Nonagenarian designs for aging and inspires younger designers

Barbara Beskind, 90, is a designer at IDEO who works with engineers on products that improve the quality of life for older people. Nicolas Zurcher/Courtesy of IDEO
Barbara Beskind, 90, is a designer at IDEO who works with engineers on products that improve the quality of life for older people.
Nicolas Zurcher/Courtesy of IDEO

NPR published a great story on Barbara Beskind, a product and interface designer in her early nineties.

My favorite excerpt:

Gretchen Addi, an associate partner at IDEO, hired Beskind. Addi says when Beskind is in a room, young designers do think differently. For example, Addi says IDEO is working with a Japanese company on glasses to replace bifocals. With a simple hand gesture, the glasses will turn from the farsighted prescription to the nearsighted one.

Initially, the designers wanted to put small changeable batteries in the new glasses. Beskind pointed out to them that old fingers are not that nimble.

“It really caused the design team to reflect,” Addi says. They realized they could design the glasses in a way that avoided the battery problem. “Maybe it’s just a USB connection. Are there ways that we can think about this differently?”

There are several wonderful take-home messages:

  • Creative and fulfilling work can extend late into the lifetime
  • Aging does not just bring limitations, it also extends perspective and wisdom
  • Designing for aging is doesn’t detract from a product but can enhance it for people of all ages
  • Having a person with such perspective on a design team changes the perspective and thoughts of the rest of the team, the core tenant of participatory design

Apple Watch Human Factors

watchThe big news in tech last week was the unveiling of the Apple Watch. I think it is a nice moment to discuss a range of human factors topics. (This topic may elicit strong feelings for or against Apple or the idea of a smartwatch but let’s keep it about the science.)

The first is technology adoption/acceptance. Lots of people were probably scratching their heads asking, “who wears a watch, nowadays?” But you do see lots of people wearing fitness bands. Superficially, that contrast seems to demonstrate the Technology Acceptance Model (TAM) in action.  TAM is a way to try to understand when people will adopt new technology. It boils down the essential factors to usability (does it seem easy to use?) and usefulness (does it seem like it will help my work or life?).

Fitness bands check both of the above boxes: since they are essentially single-function devices they are relatively easy to use and tracking fitness is perceived as useful for many people.

Back to the Watch, it may also check off both of the above boxes: it certainly appears easy to use (but we do not know yet), and because it has fitness tracking functions plus many others via apps it certainly may be perceived as useful to the same crowd that buys fitness bands.

The next topic that got me excited was the discussion of the so-called digital crown (shown below). Anne and I have previously studied the contrasts between touch screens and rotary knobs for a variety of computing tasks. Having both choices allows the user select the best input device for the task: touch for pushing big on-screen buttons and large-scale movement and knob for precise, linear movement without obscuring the screen. Using a knob is certainly easier than a touch screen if you have shaky hands or are riding a bumpy cab.

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Two small items of note that were included in the Watch was the use of the two-finger gesture on the watch face to send a heart beat to another user–the same gesture many people intuitively think of when they want to feel their own heart beat.

Finally, the Watch has the ability to send animated emoij to other users. What was noteworthy is the ability to manipulate both eyes and mouth in emoji characters. I couldn’t find any literature but I recall somewhere that there is some cross-cultural differences in how people use and interpret emoji: Western users tend to focus on the mouth while Eastern users tend to focus on the eyes (if you know what reference I’m talking about or if I’m mis-remembering, feel free to comment).

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There’s so much I haven’t brought up (haptic and multi-modal feedback, user interface design, automation, voice input and of course privacy)!

 

 

Haikuman Factors

Sometimes it’s good to take a step back from the seriousness of our work and find new focus. H(aiku)man factors is the brainchild of my colleague Douglas Gillan. Each summarizes a concept in the field while following the haiku form of 5-7-5 and an emphasis on juxtoposition and inclusion of nature. Enjoy and contribute your own in the comments!

H(aik)uman Factors3

H(aik)uman Factors2

H(aik)uman Factors

H(aik)uman Factors6

H(aik)uman Factors5

H(aik)uman Factors4

All of the above are by Doug Gillan.

