Category Archives: aging

Designing Displays for Older Adults: Chapter 1 (excerpt)

Below is the preface and excerpt of Chapter 1 from our forthcoming book.  The book is available where fine books are sold or directly from our publisher CRC Press.  Until January 31, 2011, you can get 20% off the cover price when you purchase directly from CRC Press using this link and this code: 810DE.

Preface

Price: $69.95, Cat. #: K10089, ISBN: 9781439801390, ISBN 10: 1439801398

This book is focused on the design of displays for the older user.  Why does this topic deserve a book?  Aging leads to a complex set of changes both mentally and physically that can affect technology acceptance, adoption, interaction, safety, and satisfaction.  Design with an understanding of these changes will result in better products and systems for users in all stages of the lifespan.  Conventional wisdom (possibly informed by personal experience) is that getting older leads to a decline across a broad set of skills and abilities; however, the reality is that as some capabilities decline with age others remain stable or increase.  For example, although a sixty year old man may not be able to beat his granddaughter in the computer puzzle game Tetris, the elder will invariably beat the youth in games of knowledge such as the board game Trivial Pursuit or the television quiz show Jeopardy.  Design of displays and technology can capitalize on these capabilities to ameliorate the limitations that can come with age.

As human factors professionals, we have often been frustrated at how little research makes it to practice.  This is why the target audience for this book is a usability engineer, or user interface/user experience designer who is tasked with creating an interface that might be used by older adults.  Literally hundreds of papers have been written about interface issues experienced by older adults, but how many actually influence the designs older adults use? We believe the challenge comes in part from the sheer number of articles available.  Design and usability evaluation are fast-paced activities with little time allowed for literature review.  Many professionals do not have the time to sift through thousands of papers to determine: a) which are related to the question at hand and b) whether the design or study has merit.  Another reason may be that academic papers typically target other academics and may not stress the application or design implications of their findings.  Finally, another barrier to knowledge transfer may be that academic publishing moves slower than the design and usability industry.  The time it takes for journal articles to reach the audience, from submission time, can be months to years.  As such authors may be loathe to nail down concrete design guidelines opting for the conceptual and general (but often vague and hard to implement) because their research may be published a year in the future.  This book distills decades of published aging research most relevant to the design of displays.

We believe this book offers a benefit beyond individual research studies.  The first half of the book is a primer of age-related changes in cognition, perception, and behavior.  Theory can be used to organize examples from the literature into meaningful principles that improve understanding.  Using theory backed up by evidence provides an understanding of why we see certain problems with many displays and often predicts solutions.  This understanding surpasses an individual interface and provides the practitioner with ways to plan for older users on multiple display types.  We then apply these theories in real design exercises.  In all chapters we provide specific guidelines for display examples to bridge theory and practice.

1.  ­­Introduction

Age is simply an indicator of how long one has lived, but is not a complete indicator of a specific individual’s capabilities and limitations.  One can easily imagine how a physically fit 55 year old tri-athlete could out-perform a 34 year old in a marathon, personified by Cliff Young, the sixty-one year old winner of the 1983 Sydney ultra-marathon (544 miles).  Similarly, with respect to cognitive capacity, there is wide variety in capabilities and limitations that are linked with age.  Thus the definition of “old” and “older” can be a tricky issue.  The issue is further complicated by the sheer variability in any given ability as we get older.  Generally, for younger and middle age groups, capabilities vary but this variability widens as people get older: the older adult age group (defined as those aged 65 and over) are more different from each other than people in other age groups differ from persons in their own age group.

One way to think about the older user is via their familiarity with current technologies and interface conventions.  Jakob Nielsen reported that “Between the ages of 25 and 60, the time users need to complete website tasks increases by 0.8% per year.” But does this time increase come from a rapidly changing technology or declines in the human body? Both culture and the physical aging process play a role.  Such dual causes for the same symptom exemplify why designs should be carefully analyzed as to the difficulties they produce.  It is important to know how much of a role the display plays in increased time to complete tasks versus slowed completion times due to the user’s inexperience with that type of task or any number of other variables.

