Effects of Information Visualization on Older Adults' Decision-Making Performance in a Medicare Plan Selection Task: A Comparative Usability Study.

BACKGROUND: Technology gains have improved tools for evaluating complex tasks by providing environmental supports (ES) that increase ease of use and improve performance outcomes through the use of information visualizations (info-vis). Complex info-vis emphasize the need to understand individual differences in abilities of target users, the key cognitive abilities needed to execute a decision task, and the graphical elements that can serve as the most effective ES. Older adults may be one such target user group that would benefit from increased ES to mitigate specific declines in cognitive abilities. For example, choosing a prescription drug plan is a necessary and complex task that can impact quality of life if the wrong choice is made. The decision to enroll in one plan over another can involve comparing over 15 plans across many categories. Within this context, the large amount of complex information and reduced working memory capacity puts older adults' decision making at a disadvantage. An intentionally designed ES, such as an info-vis that reduces working memory demand, may assist older adults in making the most effective decision among many options. OBJECTIVE: The objective of this study is to examine whether the use of an info-vis can lower working memory demands and positively affect complex decision-making performance of older adults in the context of choosing a Medicare prescription drug plan. METHODS: Participants performed a computerized decision-making task in the context of finding the best health care plan. Data included quantitative decision-making performance indicators and surveys examining previous history with purchasing insurance. Participants used a colored info-vis ES or a table (no ES) to perform the decision task. Task difficulty was manipulated by increasing the number of selection criteria used to make an accurate decision. A repeated measures analysis was performed to examine differences between the two table designs. RESULTS: Twenty-three older adults between the ages of 66 and 80 completed the study. There was a main effect for accuracy such that older adults made more accurate decisions in the color info-vis condition than the table condition. In the low difficulty condition, participants were more successful at choosing the correct answer when the question was about the gap coverage attribute in the info-vis condition. Participants also made significantly faster decisions in the info-vis condition than in the table condition. CONCLUSIONS: Reducing the working memory demand of the task through the use of an ES can improve decision accuracy, especially when selection criteria is only focused on a single attribute of the insurance plan.

Decision support aids with anthropomorphic characteristics influence trust and performance in younger and older adults.

This study examined the use of deliberately anthropomorphic automation on younger and older adults' trust, dependence and performance on a diabetes decision-making task. Research with anthropomorphic interface agents has shown mixed effects in judgments of preferences but has rarely examined effects on performance. Meanwhile, research in automation has shown some forms of anthropomorphism (e.g. etiquette) have effects on trust and dependence on automation. Participants answered diabetes questions with no-aid, a non-anthropomorphic aid or an anthropomorphised aid. Trust and dependence in the aid was measured. A minimally anthropomorphic aide primarily affected younger adults' trust in the aid. Dependence, however, for both age groups was influenced by the anthropomorphic aid. Automation that deliberately embodies person-like characteristics can influence trust and dependence on reasonably reliable automation. However, further research is necessary to better understand the specific aspects of the aid that affect different age groups. Automation that embodies human-like characteristics may be useful in situations where there is under-utilisation of reasonably reliable aids by enhancing trust and dependence in that aid. Practitioner Summary: The design of decision-support aids on consumer devices (e.g. smartphones) may influence the level of trust that users place in that system and their amount of use. This study is the first step in articulating how the design of aids may influence user's trust and use of such systems.

Age-sensitive design of online health information: comparative usability study.

BACKGROUND: Older adults' health maintenance may be enhanced by having access to online health information. However, usability issues may prevent older adults from easily accessing such information. Prior research has shown that aging is associated with a unique pattern of cognitive changes, and knowledge of these changes may be used in the design of health websites for older adults. OBJECTIVE: The goal of the current study was to examine whether older adults use of a health information website was affected by an alternative information architecture and access interface (hierarchical versus tag-based). METHODS: Fifty younger adults (aged 18-23) and 50 older adults (aged 60-80) navigated a health information website, which was organized hierarchically or used tags/keywords, to find answers to health-related questions while their performance was tracked. We hypothesized that older adults would perform better in the tag-based health information website because it placed greater demands on abilities that remain intact with aging (verbal ability and vocabulary). RESULTS: The pattern of age-related differences in computer use was consistent with prior research with older adults. We found that older adults had been using computers for less time (F(1,98)= 10.6, P= .002) and used them less often (F(1,98)= 11.3, P= .001) than younger adults. Also consistent with the cognitive aging literature, younger adults had greater spatial visualization and orientation abilities (F(1,98)= 34.6, P< .001 and F(1,98)= 6.8, P= .01) and a larger memory span (F(1,98)= 5.7, P= .02) than older adults, but older adults had greater vocabulary (F(1,98)= 11.4, P= .001). Older adults also took significantly more medications than younger adults (F(1,98)= 57.7, P< .001). In the information search task, older adults performed worse than younger adults (F(1,96)= 18.0, P< .001). However, there was a significant age x condition interaction indicating that while younger adults outperformed older adults in the hierarchical condition (F(1,96)= 25.2, P< .001), there were no significant age-related differences in the tag-based condition, indicating that older adults performed as well as younger adults in this condition. CONCLUSIONS: Access to online health information is increasing in popularity and can lead to a more informed health consumer. However, usability barriers may differentially affect older adults. The results of the current study suggest that the design of health information websites that take into account age-related changes in cognition can enhance older adults' access to such information.

Designing an information search interface for younger and older adults.

OBJECTIVE: The present study examined Web-based information retrieval as a function of age for two information organization schemes: hierarchical organization and one organized around tags or keywords. BACKGROUND: Older adults' performance in information retrieval tasks has traditionally been lower compared with younger adults'. The current study examined the degree to which information organization moderated age-related performance differences on an information retrieval task. The theory of fluid and crystallized intelligence may provide insight into different kinds of information architectures that may reduce age-related differences in computer-based information retrieval performance. METHOD: Fifty younger (18-23 years of age) and 50 older (55-76 years of age) participants browsed a Web site for answers to specific questions. Half of the participants browsed the hierarchically organized system (taxonomy), which maintained a one-to-one relationship between menu link and page, whereas the other half browsed the tag-based interface, with a many-to-one relationship between menu and page. This difference was expected to interact with age-related differences in fluid and crystallized intelligence. RESULTS: Age-related differences in information retrieval performance persisted; however, a tag-based retrieval interface reduced age-related differences, as compared with a taxonomical interface. CONCLUSION: Cognitive aging theory can lead to interface interventions that reduce age-related differences in performance with technology. In an information retrieval paradigm, older adults may be able to leverage their increased crystallized intelligence to offset fluid intelligence declines in a computer-based information search task. APPLICATION: More research is necessary, but the results suggest that information retrieval interfaces organized around keywords may reduce age-related differences in performance.