The proposed research addresses the need to provide information support to older chronic heart failure (CHF) patients and their informal caregivers. Many older patients have unmet information needs related to their home care (self-care) plans, illustrated by knowledge deficits and up to 90% nonadherence to important care activities such as medication-taking, nutrition and sodium restriction, physical activity, and monitoring and responding to symptoms. The health consequences of nonadherence are tremendous and costly. We hypothesize that health information technology (HIT), when designed and evaluated using Human Factors Engineering (HFE) principles and methods, can be useful and usable for older patients and lay caregivers who must manage the complex information needed for successful home care, health, & disease management. This proposal describes how the Principal Investigator (PI) will transition to research independence and a career in aging research, building on his expertise in HFE and HIT and developing additional expertise in the: a) health relevant characteristics of older, chronically ill patients, and b) proess of user-centered HIT design for these patients and their caregivers. The proposal describes a 3-year research project developing and testing an interactive Flight Plan HIT system using the HFE approach. Flight Plan will initially be developed for and tested by older CHF patients to support a broad array of disease-specific and general self-care activities.
Research Aim 1 is the Human Factors Analysis - a combination of familiarization with the geriatric CHF domain, interviews, surveys, and in-home observations. The Human Factors Analysis will yield a realistic understanding of future Flight Plan users, their tasks, contexts of use, and needs. This understanding will be critical for evidence based design of Flight Plan.
Research Aim 2 is the Design and Usability Testing of a Flight Plan prototype. The prototype will be based on Aim 1 findings and the design team's vision of a patient-centered, patient-controlled, interactive Flight Plan system. The PI's career development activities will ensure that Flight Plan conforms to HFE design principles and is clinically valid. During usability testing, older CHF patients and their lay caregivers will use the Flight Plan prototype under both controlled lab and in situ conditions. Analysis of objective and subjective usability test data will verify the usability and preliminary usefulness of Flight Plan and guide further refinement.
Research Aim 3 is the Pilot Test of Flight Plan's effectiveness and user acceptance. The Pilot Test will be a pre-post randomized controlled trial with baseline and 3 months post-intervention measures of health status, CHF knowledge, and CHF self-care behavior. Flight Plan is hypothesized to improve these measures relative to usual care. Flight Plan is expected to have higher HIT acceptance than other patient-facing HIT systems. Future work will include a larger randomized controlled trial to evaluate Flight Plan's effects on older CHF patients' health outcomes as well as extension of Flight Plan to other geriatric chronic disease domains.

Public Health Relevance

Many older patients with chronic illnesses such as chronic heart failure would benefit from health information technology if it were designed to be useful and usable for supporting their home care activities. This award will support the candidate's (1) training in geriatrics/gerontology and (2) new expertise and skill using a user-centered 'human factors' approach to design and evaluate useful and usable technology for older adults with chronic illness.

Agency
National Institute of Health (NIH)
Institute
National Institute on Aging (NIA)
Type
Research Scientist Development Award - Research & Training (K01)
Project #
5K01AG044439-03
Application #
9031036
Study Section
Neuroscience of Aging Review Committee (NIA)
Program Officer
King, Jonathan W
Project Start
2013-12-01
Project End
2016-11-30
Budget Start
2015-12-01
Budget End
2016-11-30
Support Year
3
Fiscal Year
2016
Total Cost
Indirect Cost
Name
Indiana University-Purdue University at Indianapolis
Department
Miscellaneous
Type
Schools of Arts and Sciences
DUNS #
603007902
City
Indianapolis
State
IN
Country
United States
Zip Code
46202
Mickelson, Robin Sue; Holden, Richard J (2018) Medication adherence: staying within the boundaries of safety. Ergonomics 61:82-103
Cornet, Victor P; Holden, Richard J (2018) Systematic review of smartphone-based passive sensing for health and wellbeing. J Biomed Inform 77:120-132
Abedtash, Hamed; Holden, Richard J (2017) Systematic review of the effectiveness of health-related behavioral interventions using portable activity sensing devices (PASDs). J Am Med Inform Assoc 24:1002-1013
Chui, Michelle A; Stone, Jamie A; Holden, Richard J (2017) Improving over-the-counter medication safety for older adults: A study protocol for a demonstration and dissemination study. Res Social Adm Pharm 13:930-937
Holden, Richard J; Valdez, Rupa S; Schubert, Christiane C et al. (2017) Macroergonomic factors in the patient work system: examining the context of patients with chronic illness. Ergonomics 60:26-43
Faiola, Anthony; Holden, Richard J (2017) Consumer Health Informatics: Empowering Healthy-Living-Seekers Through mHealth. Prog Cardiovasc Dis 59:479-486
Heiden, Siobhan M; Holden, Richard J; Alder, Catherine A et al. (2017) Human factors in mental healthcare: A work system analysis of a community-based program for older adults with depression and dementia. Appl Ergon 64:27-40
Holden, Richard J; Kulanthaivel, Anand; Purkayastha, Saptarshi et al. (2017) Know thy eHealth user: Development of biopsychosocial personas from a study of older adults with heart failure. Int J Med Inform 108:158-167
Srinivas, Preethi; Cornet, Victor; Holden, Richard (2017) Human factors analysis, design, and evaluation of Engage, a consumer health IT application for geriatric heart failure self-care. Int J Hum Comput Interact 33:298-312
Novak, Laurie L; Unertl, Kim M; Holden, Richard J (2016) Realizing the Potential of Patient Engagement: Designing IT to Support Health in Everyday Life. Stud Health Technol Inform 222:237-47

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