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Practical Memory Institute ____________________


Claudia Feldman. Former Deputy Director. Jane Shure. Former Director. Office of ... Eve-Marie Lacroix, MA. Joyce Backus, MSLS. The National Library of Medicine ... – PowerPoint PPT presentation

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Title: Practical Memory Institute ____________________

Aging by Design 2005 The
NIA/NLM Guidelines for Elder Online
Accessibility and the Importance of Usability
Testing Roger W. Morrell, Ph.D. Director of
Usability Assurance Practical Memory Institute
LTD Spencerville, MD, USA
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Acknowledgements Stephanie R. Dailey,
MA Education Specialist Claudia Feldman Former
Deputy Director Jane Shure Former
Director Office of Communications and Public
Liaison, NIA Richard J. Hodes, MD Director Nationa
l Institute on Aging
Kathleen Cravedi, MA Eve-Marie Lacroix, MA Joyce
Backus, MSLS The National Library of
Medicine Donald A.B. Lindberg, MD Director The
National Library of Medicine
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  • Overview
  • ? The NIH Senior Health Project
  • ? The Guidelines
  • ? Projects that have tested or incorporated
  • the Guidelines
  • ? The importance of usability testing with
  • older adults

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  • Older adults and information technology
  • ? In the beginning, electronic products were
    designed by young people to be used by young
  • ? Video games were designed.
  • ? Computers were introduced into schools.
  • ? Training opportunities were geared toward
  • younger people.

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  • ? Older adults are very interested in learning
  • how to use information technology.
  • ? Older adults are not more anxious and do
  • not have poorer attitudes toward the use of
    information technology relative to younger
  • ? Older adults can learn how to use these
    technologies and retain these skills over time.

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  • ? Other electronic products, such as
  • e-Learning and training programs on CD ROMs are
    also well received by older adults.
  • ? Underserved populations are also very
    interested in using interactive technology.
  • ? Older adults are now the fastest growing
    segment of new Internet users.

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The NIH Senior Health Project Sponsored by The
National Institute on Aging and The National
Library of Medicine
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  • Goals of the project
  • ? Isolate the basic and systematic research in
    cognitive aging, human factors and aging, and
    consumer informatics.
  • ? Develop a set of Guidelines on how to design
    online materials that are elder-accessible that
    take into consideration age-related changes in
    vision, cognition, and motor skills.
  • ? Use the Guidelines to construct an accessible
    web site that presents health information to
    older adults.

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The Guidelines
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Justification ? Use left justified text. Color ?
Avoid yellow and blue and green in close
proximity. Backgrounds ? Use dark type or
graphics on a light background.
Typeface ? Use a sans serif typeface. Type Size ?
Use 12- or 14-point. Type Weight ? Use medium or
bold face. Capitals and Lowercase ? Avoid all
caps in text. Physical Spacing ? Double space all
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Organization ? Use short segments that fit on one
page. ? Standardized the presentation of the
text. Online Glossary ? Provide an online
glossary of technical or medical terms that is
linked to the text.
Style ? Present the information
clearly. Phrasing ? Use the active
voice. Simplicity ? Write the text in simple
language. ? A sixth-grade reading level is
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Menus and Scrolling ? Avoid pull down menus
and automatically scrolling text. ? Reduce the
amount of scrolling required to read a page. ?
Incorporate scrolling icons such as top of page
if pages are longer than one screen.
Navigation ? Simple and straightforward. ? Use
explicit step-by-step procedures. ? Carefully
label links so that their destination is
clear. Consistent Layouts ? Use a standard page
design and the same symbols and icons throughout.
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Site Maps ? Provide a site map. Help and
Information ? Provide a telephone number and an
email contact.
Backward and Forward Navigation ? Incorporate
buttons such as previous page and next page
to allow the reader to re-read the text. Icons ?
Use large buttons that do not require precise
manipulations of the cursor.
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Illustrations and Photographs ? Use
text-relevant images only. Animation and Video ?
Use short segments to reduce download time and
retain viewer interest. ? Provide amounts of
downloading and viewing time required.
Text Alternatives ? Provide text alternatives
such as open- or closed- captioning or a static
version of the text. ? Provide the ability to
print out a transcript if information is
presented in animation, video, and audio.
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15 An ongoing project
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  • ? The web site was launched in October, 2003
  • on Capitol hill with Senator Tom Harkin
    conducting the first official search.
  • ? This is an ongoing project. Since the launch
    other NIH Institutes have posted health
    information on the web site.
  • ? continues to serve
  • as a model for online elder accessibility.

