Remote Cognitive Screening Of Healthy Older Adults for Primary Care With the MyCog Mobile App: Iterative Design and Usability Evaluation
BackgroundAnnual cognitive screening in adults aged >65 years can improve early detection of cognitive impairment, yet less than half of all cases are identified in primary care. Time constraints in primary care settings present a major barrier to routine screening. A remo...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
JMIR Publications
2023-01-01
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| Series: | JMIR Formative Research |
| Online Access: | https://formative.jmir.org/2023/1/e42416 |
| _version_ | 1797734537887744000 |
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| author | Stephanie Ruth Young Emily Gardiner Lattie Andrew B L Berry Lynn Bui Greg Joseph Byrne Julia Noelani Yoshino Benavente Michael Bass Richard C Gershon Michael S Wolf Cindy J Nowinski |
| author_facet | Stephanie Ruth Young Emily Gardiner Lattie Andrew B L Berry Lynn Bui Greg Joseph Byrne Julia Noelani Yoshino Benavente Michael Bass Richard C Gershon Michael S Wolf Cindy J Nowinski |
| author_sort | Stephanie Ruth Young |
| collection | DOAJ |
| description |
BackgroundAnnual cognitive screening in adults aged >65 years can improve early detection of cognitive impairment, yet less than half of all cases are identified in primary care. Time constraints in primary care settings present a major barrier to routine screening. A remote cognitive screener completed on a patient’s own smartphone before a visit has the potential to save primary care clinics time, encourage broader screening practices, and increase early detection of cognitive decline.
ObjectiveWe described the iterative design and proposed the implementation of a remote cognitive screening app, MyCog Mobile, to be completed on a patient’s smartphone before an annual wellness visit. The research questions were as follows: What would motivate primary care clinicians and clinic administrators to implement a remote cognitive screening process? How might we design a remote cognitive screener to fit well with existing primary care workflows? What would motivate an older adult patient to complete a cognitive screener on a smartphone before a primary care visit? How might we optimize the user experience of completing a remote cognitive screener on a smartphone for older adults?
MethodsTo address research questions 1 and 2, we conducted individual interviews with clinicians (n=5) and clinic administrators (n=3). We also collaborated with clinic administrators to create user journey maps of their existing and proposed MyCog Mobile workflows. To address research questions 3 and 4, we conducted individual semistructured interviews with cognitively healthy older adults (n=5) and solicited feedback from a community stakeholder panel (n=11). We also tested and refined high-fidelity prototypes of the MyCog Mobile app with the older adult interview participants, who rated the usability on the Simplified System Usability Scale and After-Scenario Questionnaire.
ResultsClinicians and clinic administrators were motivated to adopt a remote cognitive screening process if it saved time in their workflows. Findings from interviews and user journey mapping informed the proposed implementation and core functionality of MyCog Mobile. Older adult participants were motivated to complete cognitive screeners to ensure that they were cognitively healthy and saw additional benefits to remote screening, such as saving time during their visit and privacy. Older adults also identified potential challenges to remote smartphone screening, which informed the user experience design of the MyCog Mobile app. The average rating across prototype versions was 91 (SD 5.18) on the Simplified System Usability Scale and 6.13 (SD 8.40) on the After-Scenario Questionnaire, indicating above-average usability.
