A New U.S.A.B.I.L.I.T.Y. Survey on Technology by Older Adults

Background: An aging population and surge in use of technology are two socio-cultural trends occurring simultaneously. Statistics have shown that by 2050, there will be 83M older adults in the US, more than doubled the projected 42M in 2010, Ownership and use of technology are accelerating rapidly as produce and services becomes affordable. Older adults are now the fastest growing internet users worldwide, however only 47% have access to the internet at home.   Cognitive and functional limitations associated with aging could prevent successful interface by older adults with technology.  At the same time, numerous websites are not always user friendly to older adults, thus quality of information being disseminated is an issue.  The confluence between aging and technology could present challenge with their interface.  Issues related to interface could be addressed through usability evaluation/testing.  Usability refers to the fit between the users and technology.  Usability testing/evaluation measures the effectiveness of the product to the users and their satisfaction with the use of the product.  Review of the literature recognized a need for a single standardized usability questionnaires/surveys and paucity of well-validated tools to measure usability in older adults.

Conceptual framework: A U.S.A.B.I.L.I.T.Y. Model^© was developed from integration of theories/concepts from the Roy Adaptation Model, Technology Acceptance Model and Theory of Planned Behavior that would explain the intent to use technology by older adults and/or those with low or limited literacy.  The assumptions of the conceptual model are: 1) when a person turns on a device, he/she interfaces with the system and design, and operates in an environment of learning; 2) the person affects the state of the machine by manipulating the controls,; 3) the person processes the information in front of him/her based on their own unique individual factors; 4) interface between the person and the system is influenced by four determinants: efficiency, learnability, perceived user experience and perceived control and 5) the person’s perceived usability of the website would either lead to their intention to use or not to use the technology.  The four determinants of usability in this conceptual model were: efficiency, learnability, perceived user experience and perceived control.  Perceived control is believed to play a significant role in successful aging.  The lack of instrument that measures all four determinants of usability, mainly perceived control, prompted the researchers to develop a new tool.

Purpose: To present the development of a survey instrument to measure usability of a computer system by older adults.

Methods: An 8-step process of instrument development was adapted from Cronbach and Straub to construct the new usability.  Experts examined face and content validity.  The instrument was pilot tested to determine reliability. 

Findings: A 25-item U.S.A.B.I.L.I.T.Y. Survey^© was developed.  The survey was on a 5-point Likert scale, with answers ranging from 1(strongly disagree) to 5 (strongly agree).  It consisted of 9-item efficiency (4-item ease of use and 4-item usefulness), 4-item learnability, six-item perceived user experience and six-item perceived control (3-item attitudinal and 3-item cognitive).  Scores ranged from 29- 121, with score over 98 indicating good “fit” or interface.  Experts reported content validity acceptable at .97.  The internal consistency of the subscales ranged from .71 to .95. 

Conclusion: Technology offers an invaluable resource to older adults in maintaining their independence and improving quality of life.  Usability is a key towards acceptance of technology by intended users.  Understanding that having a user friendly interface could facilitate a good patient-provider encounter including teaching and learning. The derived conceptual model was developed to explain intent to use technology by older adults. The newly constructed survey instrument adds to the group of psychometric instruments currently available to nurses for the evaluation of the usability of online resources.