Usability of an Adaptive Computer Assistant that Improves Self-care and Health Literacy of Older Adults

Objectives: We developed an adaptive computer assistant for the supervision of diabetics’ self-care, to support limiting illness and need for acute treatment, and improve health literacy. This assistant monitors self-care activities logged in the patient’s electronic diary. Accordingly, it provides context-aware feedback. The objective was to evaluate whether older adults in general can make use of the computer assistant and to compare an adaptive computer assistant with a fixed one, concerning its usability and contribution to health literacy. Methods: We conducted a laboratory experiment in the Georgia Tech Aware Home wherein 28 older adults participated in a usability evaluation of the computer assistant, while engaged in scenarios reflecting normal and health-critical situations. We evaluated the assistant on effectiveness, efficiency, satisfaction, and educational value. Finally, we studied the moderating effects of the subjects’ personal characteristics. Results: Logging self-care tasks and receiving feedback from the computer assistant enhanced the subjects’ knowledge of diabetes. The adaptive assistant was more effective in dealing with normal and healthcritical situations, and, generally, it led to more time efficiency. Subjects’ personal characteristics had substantial effects on the effectiveness and efficiency of the two computer assistants. Conclusions: Older adults were able to use the adaptive computer assistant. In addition, it had a positive effect on the development of health literacy. The assistant has the potential to support older diabetics’ self care while maintaining quality of life.