2009 HESCA Conference Presentation

1. INShape Indiana: A Case Study in Evaluating Health Web Site Usability Peter J. Ellery & Jane Ellery Fisher Institute for Wellness and Gerontology 1 2009 Health Sciences Communications Association Conference - St. Louis, MO

2. Salutogenesis: A Theoretical Approach to Understanding Usability 2009 Health Sciences Communications Association Conference - St. Louis, MO 2

4. “The problem, however, is that bright ideas, as long as they are unintegrated into a good theory … are not very helpful. More significantly, a good theory will give birth to productive ideas. “ – Aaron Antonovsky, social psychologist

5. A theoretical framework is practical because it organizes and directs thinking toward solutions.2009 Health Sciences Communications Association Conference - St. Louis, MO 3

6. 2009 Health Sciences Communications Association Conference - St. Louis, MO 4 Do you have the time and resources needed to cope with the problems you face on a daily basis? Salutogenesis: Perceiving Life as Meaningful, Manageable, and Comprehensible Is the information you receive ordered, consistent, structured, and clear? Does it conform with the way you understand the world to be? Is what you do adding value and meaning to your life? Meaningful Comprehensible

8. The one quality GRRs have in common… they all foster repeated life experiences that help one see the world as ‘making sense,’ cognitively, instrumentally and emotionally

9. General examples: Wealth, ego strength, cultural stability, environment, support structure GRRs give rise to or reinforces a strong Sense of Coherence

10. 2009 Health Sciences Communications Association Conference - St. Louis, MO Does the information on your website improve the life of your client base in a way that they can appreciate? Incorporating User Sense of Coherence into the Design of Health Information Websites Does your client base have the knowledge, skills and means to effectively access and use the information offered on the website? What should a health information website contain and how should it look and work so that my client base keeps coming back and using it? Comprehensibility Is the information being offered presented in a way that the client base can readily understand and assimilate? 6

12. Existing level of knowledge related to the content presented

13. Level of comfort navigating websites

14. Willingness to download files

15. Likely security level for Internet browsing

16. Choice of web browsing software

17. Other software already loaded

18. Education level

19. Literacy level

20. Time

21. Availability of technical assistance

22. Others?

23. Once the information is received… do your clients have the resources to use the information?Incorporating General Resistance Resources/Deficits into the Design of Health Information Websites What resources do my clients have, and what deficits do they have, related to using the website and taking action on the information presented?

24. INShape Indiana: Website Usability from an Individual Perspective 2009 Health Sciences Communications Association Conference - St. Louis, MO 8

26. Primarily a web-based health and wellness promotion program that also utilizes motivational/informational emails to participants.

28. Is the website and its information valuable to the user?

29. How manageable is the website?

30. How difficult is it for the user to access and understand the website and information on it?

31. How comprehensible is the website?

32. Does the website and information conform to the users current lifestyle?

34. ASL eye tracking technology to monitor user eye movement around the web pages;

35. Morae Usability software to capture subject voice and facial expression while the website is being used; and,

37. This equipment allows us to determine:

38. Where the user looks on the screen to try and complete a task

39. The gaze path the user has as they try and complete a task, and

41. What participants are doing when they are given a task on the website

42. Which web links are used most often, and

44. Group demographics and characteristics included:

45. All were Ball State University employees currently enrolled in INShape Indiana

46. 3 to 1 Female to Male ratio (which was representative of the INShape Indiana Membership gender makeup)

47. A variety of education levels

48. 3 (Some College Education); 4 (Bachelors Degree); & 9 (Graduate or Terminal Degree)

49. A variety of age levels

50. 3 (18-24); 4 (25-34); 3 (35-44); 0 (45-54); & 6 (55 and older)

51. A variety of computer use and weekly internet access time

52. 2 (2 to 3 times per week); 3 (4 to 5 times per week); & 11 (everyday)

54. Tasks and activities were developed based on the following website sections:

55. The landing page or initial “home” page for the website

56. Signing up and the support information section of the website

57. The tools and resources section of the website

58. The current program support information

60. Join INShape Indiana and subscribe to the email list using the e-mail address subject@assessment.com. Now unsubscribe from the list.

61. Go to, and review a physical activity or tobacco cessation resource of interest to you from this website.

62. Go to, and read, an INShape Success Story that interests you.

64. Can you find a Calorie Counter on this website? Now, find out how many grams of fat are in the Chicken and Broccoli Pasta dish from Ruby Tuesdays (Answer = 80 grams).

65. Can you find the information available on this website describing how to create an exercise program for older adults?

67. In this section, they were asked to:

68. Find and read the Week 6 Ready, Set Walk newsletter.

71. And, the central image does draw viewer attention.

73. And, the central image does draw viewer attention.

75. And, the central image does draw viewer attention.

77. Good to have the FAQ’s quickly accessible here.

78. Information offered is valuable and relevant

79. Remove it from the .gov portion of the site. Too much information and too confusing.

80. Too many links and some are confusing or do not appear related to the site itself.

82. Section headers could all be links, and would be better as “roll over” links as this would reduce screen clutter.

84. Add headlines to your stories to draw reader’s attention

85. INShape Partners is confusing. Consider offering activities and events related to programs being conducted.

86. Good information that is relevant to the user related to tobacco cessation, nutrition and physical activity.

88. Showing of partners is good if they are directly supporting programs (e.g., discounts on activity equipment).

89. Older information is very helpful. Could use more images and how to information.

90. No one could find the calorie counter and it needs to be easy to read and understand. Put the link in the Nutrition section at the top … not in Nutrition under Family Wellness

92. The newsletter and video are easy to access and view.

93. I find the newsletter and videos motivating. Both help and are a real incentive to keep me going toward my goals.

94. Seems geared to beginners. Perhaps they could list different information based on ability level.

95. Watching the video may not be a good use of time.

97. Easy to wander into other sections on the government side of the site.

98. Partner page appears to be more about advertising than useful links for the user.

99. Well organized with good information but too much on the landing page.

100. The calorie counter, newsletter and videos and the website overall is supportive.

103. Comprised of rating items (1 to 5) using statements related to the meaningfulness, manageability and comprehensibility of the website.

104. Administered on-line to users of the INShape Indiana website and completed by almost 400 participants.

106. A theoretical framework can provide developers with an understanding of “how well” users relate to websites, and may even offer a rationale as to “why and how” web design strategies work.

107. Media is a tool that has the potential to “help people function optimally in their current environment;” as such, a salutogenic/sense of coherence framework may provide an important starting point in this process.