ConclusionsThrough an iterative, human-centered design process, we developed a viable remote cognitive screening app and proposed an implementation strategy for primary care settings that was optimized for multiple stakeholders. The next steps include validating the cognitive screener in clinical and healthy populations and piloting the finalized app in a community primary care clinic. |
| first_indexed | 2024-03-12T12:45:47Z |
| format | Article |
| id | doaj.art-c61192305e0f48229a2a2d7a9b79ccd9 |
| institution | Directory Open Access Journal |
| issn | 2561-326X |
| language | English |
| last_indexed | 2024-03-12T12:45:47Z |
| publishDate | 2023-01-01 |
| publisher | JMIR Publications |
| record_format | Article |
| series | JMIR Formative Research |
| spelling | doaj.art-c61192305e0f48229a2a2d7a9b79ccd92023-08-28T23:24:37ZengJMIR PublicationsJMIR Formative Research2561-326X2023-01-017e4241610.2196/42416Remote Cognitive Screening Of Healthy Older Adults for Primary Care With the MyCog Mobile App: Iterative Design and Usability EvaluationStephanie Ruth Younghttps://orcid.org/0000-0002-8205-9297Emily Gardiner Lattiehttps://orcid.org/0000-0002-3069-5996Andrew B L Berryhttps://orcid.org/0000-0002-3167-4716Lynn Buihttps://orcid.org/0000-0001-9041-9865Greg Joseph Byrnehttps://orcid.org/0000-0003-2583-6501Julia Noelani Yoshino Benaventehttps://orcid.org/0000-0003-0549-1809Michael Basshttps://orcid.org/0000-0002-7732-6557Richard C Gershonhttps://orcid.org/0000-0003-0085-0112Michael S Wolfhttps://orcid.org/0000-0002-4342-6517Cindy J Nowinskihttps://orcid.org/0000-0001-5608-909X BackgroundAnnual cognitive screening in adults aged >65 years can improve early detection of cognitive impairment, yet less than half of all cases are identified in primary care. Time constraints in primary care settings present a major barrier to routine screening. A remote cognitive screener completed on a patient’s own smartphone before a visit has the potential to save primary care clinics time, encourage broader screening practices, and increase early detection of cognitive decline. ObjectiveWe described the iterative design and proposed the implementation of a remote cognitive screening app, MyCog Mobile, to be completed on a patient’s smartphone before an annual wellness visit. The research questions were as follows: What would motivate primary care clinicians and clinic administrators to implement a remote cognitive screening process? How might we design a remote cognitive screener to fit well with existing primary care workflows? What would motivate an older adult patient to complete a cognitive screener on a smartphone before a primary care visit? How might we optimize the user experience of completing a remote cognitive screener on a smartphone for older adults? MethodsTo address research questions 1 and 2, we conducted individual interviews with clinicians (n=5) and clinic administrators (n=3). We also collaborated with clinic administrators to create user journey maps of their existing and proposed MyCog Mobile workflows. To address research questions 3 and 4, we conducted individual semistructured interviews with cognitively healthy older adults (n=5) and solicited feedback from a community stakeholder panel (n=11). We also tested and refined high-fidelity prototypes of the MyCog Mobile app with the older adult interview participants, who rated the usability on the Simplified System Usability Scale and After-Scenario Questionnaire. ResultsClinicians and clinic administrators were motivated to adopt a remote cognitive screening process if it saved time in their workflows. Findings from interviews and user journey mapping informed the proposed implementation and core functionality of MyCog Mobile. Older adult participants were motivated to complete cognitive screeners to ensure that they were cognitively healthy and saw additional benefits to remote screening, such as saving time during their visit and privacy. Older adults also identified potential challenges to remote smartphone screening, which informed the user experience design of the MyCog Mobile app. The average rating across prototype versions was 91 (SD 5.18) on the Simplified System Usability Scale and 6.13 (SD 8.40) on the After-Scenario Questionnaire, indicating above-average usability. ConclusionsThrough an iterative, human-centered design process, we developed a viable remote cognitive screening app and proposed an implementation strategy for primary care settings that was optimized for multiple stakeholders. The next steps include validating the cognitive screener in clinical and healthy populations and piloting the finalized app in a community primary care clinic.https://formative.jmir.org/2023/1/e42416 |
| spellingShingle | Stephanie Ruth Young Emily Gardiner Lattie Andrew B L Berry Lynn Bui Greg Joseph Byrne Julia Noelani Yoshino Benavente Michael Bass Richard C Gershon Michael S Wolf Cindy J Nowinski Remote Cognitive Screening Of Healthy Older Adults for Primary Care With the MyCog Mobile App: Iterative Design and Usability Evaluation JMIR Formative Research |
| title | Remote Cognitive Screening Of Healthy Older Adults for Primary Care With the MyCog Mobile App: Iterative Design and Usability Evaluation |
| title_full | Remote Cognitive Screening Of Healthy Older Adults for Primary Care With the MyCog Mobile App: Iterative Design and Usability Evaluation |
| title_fullStr | Remote Cognitive Screening Of Healthy Older Adults for Primary Care With the MyCog Mobile App: Iterative Design and Usability Evaluation |
| title_full_unstemmed | Remote Cognitive Screening Of Healthy Older Adults for Primary Care With the MyCog Mobile App: Iterative Design and Usability Evaluation |
| title_short | Remote Cognitive Screening Of Healthy Older Adults for Primary Care With the MyCog Mobile App: Iterative Design and Usability Evaluation |
| title_sort | remote cognitive screening of healthy older adults for primary care with the mycog mobile app iterative design and usability evaluation |
| url | https://formative.jmir.org/2023/1/e42416 |
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