Transcript NIH Senior Health. gov: A Research

“Using Cognitive Aging and
Vision Research to Develop
Senior-friendly Online
Resources”
***************
Stephanie Dailey
Educational Research Specialist
National Institute on Aging
NIH Senior Health. gov:
A Research-based Design
Overview

This presentation describes the
research on which the design of the
NIH Senior Health web site is based.

Also shown are the web site’s seniorfriendly features and the ways in
which they address the cognitive and
visual changes that typically occur
with aging.
What is NIHSeniorHealth?

A web site that presents aging-related health
information in a senior-friendly format.

A joint project of the National Institute on
Aging (NIA) and the National Library of
Medicine (NLM), both part of the National
Institutes of Health (NIH).

Based on NIA’s cognitive aging research.
The web site has also been tested with
groups of older adults to ensure that they
can easily use it.
NIHSeniorHealth represents an
NIH partnership involving:
 The National Institute on Aging (NIA)

Providing research on cognitive aging and
subject expertise on aging-related diseases
and conditions.
 The National Library of Medicine (NLM)

Providing expertise in effective information
delivery and “best fit” technology.
 Other NIH Institutes

Providing subject expertise on aging-related
diseases and conditions.
What makes a web site
senior friendly?

A senior-friendly web site is one
where people 60 and older can easily
see, comprehend, remember, and
navigate the information.
Why do older people need a
senior-friendly web site?

Research funded by the National
Institute on Aging has shown that
visual and cognitive changes among
older adults can affect how well they
perform in an online environment. 1
1 Craik and Salthouse, 2000; Morrell, 1997
How does NIHSeniorHealth
address these needs?

It includes senior-friendly features
that are designed to address the
types of cognitive and visual changes
in older adults that can prevent them
from having a positive online
experience.
What are the cognitive changes
that the web site addresses?

The cognitive changes addressed by
the web site design include changes
in:
 working
memory
 perceptual speed
 text comprehension
What is working memory?

Working memory is the ability to
simultaneously store and process
information. Research shows that working
memory declines with aging.2 On the web
site, repetition is one of the techniques
used to address working memory.
2 Craik and Salthouse, 2000
Using repetition helps working
memory:
Text conveys
initial
information.
Using repetition helps working memory:
Video
reinforces
Text.
Using repetition helps working memory:
Open-captioning on
videos reinforces
audio information.
Using repetition helps working memory:
Quizzes
reinforce
points made
in text.
Using repetition helps working memory:
Quiz answer
repeats
original
wording from
text.
Using repetition helps working memory:
Content is
repeated in
question-answer
format (FAQ).
Re-reading of content also aids
working memory:
Forward-backward
navigation facilitates
re-reading.
What is spatial working memory?

Spatial working memory is the ability to
visualize and recall where objects are
located. Research shows that a person’s
spatial working memory declines with
aging.3 Locating the navigational controls
in the same place on each page is one way
the web site accommodates declines in
spatial working memory.
3 Craik and Salthouse, 2000
How the web site addresses
changes in spatial working memory:
Consistent
placement of
chapter and
subchapter
buttons.
Consistent
location of
main menu
button.
Consistent
location of
“next page”
and “previous
page” buttons.
What is perceptual speed?

Perceptual speed is the speed at
which a person processes
information. Research shows that a
person’s perceptual speed slows
down with aging.4 On the web site,
there is no scrolling text, and
navigation is always under the control
of the user.
4 Salthouse, 1993.
How the web site addresses
changes in perceptual speed:
Forward-backward
navigation allows
user to
self pace.
What is text comprehension?

Text Comprehension is the ability to
understand written text. Research shows that
a person’s ability to understand certain
aspects of written text -- such as inferences -declines with aging.5
Plain language, “chunking” of information, and
the use of text-relevant images are some ways
the web sites addresses changes in text
comprehension.
5 Park, 1992
How the web site addresses
changes in text comprehension:
Content
written in
plain
language.
Minimal use
of passive
voice.
No
inferences.
Ample white space
directs the focus to
the content.
How the web site addresses
changes in text comprehension:
Content
presented
in short,
“chunked”
segments.
Text-relevant
photos aid
comprehension.
What vision changes are addressed
by the web site design?

