A User-Centered Design Approach for a Screening App for People With Cognitive Impairment (digiDEM-SCREEN): Development and Usability Study
Abstract BackgroundDementia is a widespread syndrome that currently affects more than 55 million people worldwide. Digital screening instruments are one way to increase diagnosis rates. Developing an app for older adults presents several challenges, both technical and social....
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JMIR Publications
2025-01-01
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| Series: | JMIR Human Factors |
| Online Access: | https://humanfactors.jmir.org/2025/1/e65022 |
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| author | Michael Zeiler Nikolas Dietzel Fabian Haug Julian Haug Klaus Kammerer Rüdiger Pryss Peter Heuschmann Elmar Graessel Peter L Kolominsky-Rabas Hans-Ulrich Prokosch |
| author_facet | Michael Zeiler Nikolas Dietzel Fabian Haug Julian Haug Klaus Kammerer Rüdiger Pryss Peter Heuschmann Elmar Graessel Peter L Kolominsky-Rabas Hans-Ulrich Prokosch |
| author_sort | Michael Zeiler |
| collection | DOAJ |
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Abstract
BackgroundDementia is a widespread syndrome that currently affects more than 55 million people worldwide. Digital screening instruments are one way to increase diagnosis rates. Developing an app for older adults presents several challenges, both technical and social. In order to make the app user-friendly, feedback from potential future end users is crucial during this development process.
ObjectiveThis study aimed to establish a user-centered design process for the development of digiDEM-SCREEN, a user-friendly app to support early identification of persons with slight symptoms of dementia.
MethodsThis research used qualitative and quantitative methods and involved 3 key stakeholder groups: the digiDEM research team, the software development team, and the target user group (older adults ≥65 years with and without cognitive impairments). The development of the screening app was based on an already existing and scientifically analyzed screening test (Self-Administered Tasks Uncovering Risk of Neurodegeneration; SATURN). An initial prototype was developed based on the recommendations for mobile health apps and the teams’ experiences. The prototype was tested in several iterations by various end users and continuously improved. The app’s usability was evaluated using the System Usability Scale (SUS), and verbal feedback by the end users was obtained using the think-aloud method.
ResultsThe translation process during test development took linguistic and cultural aspects into account. The texts were also adapted to the German-speaking context. Additional instructions were developed and supplemented. The test was administered using different randomization options to minimize learning effects. digiDEM-SCREEN was developed as a tablet and smartphone app. In the first focus group discussion, the developers identified and corrected the most significant criticism in the next version. Based on the iterative improvement process, only minor issues needed to be addressed after the final focus group discussion. The SUS score increased with each version (score of 72.5 for V1 vs 82.4 for V2), while the verbal feedback from end users also improved.
ConclusionsThe development of digiDEM-SCREEN serves as an excellent example of the importance of involving experts and potential end users in the design and development process of health apps. Close collaboration with end users leads to products that not only meet current standards but also address the actual needs and expectations of users. This is also a crucial step toward promoting broader adoption of such digital tools. This research highlights the significance of a user-centered design approach, allowing content, text, and design to be optimally tailored to the needs of the target audience. From these findings, it can be concluded that future projects in the field of health apps would also benefit from a similar approach. |
| format | Article |
| id | doaj-art-ee4e935babab40b9b109789a4b5fd16f |
| institution | Kabale University |
| issn | 2292-9495 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | JMIR Publications |
| record_format | Article |
| series | JMIR Human Factors |