Another way to think about the older user is by the appearance of perceptual and cognitive changes that we usually associate with aging.  This may include far-sightedness, the need for bifocals or reading glasses, hearing aids, and an increased reliance on notes rather than memory for everyday tasks.  An understanding of these changes and the effects they can have on display use is critical, because these changes often interact with each other.  Thus, understanding a single age-related change, such as vision, can lead to designs that adversely affect other senses and cognitions such as the high working memory requirements of audio displays or creating the need to scroll larger text, which can require precise movement.

1.1 What Do Older Adults Want from Technology?  What Do They do with Technology?

Across a wide range of everyday activities users encounter electronic technology.  Technology, for the purposes of this book, is broadly defined as any tool or artifact that helps the user accomplish a task, limited to electronic displays for the purposes of this book.  Even with this limitation, consider how ubiquitous technology is for most people.  Table 1.1 shows everyday technologies located in typical environments.

Many of these technologies are either specifically for or related to communication with others.  Mobile communication occurs commonly with all age groups, though use of mobile communication technologies can vary by age (Table 1.2).  Those over age sixty-five are less active users of the full range of advanced mobile services, but they are enthusiastic users of mobile voice communications, especially in emergency situations (Table 1.3).  The need to communicate is enabled through cell phone use and thus the product has been adopted by older adults.  Indeed, this adoption occurred in spite of the fact that many cell phones are not well designed for older users.  These design problems can partly explain the lower use in older age groups compared to younger.  When a user group is excluded from these everyday technologies by designs that do not accommodate them, both the quality of life of those users and the market share of the product companies can suffer.

Similar to cell phones, use of the internet as a tool beyond information seeking is becoming more common among older adults.  According to a 2006 Pew survey, 41% of internet users are over age sixty-five.  Online banking is a popular activity and 43% of internet users engage in some form of online banking.  However, only 27% of users aged sixty-five or older regularly banked online.  This is a fairly typical finding when relating age and technology use, but there are many potential reasons as to why.  These reasons range from usability issues with the interface to unease in accessing financial information over the web (mistrust).  These are two different reasons for avoiding online banking and one would take different paths to overcome them.  The lesson from investigating reasons for non-adoption of a technology is that it is important not to conclude that older adults avoid technology for any stereotypical reason, as avoidance is often affected by context, needs, and experience levels.  Understanding the barriers to the adoption of potentially useful services and products is crucial to overcoming the problems and increasing adoption.  Stereotypes of older users should be avoided in favor of evidence-based analyses.

1.2 Stereotypes of Older Users

A common stereotype of older adults is that they do not and will not use technology.  If this were true, there would be no need for this book: all displays and interfaces would be translated to disinterested older adults by their children and grandchildren.  However, this stereotype could not be farther from the truth.  Adults over sixty-five want to keep up with technology and take advantage of what a technological world has to offer.  About half of persons aged sixty-five to seventy-four are cell phone subscribers, and a third over seventy-five pay for service.  The Center for the Digital Future found that in 2009, 40% of persons over sixty-five in the United States were internet users.  Participants in our research studies frequently mention that understanding new technologies makes them feel connected to others and the world in general.

Use of the internet is one microcosm of older adults’ perception of technology.  Though the statistic of 40% using the internet seems impressive, it is paltry when compared to the nearly 100% of younger users who take advantage of the web on a daily basis.  A common stereotype of older users is that they are unable to learn to use complicated technological systems.  However, when older adults reject technology it tends to be due to not perceiving a benefit of the technology, not necessarily because it is too difficult or time consuming to learn.  The end result may be the same, fewer older adults use new technologies, but the reason is important.  When older adults perceive a benefit, they are willing to invest the time to learn.  However an unusable interface is more likely to tilt the scale in favor of “not worth it.”

Email provides another useful example to illustrate these points.  Email is form of communication, both business and personal.  Imagine someone having only this knowledge about email.  Would one understand that email allows instant communication? Would one know that they could send and receive pictures of the people they care about the very day the pictures were taken? Would they know that email is free?  Would they understand the asynchronous nature of email; that the person they are communicating with did not have to be available at the instant the email was sent, but that the message would be there waiting for the recipient(s), or even that the same message could be sent to more than one person at the same time?  If potential users do not know these things there is no reason to prefer email over a letter or a phone call.  It should not be assumed that “everyone” understands these benefits of email and if a person does not know of these benefits there is little reason to adopt the technology.

continued

This book is part of the Human Factors & Aging Series. The first volume in the series is Designing for Older Adults: Principles and Creative Human Factors Approaches by Fisk, Rogers, Charness, Czaja, and Sharit and is available now. Forthcoming titles are: Aging and Skill Acquisition: Designing Training Programs for Older Adults (Czaja & Sharit) and Designing Telehealth for an Aging Population (Charness, Demiris, & Krupinski).