Other contributions:

Inattentional blindness by Allaire Welk
Unicycling clown
Challenging primary task
Did you notice it?

Affordances by Lawton Pybus
round, smooth ball is thrown
rolls, stops at the flat, wing-back
chair on which I sit

Escalation by Olga Zielinska
headache, blurred vision
do not explore Web MD
it’s not a tumor

Automatic Processing by Anne McLaughlin
end of the workday
finally get to go home
arugh, forgot groceries

Automation by Richard Pak
Siri, directions!
No wait, I’ll get it myself
Drat, I forgot how

Prospective Memory by Natalee Baldwin
I forgot the milk!
Prospective memory failed
Use a reminder

Working Memory by Will Leidheiser
copious knowledge.
how much can I remember?
many things at once.

Wearable Fitness Trackers: A Comparative Usability Evaluation

This guest post is from graduate students Haley Vaigneur and Bliss Altenhoff. Haley and Bliss compared the usability of two fitness trackers as part of a graduate course in health informatics taught by Kelly Caine.

trackers

Wearable fitness trackers allow users to track and monitor their health. While these devices originated as a way for doctors to monitor chronically ill patients’ vitals, they have recently been developed and marketed for to a more general, health-conscious market. Equipped with advanced sensors such as accelerometers, users’ activity and sleep can be automatically tracked and then compared with their logged fitness goals and daily diet. Users can then use their statistics to help create or maintain a healthier lifestyle. Two examples of such devices are the Jawbone Up and Fitbit Flex, shown above.

Wearable technology is popular and has the potential to dramatically impact health (e.g. long-term health and activity data tracking, immediate syncing with Electronic Health Records (EHRs)). But these benefits can only be realized if the user is able to effectively use and understand these devices. This was the motivation for focusing on two of the most popular models of fitness trackers: the JawBone Up and FitBit Flex and their accompanying smartphone apps.

This study examined the usability of these two devices and their accompanying smartphone apps by having 14 participants (7 for Jawbone Up, 7 for FitBit Flex) perform a think-aloud test on five key features: Setup, Setting Goals, Tracking Diet, Tracking Activity, and Setting an Alarm. Participants then kept the wearable for three days and were encouraged to incorporate it into their normal routine. On the third day, participants completed the System Usability Scale survey and an informal interview regarding their experiences using the wearable.

Some of the key Jawbone UP findings were:

  1. Adding food or drink items was somewhat difficult due to unintuitive organization and unpredictable bugs. For example, one participant attempted to add a food item by scanning the bar code of a Lunchable, but the app added a Dr. Pepper to the log.
  2. Participants struggled to find the alarm settings, with one conducting a general web search for help to understand the Smart Sleep Window settings and how to save alarm settings.
  3. None of the participants were able to figure out how to communicate to the band or app that they would like to begin a workout. They didn’t realize that the Stopwatch menu option was intended to time the workout.

Some of the key findings of the FitBit Flex were:

Setting goals
Setting goals
wheretotap
What do I tap?
  1. Participants felt that the wristband (when using the appropriate sized band) was not uncomfortable or revealing and they were proud to wear it because it made them feel healthy.
  2. Users had a difficult time figuring out where to go on the app to set their health goals at first. Their instinct was to find it on the app homepage, or Dashboard, but it was under the Account tab.
  3. Some users had difficulty putting on the wristband, and several noted that it fell off unexpectedly. Users were also confused about where to “tap” the wristband to activate it, based on the instructions given in the app. The picture can appear to instruct the user to tap below the black screen, when the user actually needs to tap the screen directly, and firmly.
  4. Users did not realize that after turning Bluetooth on their phone, they needed to return to the app to tell the phone and wristband to begin syncing. They also noted that leaving Bluetooth on all day drained their phone battery.

    init
    Bluetooth confusion

Based on time per task and number of errors the FitBit Flex performed better than the Jawbone Up on the five tasks. Users’ ultimate trust in the data, willingness to continue using the wearable, and general satisfaction with each wearable was heavily influenced by their initial experiences (first day). The positive initial think-aloud results for the FitBit Flex were also consistent with a more positive later experience and stronger acceptance of the wearable.

