88 Usability of the Revised Color Me Healthy App in Children with Cancer

Faculty Mentor: Lauri Linder (Nursing, University of Utah)

Purpose: The purpose of this project was to evaluate the usability of the revised Color Me Healthy app from the perspectives of children with cancer and their parents.

Background: The gold standard for symptom reporting in healthcare is self-reporting. Verbal self-reporting is often difficult for children. Children may more accurately and confidently report their symptoms using an mHealth device. The Color Me Healthy app has been developed to facilitate self-reporting in children with cancer. The initial feasibility and acceptability of the app has been demonstrated; however, children and parents also noted opportunities to improve the user interface to enhance its ease of use and perceived usefulness prior to future implementation.

Methods: This User Centered Design study was guided by the Technology Acceptance Model which indicates that Ease of Use and Perceived Usefulness influence the adoption of a given technology. Children (6-12 years of age) receiving cancer treatment and their parents were invited to participate in usability evaluations in which they were guided through the app and asked to complete specific tasks within the app. Completion of tasks were documented on a usability log and scored as “completed independently,” “required a verbal prompt,” or “required a physical prompt.” Children and parents participated in brief interviews in which they were asked what they liked best about the app, what they liked the least, and suggestions for improvement. Parents also completed the Technology Acceptance Model Perceived Usefulness Scale (TAM PUS). Possible TAM PUS scores range from 4 to 24 with lower scores representing greater perceived usefulness. As 5 child-parent dyads completed usability evaluations, data were summarized and shared with the developer team to guide additional refinements.

Assessment: Fourteen racially, ethnically, and geographically diverse parent-child dyads participated. Children were a median of 8.5 years; 9 were boys; and 13 had leukemia. Parents were a median of 38.5 years of age, and 11 were mothers. After 3 cycles of usability evaluations, children and parents were able to complete key tasks independently, supporting its ease of use. Eleven children and 12 parents also indicated their preference for using the app as a method of symptom reporting, supporting its perceived usefulness. Median TAM PUS scores were 7 across all 3 cycles and provided evidence that parents deemed the app useful to understand and respond to their child’s symptoms.

Conclusion: mHealth devices, including the Color Me Healthy app provide promising methods of symptom self-reporting in children with cancer. Because nurses should encourage self-reporting tools whenever possible, mHealth tools may provide an approach to self-reporting that is perceived as safer and more familiar. The revised version of the Color Me Healthy app demonstrates ease of use and perceived usefulness. Future directions include evaluation of the clinical utility of the revised app to support initiation of symptom management interventions.