Almost Here: Designing Displays for Older Adults

After a long process and over a year of work, Anne’s and my book on user interface design for older adults is almost available!  The cover of our book has been finalized (shown below).  The book will be released September 21st, 2010 and will be available where fine books are sold or directly from our publisher CRC Press.

Price: $69.95, Cat. #: K10089, ISBN: 9781439801390, ISBN 10: 1439801398, Publication Date: September 21, 2010, Number of Pages: 232

We’ll give away a few copies of our book and in a future post provide an excerpt when we get permission.  Unfortunately, the book is not scheduled to be available in electronic format but we hope that will change. An ebook will also be available (thanks Peg!).

Here is our description of the book:

Features

  • Contains state-of-the-art aging research written in an accessible format
  • Includes four chapters of worked examples that put design suggestions into practice
  • Focuses on designing for the aging population
  • Explores the “hows” and “whys” of designing for an aging population

Summary

A distillation of decades of published research, this book is a primer on age-related changes in cognition, perception, and behavior organized into meaningful principles that improve understanding. It explores the complex set of mental and physical changes that occur during aging and that can affect technology acceptance, adoption, interaction, safety, and satisfaction. The authors apply these theories in real design exercises and include specific guidelines for display examples to bridge theory and practice. It opens the way for designing with an understanding of these changes that results in better products and systems for users in all life stages.

Online Banking Should Be Easier for Seniors

A new study has identified how poorly designed online and electronic banking is for older users and will seek to find remedies.

From the news article in www.theengineer.co.uk:

The new assistive technology developed by Newcastle and York researchers will be tried out by a variety of focus groups over 18 months.

Some ideas include a wallet shaped foldable display. One half would display recent transactions with dates and amounts, the other half your current balance, as a figure and an analogue quantity.

Monk said other assistive technology devices could mimic the ‘physicality’ of cash. This is important, he said, because many older people work in a ‘cash economy’ and are wary of ATM cards because there is no way to immediately see the amount of money being withdrawn.

From the comments section of the article, showing the need for this project:

I have an elderly relative who has arthritic hands. When trying to enter her pin number at the supermarket checkout, she cannot push the buttons on the keypad hard enough to make the number register. Could they be made more sensitive? Or perhaps replace the keypad with a touch screen? Or something else?

Here is a link to Andrew Monk’s homepage to stay tuned in for the results.

This news story was sent in by Darin Ellis of Wayne State University. Thanks, Darin!

Careers in Human Factors & Aging

A graduate student contacted me with questions about career paths for those of us in HF with an aging background.  This sounded like a great opportunity for discussion so I’m posting it here.  If you can contribute responses to any or all of these questions, please leave a comment!

I am giving a presentation on the Aging Technical Group [of the Human Factors and Ergonomics Society] in my Human Factors Professional Issues course and the focus is on potential career options in this area. I am gathering information from past ATG newsletters and publications within HFES Proceedings in recent years.

I am emailing you to ask if you could provide any additional career-related information. Some questions that I thought might be relevant are listed below.

  1. What are the most common areas of research within human factors in aging?
  2. What are some of the largest changes in research trends within this area?
  3. What are the most common types of careers that individuals working in aging within the realm of human factors typically hold?
  4. What are some unexpected places that one may find hf aging professionals employed?
  5. Is there anything in particular that sets careers in aging apart from working within other areas of hf?
  6. Any other information you can provide about careers in this area

Also, if you could provide any additional suggestions for resources where I might find more information (other than what I listed above), I would very much appreciate it.

HF Graduate Programs: North Carolina State University

This is the second post in our 2-part look at some HF programs.  Rich’s post about Clemson’s program can be found here.