Vision changes that occur with aging include
reductions in the amount of light that reaches the
retina, loss of contrast sensitivity and loss of the
ability to detect fine details.6 The web site
accommodates these visual changes in older adults
by using:
 A “talking web” that reads the text aloud
 Large, sans serif type
 Buttons that enlarge text and show high
contrast
 Dark type against a light background and lots
of white space
 Large icons
6 Echt, 2002
How the web site addresses vision
changes:
Dark type
against a light
background
provides high
color contrast.
Talking Web.
Higher contrast.
Larger type.
Large, sans
serif type.
Testing

The NIH Senior Health web site has
been tested a number of times with
groups of older people. The ages of
the people tested ranged from 60 to
88.7

Both usability testing and online and
in-person focus group testing were
used.
7 Morrell, Dailey, and Rousseau, 2003
Testing

The site was tested to determine how
easy it was for older adults to
navigate, understand, and read the
information presented.

The site was also tested for its visual
appeal.
Testing

Throughout the many rounds of
testing, the writing style and the page
layout were consistently rated highly
by older users.

Test results pointed to navigation as
the area most in need of adjustment.
Testing
The following screen captures show
findings and recommendations from
early usability testing.
Positive aspects of the design as determined by
usability testing on an early version of the site.
The information is
divided into short
concise blocks which
doesn’t overwhelm the
reader.
Top Menus
Side Menus
Main Text
Bottom Menus
Positive aspects of the design as determined by
usability testing on an early version of the site.
The text is large enough for the
older adults to read.
These recommendations from usability testing on an
early version of the web site were incorporated into the
design.
1
2
3
4
 The site requires the user take too many steps to access the lower levels of information.
 Consider placing the important information higher up in the structure. Consider getting rid of
the “Welcome to AgePage” page. Replace the information with the information listed on the
“Topics” page.
These recommendations from usability testing on an
early version of the web site were incorporated into the
design.
The structure of the site is too deep.
In order to get to a list of topics pertaining to the overview of what Alzheimer’s disease is, the site requires 4
clicks from the user. At this point, the user sees another list of topics.
Recommendation: Consider reducing the number of steps required of the user to access important
information. For example, the middle page between the Home Page and the list of topics is an unnecessary
step.
There are too many preliminary steps. Put meaningful choices of content higher in the tree structure.
 Most
Popular Topics:
1.
2.
3.
4.
5.
Exercise for Older Adults
Alzheimer’s Disease
Balance Problems
Prostate Cancer
Lung Cancer
Web Site Traffic
Oct 1 – June 30

Page Views =

Unique visitors = 266,260
2,375,110
References
Craik, F.I.M., and Salthouse, T.A. The Handbook of
Aging and Cognition. Mahwah, NJ: Lawrence
Erlbaum Associates, 2000.
Echt, K.V. Designing web-based health information for
older adults: Visual considerations and design
directives. In R.W. Morrell, ed. Older Adults, Health
Information and the World Wide Web, 61-88.
Mahwah, NJ: Lawrence Erlbaum Associates, 2002.
Morrell, R.W. The application of cognitive theory in
aging research.
Cognitive Technology, 2 (1997): 44-47.
References (contd.)
Morrell, R. W., Dailey, S. R., & Rousseau, G. K. (2003).
Commentary: Applying Research: the NIH Senior Health
Project. In N. Charness & K. W. Schaie, (eds), Impact of
Technology on Successful Aging (pp. 134 - 161). New
York: Springer Publishing.
Park, D.C. (1992). Applied cognitive aging research. In F.I.M.
Craik & T.A. Salthouse, (Eds.). Handbook of Cognition and
Aging. (pp. 449-493). Mahwah, NJ: Lawrence Erlbaum
Associates.
Salthouse, T.A. (1993) Speed Mediation of Adult Age
Differences in Cognition. Developmental Psychology, 29,
722-738.
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at
www.nihseniorhealth.gov