Enabling older adults to carry out paperless falls-risk self-assessments using guidetomeasure-3D: A mixed methods study

• Published in: Journal of biomedical informatics 2019-04, Vol.92, p.103135-103135, Article 103135
• Main Authors: Hamm, Julian, Money, Arthur G., Atwal, Anita
• Format: Article
• Language: English
• Subjects: 3D mobile visualisation; Assistive equipment; Extrinsic risk factors; Falls; Health informatics; Measurement guidance; Occupational therapy; Self-assessment; Technology-based systems
• ISSN: 1532-0464; 1532-0480
• DOI: 10.1016/j.jbi.2019.103135

[Display omitted] •Guidetomeasure-3D, a Web-enabled mobile measurement guidance app for older-adult patients.•The app outperformed paper-based equivalent guidance in terms of accuracy, accuracy consistency, task efficiency, and usability.•Users reported improved visual quality, clarity, and more precise guidance overall.•Future research will explore depth sensing technologies to automate measurement. The home environment falls-risk assessment process (HEFAP) is a widely used falls prevention intervention strategy which involves a clinician using paper-based measurement guidance to ensure that appropriate information and measurements are taken and recorded accurately. Despite the current use of paper-based guidance, over 30% of all assistive devices installed within the home are abandoned by patients. This is in part due to poor fit between the device, the patient, and the environment in which it is installed. Currently HEFAP is a clinician-led process, however, older adult patients are increasingly being expected to collect HEFAP measurements themselves as part of the personalisation agenda. Without appropriate patient-centred guidance, levels of device abandonment to are likely to rise to unprecedented levels. This study presents guidetomeasure-3D, a mobile 3D measurement guidance application designed to support patients in carrying out HEFAP self-assessments. The aim of this study is to present guidetomeasure-3D, a web-enabled 3D mobile application that enables older-adult patients to carry out self-assessment measurement tasks, and to carry out a mixed-methods evaluation of its performance, and associated user perceptions of the application, compared with a 2D paper-based equivalent. Thirty-four older adult participants took part in a mixed-methods within-subjects repeated measures study set within a living lab. A series of HEFAP self-assessment tasks were carried out according to two treatment conditions: (1) using the 3D guidetomeasure-3D application; (2) using a 2D paper-based guide. SUS questionnaires and semi-structured interviews were completed at the end of the task. A comparative statistical analysis explored performance with regards to measurement accuracy, accuracy consistency, task efficiency, and system usability. Interview transcripts were analysed using inductive and deductive thematic analysis (informed by UTAUT). The guidetomeasure-3D application outperformed the 2D paper-based guidance in terms of accuracy (smaller mean error difference