The psychology graduate program at NCSU in Raleigh, North Carolina, U.S.A, boasts eight faculty in the Human Factors and Ergonomics specialization. This is in addition to the faculty in our sister program in Industrial Engineering and related faculty in areas as diverse as Industrial Design and Education.  Graduates of the program can be found both in academia and industry (e.g., Virginia Tech faculty, IBM, HumanCentric, Dell).

A sampling of the kinds of research we do here:

  • Warnings – when are they appropriate, how to create them, how they can be misunderstood
  • Medication adherence – when do people share their prescriptions with others?
  • Methods of knowledge acquisition for collecting data from experts to be used to create artificial intelligence, training programs, and display formats
  • Designing instruction and feedback for diverse cognitive ability levels
  • Controlling robots
  • Spatial math
  • Visual spatial perception, auditory spatial perception
  • The intersection of technology and human aging

We also have an active Human Factors and Ergonomics Society student chapter.

Our admissions process begins in the fall, when we start accepting applications for review in January. The current deadline for applications is January 1st of each year, but check the website to be certain.

I’m happy to answer emails from prospective students. Let me know what areas you are interested in and I can help connect you with the faculty here closest to those areas.

The director of our graduate program is the best person to ask about admissions and requirements:

Donald H. Mershon, Ph.D.

email: don_mershon at ncsu.edu

The website for the Director of Graduate Programs

HF Graduate Programs: Clemson University

This is the first post in our 2-part look at some HF programs. Anne’s post about North Carolina State University’s program can be found here.

Did you know that Human Factors is not only a fun blog, but something you could get a graduate degree in?  The field is known by many names but they are the same, more or less¹ (for example, Anne and I received our degree in “engineering psychology”).

The degree is fairly generic and is defined further by specialization (for example, human-computer interaction and usability are closely associated with HF but by no means limited to it).  Human factors graduates work in industry (evaluating software/hardware usability, designing), government, and research.

The Human Factors and Ergonomics Society (HFES) website has a non-exhaustive list of accredited programs in the U.S.  Clemson’s HF graduate degree program [link to Clemson’s program, HFES link to Clemson] is the only accredited program in South Carolina.  Anne will highlight her own university (North Carolina State University).  If you’d like to mention your program (or Alma mater, please comment, especially our international readers).

Unfortunately, we probably should have done these posts months ago when students were researching and applying to programs but better late than never!  Still deciding on whether to do the M.S. or PhD?  See this article (PDF link) provided by HFES.  It’s old but still has great information.

Clemson University

Clemson University is located in Clemson, South Carolina which is situated in the foothills of the Blue Ridge Mountains (in the upper left corner of the state).  The area is known as the “upstate” of South Carolina and is adjacent to one of the largest metropolitan areas of the state (Greenville-Spartanburg area).

The Department of Psychology at Clemson University offers both master’s and PhD degrees in Human Factors.  Clemson’s program is newer than most (established in 1988) but already has graduated several PhD students who work in academia and industry.  The faculty have a wide variety of research interests.  My own interests are pretty well covered by my posts on this blog.

We do not have rolling admissions; instead, applications are accepted yearly and acceptances are made in mid-late spring.  It is probably a very good idea to target people who’s research sounds interesting to you and then ask them if they are taking students that year.

Feel free to ask me questions about the program but the best person to ask is our graduate coordinator:

Dr. Robert Sinclair
Clemson University
Department of Psychology
418 Brackett Hall
Clemson, SC 29634
(864) 656-3931
(864) 656-0358 (fax)
rsincla@clemson.edu

¹similar terms to human factors:  applied cognitive psychology, applied experimental psychology, engineering psychology

HF Potpourri

  • James Rubinstein sends along a this post about a 32 inch LCD TV presumably designed for older users.  It has features such as a dramatically simplified remote control, fewer wires, and a shut-off timer.  [Engadget]
  • Designing Devices is a relatively new blog devoted to “how and why to create devices” from Dan Saffer (author of Designing for Interaction).  I’m loving the long posts (especially the one on Controls).
  • In the “why didn’t they do this sooner” category is an Ethnography application for the iPhone called Everyday Lives (warning, link opens iTunes).  It lets you record audio, video, images and other data in the field (via UXforward).

