Safe Food Management and Smartphone Technology: Investigating the Impact of an App on Consumer Knowledge Retention.

OBJECTIVES: Diffusion of smartphones has normalised consumers' use of mobile applications (apps). But how do app designs and contexts of use interact with differential consumer attributes to impact on their effectiveness, usability and value over time? For consumer food safety, answering these questions is of importance as numerous food choices increase challenges in safe food management (SFM). This research reports on results of a randomised field experiment with Australian consumers using an SFM mobile app developed by the researchers. METHOD: The SFM app development employed insights from the Health Literacy Online Heuristics framework and the experiment involved evaluation of information and/or knowledge acquisition from the app versus from a paper-based version. The experiment spanned four weeks and involved eight participants (experimental group n=4; control group n=4). RESULTS: The results highlight differentials in cognitive burden between paper and the app; beneficial affordances from the app for refreshing consumer knowledge; and longer knowledge retention on safe food management from app use over-time. DISCUSSION: We identified two key impacts of the app on consumer knowledge acquisition and knowledge retention. First, the SFM app takes longer to achieve knowledge acquisition but results in longer knowledge retention than the control. Second, the SFM app induces some level of cognitive load in adoption however; the affordance of its reuse for quick but infrequent revisitations facilitates knowledge retention. Although the study is limited by the small sample size, it however highlights the need for a large scale and purely quantitative investigation that are generalisable to the Australian population. CONCLUSION: It is anticipated that the insights gained from this study can be used to develop nationwide interventions for addressing consumer SFM knowledge gaps in the home; thus, moving a step closer towards addressing SFM behaviours of Australian consumers.

Trialling an electronic decision aid for policy developers to support ageing well.

The complex process of developing policies and planning services requires the compilation and collation of evidence from multiple sources. With the increasing numbers of people living longer there will be a high demand for a wide range of aged care services to support people in ageing well. The premise of ageing well is based on providing an ageing population with quality care and resources that support their ongoing needs. These include affordable healthcare, end of life care improvement, mental health services improvement, care and support improvement for people with dementia, and support for healthy ageing. The National Health and Medical Research Council funded a research project to develop a policy tool to provide a framework to assist policy makers and service planners in the area of ageing well in rural and regional Australia. It was identified that development of an electronic version of the policy tool could be useful resulting in a small pilot development being undertaken and tested with policy makers and service planners. This paper describes the development and trialling of a tablet based application used to assess the acceptability of computerised forms for participants actively involved in policy development. It reports on the policy developer's experience of the electronic tool to support ageing well policy making based on evidence.

Value versus Use for Patients: Findings from an ICT supported Cystic Fibrosis Self-Management Project.

This paper presents findings from the implementation of an online symptom monitoring diary that was part of a broader project aimed to support self-management of cystic fibrosis and the development of an online community of practice (CoP). The findings challenge conventional perspectives on how value is acquired by patients and their families from electronic tools designed to provide them with support. Additionally, the findings highlight complex relationships between user needs and subsequent tool use that challenge approaches to the measurement of value from ehealth projects.

Views of Young People in Rural Australia on SPARX, a Fantasy World Developed for New Zealand Youth With Depression.