This study found that there is still much room for improvement in the usability of the accompanying smartphone apps. A major concern for these kinds of devices is keeping user interest and motivation, which can easily be lost through confusing or cumbersome designs. By striving to improve the human factors of the apps simultaneous to the capabilities of the actual wearables, there is great potential for greater user satisfaction, and thus more long-term use.

While activity tracking wearables are currently most popular with more tech-savvy, active people, these devices should be designed to be used by all ages and levels of experience users. These devices could change health monitoring drastically and give people the power and ability to make better choices, and live healthier lifestyles.

Haley Vaigneur is a graduate student in Industrial Engineering at Clemson University. Her concentration is Human Factors and Ergonomics, emphasizing on research in the healthcare field.

Bliss Altenhoff is a Doctoral Candidate studying Human Factors Psychology at Clemson University, where she received her M.S. in Applied Psychology in 2012.  She is a member of the Perception and Action (PAC) lab, where her research is concentrated on enhancing human perception and performance by enriching perceptual display technologies for laparoscopic surgeons. .

ACKNOWLEDGMENTS
This material is based upon work supported by the National Science Foundation under Grant No. 1314342. Any opinions, findings, and conclusions or recommendations expressed in this material are those of the author(s) and do not necessarily reflect the views of the National Science Foundation.

Interesting control/display

Anne sent me an example of, “why haven’t they thought of this before”: an air vent with the temperature display and control knob all in one.

In this article describing the new Audi TT with glass dashboard, they describe the novel control/display/air vent seen in the image above. I guess one problem here is if it is accessible to only the driver or if it’s centrally located.

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The dashboard (shown in the linked article), however, is another story. While it looks futuristic, it looks like a distraction nightmare!

Radio interview with Rich

Our own Rich Pak was interviewed by the Clemson radio show “Your Day.”

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They cover everything from the birth of human factors psychology to the design of prospective memory aids for older adults. Enjoy!

Worst Mobile Interface Ever

I was reading articles the other day and came across a site that, as many do, reformatted for my phone. Almost all reformatted-for-mobile sites are terrible, but this one is my favorite.
photo
You cannot scroll through the 21 page article by moving your finger up and down, as would happen on a website. The only way to change pages is via the horizontal slider at the bottom. Good luck trying to move it so slightly it only goes forward one page! And yes, moving the slider left and right does move the page up and down.

Tylenol: A narrow margin of safety

I’m always surprised at how many people don’t know how dangerous Tylenol (or anything with acetaminophen/paracetamol) is. I can’t remember where I initally learned that just a few pills could cause liver failure, but it was at least 10 years ago. Of course, more than 10 years ago, I remember that Tylenol was the only painkiller allowed to be given out in my high school because it was so “safe.”

Anyway, it’s certainly been in the news lately and I have collected some interesting sources. First off, This American Life devoted an hour to investigating the problem, its history, and ongoing conflict. Absolutely worth a listen. Here is a teaser bit of the transcript:

Will Lee is one of the liver specialists and researchers who’s been calling attention to the dangers of acetaminophen. He is at the University of Texas Southwestern Medical Center and talked to reporter Sean Cole.

Will Lee: In one of the articles, we actually printed up the little coupon that I got with my Zocor prescription that says, $2 off on your next acetaminophen bottle. And one of the things on the coupon, it says safest. Not safer, or not safe, but safest. Well, this is the number-one drug killing Americans every year.

Sean Cole: Over-the-counter drug killing Americans.

Will Lee: Over-the-counter drug.

Sean Cole: Not the safest.

Will Lee: Not the safest, for sure. So I guess that’s– if you think I have a bee in my bonnet, that’s probably where it came from.

There are two human factors issues related to this “narrow margin of safety” that I’d like to highlight:

1. Warning design
2. Counter-intuitive doses for children

Warnings

If you’d like a good overview of warning design, see Wogalter, Conzola, & Smith-Jackson, 2002.

