (1)):63–70
  23. Austin PE, Matlack R, Dunn KA, Kesler C, Brown CK. Discharge instructions: do illustrations help our patients understand them?. Ann. Emerg. Med. 1995;25(March (3)):317–320
  24. Mansoor LE, Dowse R. Effect of pictograms on readability of patient information materials. Ann. Pharmacother. 2003;37(July–August (7/8)):1003–1009
  25. Ngoh L. Design, development, and evaluation of visual aids for communicating prescription drug instructions to nonliterate patients in rural cameroon. Patient Educ. Couns. 1997;30(3):257
  26. Kripalani S, Robertson R, Love-Ghaffari MH, Henderson LE, Praska J, Strawder A, et al. Development of an illustrated medication schedule as a low-literacy patient education tool. Patient Educ. Couns. 2007;66(June (3)):368–377
  27. Sweller J, Van Merrienboer J, Paas F. Cognitive architecture and instructional design. Educ. Psychol. Rev. 1998;10(3):251–296
  28. J. Nielsen, Characteristics of usability problems found by heuristic evaluation [Internet]. [cited 2009 August 25], available from: http://www.useit.com/papers/heuristic/usability_problems.html.
  29. Bastien, Usability testing: a review of some methodological and technical aspects of the method, Int. J. Med. Inf. (2009) (Epub ahead of print).
  30. Nielsen J. Usability Engineering. San Diego, LA: Morgan Kaufman; 1993;
  31. K. Cogdill, MEDLINEplus Interface Evaluation: Final Report, College of Information Studies, University of Maryland, College Park, MD, 1999.
  32. Nahm ES, Preece J, Resnick B, Mills ME. Usability of health web sites for older adults: a preliminary study. Comput. Inform. Nurs. 2004;22(6):326;34
  33. J. Britto, W. Munafo, H. Rogers, Usability testing finds new problems for novice users of pediatric portals, J. Am. Med. Inform. Assoc. (2009) (Epub ahead of print).
  34. Lai TY. Iterative refinement of a tailored system for self-care management of depressive symptoms in people living with HIV/AIDS through heuristic evaluation and end user testing. Int. J. Med. Inform. 2007;76(Suppl. 2):S317–S324
  35. Scandurra H, Koch L. Usability laboratory test of a novel mobile homecare application with experienced home help service staff. Open Med. Inform. J. 2008;2:117
  36. Treadwell I. The usability of personal digital assistants (PDAs) for assessment of practical performance. Med. Educ. 2006;40(9):855
  37. Bright T, Bakken S, Johnson S. Heuristic evaluation of eNote: an electronic notes system. AMIA. In: Annual Symposium Proceedings. 2006;p. 864
  38. Tang Z, Johnson T, Tindall , Zhang J. Applying heuristic evaluation to improve the usability of a telemedicine system. Telemed. J. E-health. 2006;12(1):24
  39. J. Hyun, B. Stetson, Development and evaluation of nursing user interface screens using multiple methods, J. Biomed. Inform. (2009) (Epub ahead of print).
  40. National Cancer Institute, Clear & Simple: Developing Effective Print Materials for Low-Literate Readers [Internet], National Institutes of Health, (cited 2009 August 1), available from: http://www.nci.nih.gov/cancerinformation/clearandsimple.
  41. PlainLanguage.gov, Simple Words and Phrases [Internet], PlainLanguage.gov, (cited 2009 August 25), available from: http://www.plainlanguage.gov/howto/wordsuggestions/simplewords.cfm.
  42. L.G. Doak, C.C. Doak, Pfizer Principles for Clear Health Communication [Internet], Pfizer Inc., (cited 2009 August 1), available from: http://www.pfizerhealthliteracy.com/pdf/PfizerPrinciples.pdf.
  43. Houts PS, Doak CC, Doak LG, Loscalzo MJ. The role of pictures in improving health communication: a review of research on attention, comprehension, recall, and adherence. Patient Educ. Couns. 2006;61(May (2)):173–190
  44. Shneiderman B. Designing the User Interface: Strategies for Effective human–computer-interaction. 3rd ed.. Reading, MA: Addison-Wesley; 1998;639 pp.
  45. D. Pierottie, Heuristic Evaluation—A System Checklist [Internet], (cited 2009 Aug 2), available from: http://www.stcsig.org/usability/topics/articles/he-checklist.html.
  46. D. Chisnell, J. Redish, Designing Web Sites for Older Adults: Expert Review of Usability for Older Adults at 50 Web Sites [Internet], (cited 2009 August 8), available from: http://assets.aarp.org/www.aarp.org_/articles/research/oww/AARP-50Sites.pdf.
  47. Ericsson KA, Simon HA. Protocol Analysis: Verbal Reports as data. Rev ed.. Cambridge, MA: MIT Press; 1993;443 pp.
  48. Davis FD. Perceived usefulness, perceived ease of use, and user acceptance of information technology. MIS Quart. 1989;13(3):319
  49. Baker DW, Williams MV, Parker RM, Gazmararian JA, Nurss J. Development of a brief test to measure functional health literacy. Patient Educ. Couns. 1999;38(September (1)):33–42
  50. Webber RP. Basic Content Analysis. Beverly Hills, CA: Sage; 1985;
  51. Houts PS, Witmer JT, Egeth HE, Loscalzo MJ, Zabora JR. Using pictographs to enhance recall of spoken medical instructions II. Patient Educ. Couns. 2001;43(June (3)):231–242
  52. Luddington-Hoe SM, Golant SK. Kangaroo Care: The Best You Can do to help your Preterm Infant. New York, NY: Bantam Books; 1993;

PII: S1386-5056(10)00097-3

doi: 10.1016/j.ijmedinf.2010.05.001

International Journal of Medical Informatics
Volume 79, Issue 8 , Pages 565-575 , August 2010

Article Tools

* Image Usage & Resolution