Vision-themed Potpourri

Today’s potpourri happens to be related to understanding or enhancing what your users see (or don’t see):

Browser Size view of HFB
  • Google Browser Size let’s you see how much of your web content is visible by users.
  • Rocker Lou Reed (of the Velvet Underground) designs an iPhone app for near-sighted users.  It basically increases the font size in the contacts application.  It appears that Mr. Reed has common ground with older users?  (OK, lame attempt to insert the Reed song, “Good evening Mr. Waldheim”).  [Wired]
  • When minimalism in user interfaces is too much (UXforward)
  • Perhaps confirming what we suspected, visual alerts are more disruptive than auditory alerts (LiveScience).
  • Lifehacker has an interesting discussion of the merits of multiple-monitors or single big ones as well as a list of useful utilities (I prefer multiple versus a single big one; use 2-24 inches).

HF Potpourri

More potpourri from the web:

Human Factors and Healthcare: The older patient & nurse

I‘ve recently published two papers on the topic of human factors and healthcare. Each paper covers a different “stakeholder”: the older patient and the nurse.  The first paper is available for free but the second paper (a collaboration with my architect colleague Dina Battisto) is available at your local library (or you can request a PDF reprint from me).

Pak, R., Price, M. M., & Thatcher, J. (2009). Age-sensitive design of online health information. Journal of Medical Internet Research.

ABSTRACT
Background:
Older adults’ health maintenance may be enhanced by having access to online health information. However, usability issues may prevent older adults from easily accessing such information. Prior research has shown that aging is associated with a unique pattern of cognitive changes, and knowledge of these changes may be used in the design of health websites for older adults. Objective: The goal of the current study was to examine whether older adults use of a health information website was affected by an alternative information architecture and access interface (hierarchical versus tag-based). Methods: Fifty younger adults (aged 18-23) and 50 older adults (aged 60-80) navigated a health information website, which was organized hierarchically or used tags/keywords, to find answers to health-related questions while their performance was tracked. We hypothesized that older adults would perform better in the tag-based health information website because it placed greater demands on abilities that remain intact with aging (verbal ability and vocabulary). Results: The pattern of age-related differences in computer use was consistent with prior research with older adults. We found that older adults had been using computers for less time (F1,98= 10.6, P= .002) and used them less often (F1,98= 11.3, P= .001) than younger adults. Also consistent with the cognitive aging literature, younger adults had greater spatial visualization and orientation abilities (F1,98= 34.6, P< .001 and F1,98= 6.8, P= .01) and a larger memory span (F1,98= 5.7, P= .02) than older adults, but older adults had greater vocabulary (F1,98= 11.4, P= .001). Older adults also took significantly more medications than younger adults (F1,98= 57.7, P< .001). In the information search task, older adults performed worse than younger adults (F1,96= 18.0, P< .001). However, there was a significant age × condition interaction indicating that while younger adults outperformed older adults in the hierarchical condition (F1,96= 25.2, P< .001), there were no significant age-related differences in the tag-based condition, indicating that older adults performed as well as younger adults in this condition. Conclusions: Access to online health information is increasing in popularity and can lead to a more informed health consumer. However, usability barriers may differentially affect older adults. The results of the current study suggest that the design of health information websites that take into account age-related changes in cognition can enhance older adults’ access to such information.

Battisto, D. B., Pak, R., Vander Wood, M. A., & Pilcher, J. J. (2009). Employing a task analysis to describe nursing work in acute care patient environments. Journal of Nursing Administration, 39(12), 537-547.

ABSTRACT
To improve the healthcare environment where nurses work and patients receive care, it is necessary to understand the elements that define the healthcare environment. Primary elements include (a) the occupants of the room and what knowledge, skills, and abilities they bring to the situation; (b) what tasks the occupants will be doing in the room; and (c) the characteristics of the built environment. To better understand these components, a task analysis from human factor research was conducted to study nurses as they cared for hospitalized patients. Multiple methods, including a review of nursing textbooks, observations, and interviews, were used to describe nurses’ capabilities, nursing activities, and the environmental problems with current patient room models. Findings from this initial study are being used to inform the design and evaluation of inpatient room prototype and to generate future research in improving clinical environments to support nursing productivity.

The picture at the top of this post is the room prototype referenced in the abstract above.  Further details on its design and evaluation will be covered in another forthcoming paper.