The warnings are printed in red on the lid of the container and say “Contain acetaminophen – Always read the label.”
warning
I know it took a long time to even have this, but I’d like to point out that this does not follow the best practices for warning design because it does not include the consequences or focus on the “hidden hazard.” Hidden hazards are really the reason warnings are important. Here are some examples:
  1. Does a knife need a warning that it is sharp? No, that’s not a hidden hazard. Now, if the knife is SO sharp it’s unexpectedly dangerous, then it needs a warning that conveys that information. I had a friend in high school who had a habit of testing knives with his fingertip. This never cuts you, just gives a feel for sharpness. Well, one time he had someone sharpen a swiss army knife for him – and what usually would have “felt sharp” went instantly through the skin down to the bone. That’s a hidden hazard.
  2. Does coffee need a warning that it’s hot? No, not if it’s just drink-ably hot. But yes if it is purposefully super-heated enough to cause 3rd degree burns. Watch this video to get new insight on the McDonald’s coffee story.

It is the narrow margin of safety that is the hidden hazard of acetaminophen. Nothing else available over the counter can kill you with such a small increase in dose. You can take 20x the recommended dose of Advil before it becomes threatening. I ignored the dosing for Advil once and took 6 in 3 hours rather than 2 – it made me sick and I regretted it, but would I deserve to die for that mistake? I could have died if it had been Tylenol instead of Advil. This hidden hazard is the most critical part of the warning – even if it’s on the label, I think it should be highlighted on the lid.

Which brings me to… the hidden hidden hazard that was created by the Tylenol company.

Counter-intuitive doses for children
In brief, for over a decade Tylenol provided medication labeled for infants and medication labeled for children (and of course, medication for adults). 99/100 people on the street would assume that these were in order of strength – least for the infants, more for the kids, and most for the adults. That assumption was correct for the kids and the adults. The counter-intuitive dose was for the infants: instead of being weaker because they were smaller, it was much higher. Their reasoning was that it is hard to get medication into an infant, so if it’s stronger you can get an effect with less. An article from Pro-Publica gives a more detailed summary.
An excerpt from Pro-Publica:

The two types of pediatric Tylenol had a counterintuitive difference. Drop for drop, the strength of Infants’ Tylenol far exceeded that of Children’s Tylenol.

In addition, the active ingredient in Tylenol, acetaminophen, has what the FDA deems a narrow margin of safety. The drug is generally safe at recommended doses, but the difference between the dose that helps and the dose that can cause serious harm is one of the smallest for any over-the-counter drug.

By confusing the pediatric products and administering too much of the infants’ version, parents could inadvertently overdose their children. Other manufacturers also made two children’s products with different concentrations of acetaminophen.

Between 2000 and 2009, the FDA received reports of 20 children dying from acetaminophen toxicity – a figure the agency said likely “significantly underestimates” the problem. Three deaths were tied directly to mix-ups involving the two pediatric medicines. Such errors may have caused some of the other deaths, but the agency has acknowledged that its data lacks sufficient detail to determine the precise cause.

This American Life included a heartbreaking case where parents were instructed to give their infant doses measured in terms of the children’s Tylenol (their doctor just said “Tylenol”), but since they had an infant they did what anyone would and used the Tylenol for infants, resulting in the death of their baby.

The big push seems to be for better warnings (with the example in the picture as “better.”) Indeed, this can have an impact – for example, as reported in the NY Times, removing infant versions of medication and saying a drug is “not for children under 2″ reduced drug-related emergency room visits for that age range by half.

Excerpt from the NY Times article:

In 2007, amid mounting concern that infant cough and cold medicines were unsafe and misused, manufacturers voluntarily withdrew products intended for children younger than 2. The makers revised the labels on the rest of the medicines, which now warn parents that they should not be given to children younger than 4.

Government researchers said on Monday that those moves have had a remarkable effect: a significant decrease in emergency hospital visits by toddlers and infants with suspected medical problems after using these medicines.