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? This is the Talking Web.
? Type size can be immediately enlarged.
? Page contrast can be changed.
? Example of a page using the Contrast
? The navigation system is readily apparent
and consistent.
? The typeface and type size used are easy to
? Large buttons are easy to click on.
? The videos feature open captioning and
transcript print out availability.
? The videos are easy to use.
? Animations are used to illustrate textual
  • The web site has won several
  • Awards
  • ? 2004 International Council on Active Aging
    Award for one of North Americas six most
    innovative active aging programs
  • ? Outstanding 2004 Plain Language Award
  • from the National Institutes of Health
  • ? 2005 Honorable Mention Award from Medicine on
    the Net

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Projects that have incorporated the
Guidelines Research projects A new project A
project to be expanded
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Research Projects Annie Becker, Ph.D. Research
grant funded by The National Science
Foundation Roger W. Morrell, Ph.D. SBIR grant
funded by The National Institute on Aging
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  • Assessments of Existing Web Sites
  • ? Becker (in press) conducted heuristic
  • usability studies on 125 government, commercial,
    and nonprofit web sites designed to provide
    health resources.
  • ? The NIA/NLM Guidelines and other factors
  • were used as gauges to test the
    elder-accessibility of the web sites.
  • ? The results showed that none of the categories
    of accessibility tested attained high ratings of
    overall usability.

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  • ? Approximately 93 of the web sites used
  • small fonts and 24 of the web sites required
    manipulations requiring intricate mouse skills.
  • ? Approximately 30 of the web sites required
    higher than a high school education to comprehend
    the health information sampled.
  • ? The study concluded that many current health
    information web sites are not accessible at some
    level to older adults.

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Redesign of Existing Web Sites ? Morrell (2005)
conducted individual usability testing on
sections of a nonprofit and a for-profit web site
with older adults as participants (average age
73.2 years of age). ? Usability testing was
then conducted on the same sections of the web
sites with another matched group of older adults
after they had been revised according to the
NIA/NLM Guidelines.
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  • ? Results demonstrated dramatic differences
  • in performance of the usability tasks with
    successful task performance improving from 0 to
    100 in some instances.

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The Sharper Memory Project a new
project Practical Memory Institute LTD SBIR
grant funded by The National Institute on
Aging Awarded to Robert Rager, President,
Practical Memory Institute LTD and Preston
Harley, Ph.D., Principal Investigator
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The Sharper Memory Project will include ? The
development of a new Sharper Memory cognitive
fitness educational web site designed to improve
cognitive health literacy.
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  • Features of the web site
  • ? Access to resources on memory improvement
  • for individuals of all ages.
  • ? A Sharper Memory Monitor feature that will
    allow users to select and plan interventions to
    improve memory and to record changes in memory
    over time.
  • ? Memory enhancement techniques.
  • ? Information for caregivers and resources for

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? A monthly e-Newsmagazine on memory improvement

? A parent web site is available for additional
information and the purchase of products.

Initial research findings ? Initial focus group
assessments indicate that the older adults want
their own private, individualized web site. ?
The older adults do not want to admit to others
that they are having memory problems.
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The BusinessThinkingTM Project a project to be
expanded SeniorThinking, LLC SBIR grant funded
by The National Institute on Aging Awarded to
Marian Stoltz-Loike, Ph.D., CEO, SeniorThinking,
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  • ? All products are designed in CD-ROM
  • format and can be engineered to be
  • accessed through corporate/government intranets,
    the web site,
  • as well as the Internet in general.
  • ? The products are designed to be used to
    alleviate the high costs of personnel training
  • in traditional formats.

