Effects of Aging and Domain Knowledge on Usability in Small Screen Devices for Diabetes Patients

  • André Calero Valdez
  • Martina Ziefle
  • Andreas Horstmann
  • Daniel Herding
  • Ulrik Schroeder
Part of the Lecture Notes in Computer Science book series (LNCS, volume 5889)


Technology acceptance has become a key concept for the successful rollout of technical devices. Though the concept is intensively studied for nearly 20 years now, still, many open questions remain. This especially applies to technology acceptance of older users, which are known to be very sensitive to suboptimal interfaces and show considerable reservations towards the usage of new technology. Mobile small screen technology increasingly penetrates health care and medical applications. This study investigates impacts of aging, technology expertise and domain knowledge on user interaction using the example of diabetes. For this purpose user effectiveness and efficiency have been measured on a simulated small screen device and related to user characteristics, showing that age and technology expertise have a big impact on usability of the device. Furthermore, impacts of user characteristics and success during the trial on acceptance of the device were surveyed and analyzed.


Usability Aging Health care Performance Small screen device Perceived Ease of Use Perceived Usefulness Technical experience Domain knowledge 


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  1. 1.
    Federal Statistical Office Germany: Germany’s population until 2050 – 11th coordinated population projection, Wiesbaden (2006),
  2. 2.
    Siebert, H.: Economic Policy for Aging Societies. Springer, Berlin (2002)Google Scholar
  3. 3.
    Arning, K., Ziefle, M.: Understanding age differences in PDA acceptance and performance. Computers in Human Behaviour 23, 2904–2927 (2007)CrossRefGoogle Scholar
  4. 4.
    Arning, K., Ziefle, M.: Barriers of information access in Small-Screen-Device applications: The relevance of user characteristics for a transgenerational design. In: Stephanidis, C., Pieper, M. (eds.) ERCIM Ws UI4ALL 2006. LNCS, vol. 4397, pp. 117–136. Springer, Heidelberg (2007)CrossRefGoogle Scholar
  5. 5.
    Leonhardt, S.: Personal Healthcare Devices. In: Mukherjee, S., et al. (eds.) AmIware: Hardware Technology Drivers of Ambient Intelligence, ch. 6.1, pp. 349–370. Springer, Dordrecht (2006)CrossRefGoogle Scholar
  6. 6.
    Ziefle, M., Bay, S.: How older adults meet complexity: aging effects on the usability of different mobile phones. Behaviour & Information Technology 24(5), 375–389 (2005)CrossRefGoogle Scholar
  7. 7.
    Ziefle, M., Bay, S.: How To Overcome Disorientation in Mobile Phone Menus: A Comparison of Two Different Types of Navigation Aids. Human-Computer Interaction 21, 393–433 (2006)CrossRefGoogle Scholar
  8. 8.
    Ziefle, M., Bay, S.: Transgenerational Designs in Mobile Technology. Handbook of Research on User Interface Design and Evaluation for Mobile Technology 1, 122–141 (2008)Google Scholar
  9. 9.
    Holzinger, A., Schaupp, K., Eder-Halbedl, W.: An Investigation on Acceptance of Ubiquitous Devices for the Elderly in a Geriatric Hospital Environment: Using the Example of Person Tracking. In: Miesenberger, K., Klaus, J., Zagler, W.L., Karshmer, A.I. (eds.) ICCHP 2008. LNCS, vol. 5105, pp. 22–29. Springer, Heidelberg (2008)CrossRefGoogle Scholar
  10. 10.
    German Diabetes Union: Report on Public Health - Diabetes (2007),
  11. 11.
    Tililil, et al.: Guideline of the German Diabetes Association for treatment of Diabetes melliutus type 2, 177 (1998)Google Scholar
  12. 12.
    Yeung, S.E., Fisher, A.L., Dixon, R.A.: Exploring effects of type 2 diabetes on cognitive functioning in older adults. Neuropsychology 23(1), 1–9 (2009)CrossRefGoogle Scholar
  13. 13.
    Dixon, et al.: Adjustable Gastric Banding and Conventional Therapy for Type 2 Diabetes. The Journal of the American Medical Association 299(3), 316–323 (2008)CrossRefGoogle Scholar
  14. 14.
    Holzinger, A.: Usability Engineering for Software Developers. Communications of the ACM 48(1), 71–74 (2005)CrossRefGoogle Scholar
  15. 15.
    Holzinger, A., Searle, G., Kleinberger, T., Seffah, A., Javahery, H.: Investigating Usability Metrics for the Design and Development of Applications for the Elderly. In: Miesenberger, K., Klaus, J., Zagler, W.L., Karshmer, A.I. (eds.) ICCHP 2008. LNCS, vol. 5105, pp. 98–105. Springer, Heidelberg (2008)CrossRefGoogle Scholar
  16. 16.
    Nischelwitzer, A., Pintoffl, K., Loss, C., Holzinger, A.: Design and Development of a Mobile Medical Application for the Management of Chronic Diseases: Methods of improved Data Input for Older People. In: Holzinger, A. (ed.) USAB 2007. LNCS, vol. 4799, pp. 119–132. Springer, Heidelberg (2007)CrossRefGoogle Scholar