| spelling | doaj-art-ee4e935babab40b9b109789a4b5fd16f2025-01-29T21:00:53ZengJMIR PublicationsJMIR Human Factors2292-94952025-01-0112e65022e6502210.2196/65022A User-Centered Design Approach for a Screening App for People With Cognitive Impairment (digiDEM-SCREEN): Development and Usability StudyMichael Zeilerhttp://orcid.org/0009-0002-7267-9764Nikolas Dietzelhttp://orcid.org/0000-0002-5820-3738Fabian Haughttp://orcid.org/0000-0001-5697-3686Julian Haughttp://orcid.org/0000-0001-6323-3184Klaus Kammererhttp://orcid.org/0000-0001-8998-0890Rüdiger Prysshttp://orcid.org/0000-0003-1522-785XPeter Heuschmannhttp://orcid.org/0000-0002-2681-3515Elmar Graesselhttp://orcid.org/0000-0002-9009-5351Peter L Kolominsky-Rabashttp://orcid.org/0000-0002-7168-058XHans-Ulrich Prokoschhttp://orcid.org/0000-0001-6200-753X Abstract BackgroundDementia is a widespread syndrome that currently affects more than 55 million people worldwide. Digital screening instruments are one way to increase diagnosis rates. Developing an app for older adults presents several challenges, both technical and social. In order to make the app user-friendly, feedback from potential future end users is crucial during this development process. ObjectiveThis study aimed to establish a user-centered design process for the development of digiDEM-SCREEN, a user-friendly app to support early identification of persons with slight symptoms of dementia. MethodsThis research used qualitative and quantitative methods and involved 3 key stakeholder groups: the digiDEM research team, the software development team, and the target user group (older adults ≥65 years with and without cognitive impairments). The development of the screening app was based on an already existing and scientifically analyzed screening test (Self-Administered Tasks Uncovering Risk of Neurodegeneration; SATURN). An initial prototype was developed based on the recommendations for mobile health apps and the teams’ experiences. The prototype was tested in several iterations by various end users and continuously improved. The app’s usability was evaluated using the System Usability Scale (SUS), and verbal feedback by the end users was obtained using the think-aloud method. ResultsThe translation process during test development took linguistic and cultural aspects into account. The texts were also adapted to the German-speaking context. Additional instructions were developed and supplemented. The test was administered using different randomization options to minimize learning effects. digiDEM-SCREEN was developed as a tablet and smartphone app. In the first focus group discussion, the developers identified and corrected the most significant criticism in the next version. Based on the iterative improvement process, only minor issues needed to be addressed after the final focus group discussion. The SUS score increased with each version (score of 72.5 for V1 vs 82.4 for V2), while the verbal feedback from end users also improved. ConclusionsThe development of digiDEM-SCREEN serves as an excellent example of the importance of involving experts and potential end users in the design and development process of health apps. Close collaboration with end users leads to products that not only meet current standards but also address the actual needs and expectations of users. This is also a crucial step toward promoting broader adoption of such digital tools. This research highlights the significance of a user-centered design approach, allowing content, text, and design to be optimally tailored to the needs of the target audience. From these findings, it can be concluded that future projects in the field of health apps would also benefit from a similar approach.https://humanfactors.jmir.org/2025/1/e65022 |
| spellingShingle | Michael Zeiler Nikolas Dietzel Fabian Haug Julian Haug Klaus Kammerer Rüdiger Pryss Peter Heuschmann Elmar Graessel Peter L Kolominsky-Rabas Hans-Ulrich Prokosch A User-Centered Design Approach for a Screening App for People With Cognitive Impairment (digiDEM-SCREEN): Development and Usability Study JMIR Human Factors |
| title | A User-Centered Design Approach for a Screening App for People With Cognitive Impairment (digiDEM-SCREEN): Development and Usability Study |
| title_full | A User-Centered Design Approach for a Screening App for People With Cognitive Impairment (digiDEM-SCREEN): Development and Usability Study |
| title_fullStr | A User-Centered Design Approach for a Screening App for People With Cognitive Impairment (digiDEM-SCREEN): Development and Usability Study |
| title_full_unstemmed | A User-Centered Design Approach for a Screening App for People With Cognitive Impairment (digiDEM-SCREEN): Development and Usability Study |
| title_short | A User-Centered Design Approach for a Screening App for People With Cognitive Impairment (digiDEM-SCREEN): Development and Usability Study |
| title_sort | user centered design approach for a screening app for people with cognitive impairment digidem screen development and usability study |
| url | https://humanfactors.jmir.org/2025/1/e65022 |
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