Dr. Daniel Frattarelli, a former chairman of the committee on drugs at the American Academy of Pediatrics, praised the study, saying it showed that “the label is a very powerful tool for changing parent behavior.”

In the new study, published in the journal Pediatrics, researchers at the Centers for Disease Control and Prevention reviewed data from 63 hospitals to estimate the number of emergency visits from 2004 to 2011 by young children who had taken cough and cold medicines.

Children under 2 accounted for 4.1 percent of all emergency visits for suspected drug-related effects before the 2007 withdrawal, the researchers found, and accounted for 2.4 percent afterward.

However, even casual readers of the blog have probably noted how often I mention the Hierarchy of Safety: first try to design out the hazard, guard against the hazard, and warn. I’m not saying warnings aren’t important, but if we want to have the biggest impact we should be working on designing out or guarding against the hazard. Some ideas in that realm include bottle design that restricts the flow of liquid (this could prevent a child from dosing him or herself, but not parents from giving the wrong dose), and packaging “single servings” of medication, so that its obvious how much to give at one time. Although the treehugger in me isn’t a fan of more packaging, this also could provide more space for good warnings AND have those warnings in extremely close spatial and temporal proximity to use of the product.

 

Brilliant guard against accidents in indoor rock climbing

For those who don’t follow news of climbing accidents as closely as I do, there has been a spate of accidents associated with the automatic belay devices (autobelays) installed at climbing gyms.

These devices are handy to have around as they negate the need for a climbing partner, allowing one to exercise and train alone. The climber clips his or her harness into the device at the bottom of the wall, and it automatically retracts (like a seat belt) when you climb upward. At the top, you let go of the wall and the device lowers you slowly back to the ground. You are probably imagining that the accidents had to do with failures of the equipment – while that is not unheard of, the most recent issues have all been with climbers forgetting to clip into the system at all.

The most recent tragedy occurred this past September, where an experienced climber died after a fall in a Texas gym, and it’s been listed as so common it happens at “every gym,” though not always resulting in a fall. Here is the facebook page with members of another gym discussing a similar accident.

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If you talk with climbers or read accident forums you will invariably be faced with a large contingent bent on blaming the victim. I’ll grant that it is hard to imagine forgetting to clip into a safety device and climb 30 feet up a wall, but that’s because I hardly ever do it. One characteristics these accidents share is that the victims were experienced and used the auto-belays frequently.

When a procedure becomes automatic, it becomes more accurate and less effortful, but it also becomes less accessible to the conscious mind. When a step is skipped, but all other steps are unaffected, it’s especially hard to notice the skipped step in an automatic process. If caring more or working harder or “being more careful” could actually prevent this type of problem, we wouldn’t have any toddlers left in hot cars, perfectly good airplanes flown into the ground, or climbers falling because they didn’t clip into the autobelay.

That brings me to the device I saw installed at a climbing gym last night.

guardAbove: The guard in place, clipped to the wall and ready to go. Notice how it blocks the footholds of the climbs.

photo 2Above: Nikki shows how to unclip the guard before attaching to her harness.

 

photo 4Above: Clipped in and safely ready to go. Guard is on the ground and out of the way (it is ok to step on it!)

Let me tell you why I think this is brilliant.

  • It’s highly visible.
  • It functions as a guard. This adheres to the hierarchy of safety: First, try to design out the hazard. Second, guard against the hazard. Last, warn. These are in order of effectiveness. Prior to this device, I had only seen signs on the wall saying “Clip in!” (And a year ago, even those didn’t exist.) This device physically blocks the start of the climbing routes, demanding interaction before one starts climbing.
  • Using it properly does not add any additional time or mess to climbing a route. If it weren’t there, the climber would still have to unclip the autobelay from an anchor close to the ground, etc. With it there, the climber does the same thing and once done, the guard becomes a flat mat that doesn’t get in anyone’s way.

Is it perfect? No. You can also climb with a belayer on the same or nearby routes, and then it’s also blocking your way at the start of the climb. Some adaptation should be made by the route-setters at the gyms to minimize this. But overall, what a great and simple solution.

 

Not blaming the user since 2007!

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