User needs, requirements and usability issues of a platform for healthy living: "BENEFIT for all"

Background: Make healthy living fun – this is the goal of the online ‘BENEFIT’ Personal Health Platform (PHP), which aims to support cardiac patients with adopting and maintaining a healthy lifestyle, by facilitating healthy behavior and rewarding it [1]. Grounding a healthy lifestyle in patients’ daily life, creating long-lasting behavior change and healthy habits is a challenge. This study aims to evaluate the user experience/usability with the Benefit PHP. Methods: Two rounds of online usability tests with additional interviews were conducted with cardiac patients. Round 1) cardiac patients who were recently introduced to the BENEFIT PHP, just after finishing their revalidation process in the hospital. Round 3) cardiac patients who use the BENEFIT PHP for more than six months after they finished their revalidation process in the hospital. During both rounds, the BENEFIT PHP was evaluated by testing scenarios of use, and subsequently interview patients. In addition, participants were asked to fill in the Twente Engagement with Ehealth Technologies Scale (TWEETS) measuring their engagement with the technology [2]. Findings: Main usability findings in the first round (novice users) include the observation that most basic tasks (e.g., entering and viewing self-monitoring values such as blood pressure), are easy to perform. Some minor issues were identified such as use of difficult language, and difficulty in personalizing the overview dashboard. The usability tests and user comments show that the system guides users through the first tasks. Users encounter problems in goal-setting, and interpretation of entered values. The presence of a virtual coach (no mayor usability issues) contributes to motivation and a feeling of being ‘seen’. Outcomes of the TWEETS showed that users are neutral about the BENEFIT PHP as being part of their daily routine, making it easier to work on their goals, helping to get insight in their behavior, enjoying to use, and as fitting them as a person. Users agree that BENEFIT PHP is easy to use, can be used as often as needed, motivates them to reach their goal, and makes it enjoyable to see the progress they make. The second round of usability test will be conducted in February-April; the results will be compared to the first round’s results to learn about possible changes in use and user experience. Discussion: The development process in this project has been iterative; many evaluations contributed to (proposed) changes in the design of the platform. No mayor usability issues were identified, previous user involvement may have contributed to this finding. Regarding user goals and expectations, some issues were encountered; users claimed a desire to also ‘do’ something with their data; receive support to learn and understand what is happening. Also, presence of a coach, even if there is little interaction with the coach is important for the patients and their use of the PHP. In fact, such findings shed light on the context and requirements for implementation of this project into various possible contexts.