Development and Usability Testing of a Mobile Health Game Application for Older Adults on Warfarin

Abstract

Background: Chronic disease management constitutes a special challenge in the United States due to deficiencies in the healthcare system. Chronic disease self-management (CDSM) using technology and gaming principles is a promising way to overcome these challenges. Yet, there are few disease-specific apps to benefit the populations likely to benefit from such innovations. Purpose: This proof of concept study evaluated the feasibility of a Warfarin game app for older adults. The aims were to: 1) Design and develop a mobile game app to educate patients on Warfarin; and 2) Conduct usability testing of the game app among patients on Warfarin receiving care at an anticoagulation clinic. Methods: Following the design and development of a Warfarin app called Coumadin Hero, the usability testing of the app was conducted with 25 participants. Heuristics and user testing were conducted. The Technology Acceptance Model (TAM) was the theory that informed the study design and implementation. An adaptation of the Perceived Health Web Site Usability Questionnaire (PHWSUQ) was used to assess the participant usability. Descriptive and correlational statistics were used to analyze game play data and responses to survey questionnaires. Results: The median percent correct of Vitamin K food identification was 79%. Generally, participants had higher knowledge of Vitamin K levels in green vegetables (92% - 96%). User technology experience and demographic characteristics were not associated with Vitamin K food knowledge or level of satisfaction. The overwhelming majority of users found the app easy to learn and use. The ease of reading and finding information were 68 – 72%, respectively. Conclusion: Because self-management is vital for people taking Warfarin, using a game app as a supplement to traditional teaching could have significant positive impact on their health. As apps are increasingly easy to develop and smartphone use increases, apps should be developed to help people manage chronic diseases. Findings from this study support people’s interest and ability to use apps.