BACKGROUND: A randomized control trial demonstrated that a computerized cognitive behavioral therapy (cCBT) program (Smart, Positive, Active, Realistic, X-factor thoughts [SPARX]) was an appealing and efficacious treatment for depression for adolescents in New Zealand. Little is known about the acceptability of computerized therapy programs for rural Australians and the suitability of computerized programs developed in one cultural context when used in another country. Issues such as accents and local differences in health care access might mean adjustments to programs are required. OBJECTIVE: This study sought to explore the acceptability of SPARX by youth in rural Australia and to explore whether and how young people would wish to access such a program. METHODS: Focus groups and semistructured interviews were conducted with 16 young people attending two youth-focused community services in a small, rural Tasmanian town. An inductive data-driven approach was used to identify themes using the interview transcripts as the primary data source. Interpretation was supported by demographic data, observer notes, and content analysis. RESULTS: Participants reported that young people want help for mental health issues but they have an even stronger need for controlling how they access services. In particular, they considered protecting their privacy in their small community to be paramount. Participants thought computerized therapy was a promising way to increase access to treatment for youth in rural and remote areas if offered with or without therapist support and via settings other than school. The design features of SPARX that were perceived to be useful, included the narrative structure of the program, the use of different characters, the personalization of an avatar, "socialization" with the Guide character, optional journaling, and the use of encouraging feedback. Participants did not consider (New Zealand) accents off-putting. Young people believed the SPARX program would appeal to those who play computer games generally, but may be less appealing for those who do not. CONCLUSIONS: The findings suggest that computerized therapy offered in ways that support privacy and choice can improve access to treatment for rural youth. Foreign accents and style may not be off-putting to teenage users when the program uses a playful fantasy genre, as it is consistent with their expectation of fantasy worlds, and it is in a medium with which they already have a level of competence. Rather, issues of engaging design and confidential access appeared to be more important. These findings suggest a proven tool once formally assessed at a local level can be adopted cross-nationally.

Pilot evaluation of web enabled symptom monitoring in cystic fibrosis.

BACKGROUND: People with cystic fibrosis (CF) frequently experience isolation and are subjected to extensive complex treatment regimens which could be complemented by remote support. In the current research this is particularly relevant as the location, Tasmania, has the second highest incidence of CF in the world. This paper provides an overview of the evaluation of a pilot trial of an information system conceptualised and developed to assist people with CF, and their families, to enhance their skills and communication in relation to self-management for their condition. METHODS: The pilot involved people with CF ranging in age from 19 months to 52 years and their families. The primary outcome was the perceived usability of the online-symptom diary from the user's perspective. To assess perceived usability qualitative semi-structured interviews were conducted pre- and post-pilot and analysed using thematic coding. RESULTS: Participants initially and primarily perceived myCF as a system that would help others and enable peer support. Connectivity and involvement were highlighted as complex issues that needed consideration. CONCLUSION: There was an overall encouraging response to the pilot and indications that the use of information communication technology to complement health care delivery and facilitate self-care skills may be particularly suited to the Australian context where geographical distances and isolation provide a relative barrier to specialist care for chronic complex conditions.

Supporting cystic fibrosis with ICT.

ICT use in cystic fibrosis management provides an alternative means of information supply to individuals, families, health care professionals and other stakeholders. The purpose of this paper is to present the evolution of a series of projects culminating in a project that translates the previous research into practice. In this paper the sequential nature of the projects will be detailed. The three projects explored are the Pathways Home for Respiratory Illness Project (Pathways Home), Enhancing Self-Efficacy for Self-Management in People with Cystic Fibrosis and the Tasmanian Community Fund Project (myCF pilot).

Social media and patient self-management: not all sites are created equal.

This paper compares two social media sites that aim to support patients to enhance self-management. The first site, PatientsLikeMe is a well established global site designed to allow peer-to-peer communication between people with similar conditions. The second, HealthShare, is a recently developed site for Australians described as "Australia's Social Health Network". The comparison conducted examines the purpose, ownership, and design of both sites as well as how the data they collect is used. Analysis highlights that PatientsLikeMe actively facilitates patient self-management, while HealthShare is revealed to be a professionally moderated health information portal presented as a social networking site. While the impetus for the development of PatientsLikeMe is clear, the motives underpinning HealthShare are less obvious. With increasing patient interest in connecting with, and sharing information with one another, awareness of the nature and motivations underpinning sites that provide these services is of increasing relevance.

The role of user-centred design within online community development.

Research has evidenced the benefits of using information and communications technology (ICT) in chronic disease management including improving information availability, communication methods and raising individual patient's self-awareness of their own conditions. Extending ICT use to support patients in the community through online services draws attention to the complex task of how to meaningfully acquire input from all potential users of such systems and to balance their competing interests. This paper explores these issues across system analysis, specification and design for a community based patient support system. The paper highlights user-centred design challenges in a situation where the patient-users were not able to be included during the planning stage and explores how this impacted on the subsequent development.