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  • ? The BusinessThinkingTM products are
  • e-learning courses on the use of software
    PowerPoint, Excel, Word, and use of the Internet
    for people over the age of 50.
  • ? Other courses include Career Development, Job
    Finding, and Pre-Retirement Planning.
  • ? Additional courses are in the development

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? An explanation is presented immediately on how
to use BusinessThinkingTM products.

? All products begin with an Index.

? All courses are carefully organized.

? Illustrations and animations are used.

? All procedures are presented in a step-by-step

? Design is consistent throughout all products.

The Research Component of the BusinessThinkingTM
Project ? Usability tests were conducted on all
products with mature adults (ages 50 69),
individuals representative of mature adults still
in the workforce. ? Knowledge assessments were
also conducted to determine if mature adults can
learn from the products.
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Findings ? Application of the NIA guidelines has
resulted in almost errorless performance of
usability tasks. ? In some instances, certain
subcategories of information were hard to find
(this information was not crucial to
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? Improvement in knowledge acquisition improved
23 on information about career development
when the CD-ROM was used alone. ? We tested
taking the CD-ROM home and using it for one
week, adding an instructor-led Web-based
component (via Webex), and adding a peer2peer
component. ? All methods resulted in 50
improvement in performance of tasks after only
about 3-4 hours of instruction.
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  • These results suggest that mature adults can
    learn from e-learning products whether they
  • use them
  • ? by themselves,
  • ? with two or more people in a small
  • group, or
  • ? via the Internet.

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The Importance of Usability Testing with Older
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  • ? According to Mandel, Usability is the glue
  • that holds together all of the pieces that
    (hopefully) fit together and make up any product
  • (Mandel, 1997, p. 101).
  • ? Usability testing can be of great value
  • because no amount of careful and meticulous
    planning can predict all the problems that are
    going to be experienced when using information

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  • ? Usability testing reveals whether potential
    users can actually use a product.
  • ? Usability testing provides feedback to improve
    product design, to reduce and remove glitches,
    bugs and problems, to compare products and
    versions or prototypes, and to validate that
    products meet pre-determined usability goals and
  • ? More formal usability testing occurs in a
    laboratory environment where representative users
    are brought in to use prototypes of the software
    or online product.

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  • ? Test subjects are asked to use the prototype
    and perform a series of tasks that are deemed
    representative and necessary for use of the
  • ? Participants are asked to think aloud and often
    the sessions are videotaped for later scoring and
    clarification of performances.
  • ? Results from each iterative round of usability
    testing are employed to further refine and
    redesign the product to ensure its usability.
  • (see Mandel, 1997 Nielsen Mack, 1004 Rubin,
    1994 or visit the Usability Professionals
    Association web site for
  • in-depth discussions of usability testing in

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  • ? Usability testing is crucial for online and
    other electronic products designed for use by
    older adults.
  • ? Only through successive usability testing with
    individual older adults can you determine if your
    products are designed to mediate age-related
    changes in vision, memory, comprehension, and
    motor skills.
  • ? The good news is that usability testing with
    older adults is beginning to move to the

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  • ? Most important, the NIA/NLM Guidelines outlined
    in this presentation may be used to
  • form the basis of protocol development when
    conducting usability testing with older adults in
    order to facilitate this type of assessment.
  • ? Morrell and Stoltz-Loike will be presenting
  • an outline of how to conduct usability testing
    successfully with older adults in Making the
    Internet Century Accessible to Older Adults.

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Summary ? There is an existing set of
Accessibility Guidelines that have been produced
by the National Institute on Aging and the
National Library of Medicine that have been shown
to increase usability of online materials for
older adults. ? Accessible online materials can
be produced for older adults.
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? Only through usability testing with individual
older adults can we ensure that online and other
electronic materials are truly elder-accessible.

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Thank you. Practical Memory Institute LTD P.O.
Box 212 Spencerville, MD, USA Tel
301.384.0012 Fax 301.384.5566
Practical Memory Institute ____________________
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