  17. 17.
    Holzinger, A., Searle, G., Nischelwitzer, A.: On some Aspects of Improving Mobile Applications for the Elderly. In: Stephanidis, C. (ed.) HCI 2007. LNCS, vol. 4554, pp. 923–932. Springer, Heidelberg (2007)CrossRefGoogle Scholar
  18. 18.
    Lin, D.M.: Age differences in the performance of hypertext perusal. In: Proceedings of the Human Factors and Ergonomics Society 45th Annual Meeting, pp. 211–215. Human Factors Society, Santa Monica (2001)Google Scholar
  19. 19.
    Ziefle, M., Bay, S.: Mental Models of a Cellular Phone Menu. Comparing Older and Younger Novice. In: Brewster, S., Dunlop, M.D. (eds.) Mobile HCI 2004. LNCS, vol. 3160, pp. 25–37. Springer, Heidelberg (2004)Google Scholar
  20. 20.
    Ziefle, M.: Aging and Mobile Displays: Challenges and requirements for age-sensitive electronic information designs. In: Proceedings of the 9th International Conference on Work With Computer Systems, WWCS 2009, Beijing, China (2009)Google Scholar
  21. 21.
    Arning, K., Ziefle, M.: Assessing computer experience in older adults: Development and validation of a computer expertise questionnaire for older adults. Behaviour and Information Technology 27(1), 89–93 (2008)CrossRefGoogle Scholar
  22. 22.
    Parush, A., Yuviler-Gavish, T.: Web navigation structures in cellular phones. The depth-breadth trade-off issue. International Journal of Human-Computer Studies 60, 753–770 (2004)CrossRefGoogle Scholar
  23. 23.
    Westermann, S.J.: Individual differences in the use of command line and menu computer interfaces. International Journal of Human Computer Interaction 9, 183–198 (1995)CrossRefGoogle Scholar
  24. 24.
    Craik, F.I., Salthouse, T.A.: Handbook of Aging and Cognition. Lawrence Erlbaum, Hillsdale (1992)Google Scholar
  25. 25.
    Ziefle, M.: The influence of user expertise and phone complexity on performance, ease of use and learnability of different mobile phones. Behaviour and Information Technology 21(5), 303–311 (2002)CrossRefGoogle Scholar
  26. 26.
    Downing, R.W., Moore, J.L., Brown, S.W.: The effects and interaction of spatial visualization and domain expertise on information seeking. Computers in Human Behaviour 21, 195–209 (2005)CrossRefGoogle Scholar
  27. 27.
    Czaja, S.J., Sharit, J.: Age differences in the Performance of Computer-based work. Psychology and Aging 8, 59–67 (1993)CrossRefGoogle Scholar
  28. 28.
    Morrow, D., Miller, L.S., Ridolfo, H., Kokayeff, N., Chang, D., Fischer, U., Stine-Morrow, E.: Expertise and aging in a pilot decision making task. In: Proceedings of the Human Factors and Ergonomics Society 48th Annual meeting, pp. 228–232 (2004)Google Scholar
  29. 29.
    Ziefle, M., Schroeder, U., Strenk, J., Michel, T.: How young and older users master the use of hyperlinks in small screen devices. In: Proceedings of the SIGCHI conference on Human factors in computing systems 2007, pp. 307–316. ACM, New York (2007)CrossRefGoogle Scholar
  30. 30.
    Davis, F.D.: Perceived usefulness, perceived ease of use, and user acceptance of information technology. MIS Quarterly 13, 319–340 (1989)CrossRefGoogle Scholar
  31. 31.
    Adams, D.A., Nelson, R., Todd, P.A.: Perceived usefulness, ease of use, and usage of information technology: A replication. MIS Quarterly 16, 227–247 (1992)CrossRefGoogle Scholar
  32. 32.
    Schajna, B.: Empirical evaluation of the revised technology acceptance model. Management Science 42, 85–92 (1996)CrossRefGoogle Scholar
  33. 33.
    Schroeder, U., Spannagel, C.: The Role of Interaction Records in Active Learning Processes. In: Isaias, P., Nunes, M.B., dos Reis, A.P. (eds.) Proceedings of the IADIS Virtual Multi Conference on Computational Information Systems, pp. 99–104 (2005); Behaviour 21, 195–209 (2005)Google Scholar
  34. 34.
    Spannagel, C., Gläser-Zikuda, M., Schroeder, U.: Application of Qualitative Content Analysis in User-Program Interaction Research. Forum: Qualitative Social Research 6(2) (2006),
  35. 35.
    Jacareto Sourceforge Repository,
  36. 36.
    Ziefle, M.: Spatial cues in small screen devices: Benefit or handicap? In: Proc. 12th IFIP TC13 Conference in Human-Computer Interaction, INTERACT (2009)Google Scholar
  37. 37.
    Ziefle, M., Bay, S.: How to overcome disorientation in mobile phone menus: A comparison of two different types of navigation aids. Human Computer Interaction 21(4), 393–432 (2006)CrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2009

Authors and Affiliations

  • André Calero Valdez
    • 1
  • Martina Ziefle
    • 1
  • Andreas Horstmann
    • 2
  • Daniel Herding
    • 2
  • Ulrik Schroeder
    • 2
  1. 1.Human Technology CentreHumtec
  2. 2.Computer-supported learning research group, Department of Computer ScienceRWTH Aachen UniversityGermany

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