User-centered design to examine interaction of people with MCI or dementia with smartwatches: the SAMi intervention study framework

AuthorRong, Eleonora; Köhler, Stefanie; Bieber, Gerald; Teipel, Stefan; Goerss, Doreen
AbstractBackground: Assistive technologies show promising features to support people with cognitive impairment in daily life, e.g. mobile sensors for falls detection. But adoption of the rapidly evolving technologies is still limited in practice. We applied user-centered design to investigate factors contributing or hindering successful interventions on smartwatches. Methods: We previously presented data from qualitative studies which analyzed values and needs for assistive technologies. In this subsequent study, we included patients with MCI and dementia. To prevent participants from feeling overwhelmed, we accompanied participants during a test intervention (0). Patients’ reactions to the following two tasks delivered by the smartwatch were observed remotely via cameras: A) drinking some water, as a task related to nursing and B) circling bells on a worksheet, as an occupational task. We also implemented two different intervention-intensities: 1) regular and 2) intensive, with respect to vibration, alarm sounds and instructions. User feedback was obtained with questionnaires. Here, we present data of the feasibility analysis after completion of n = 20 patient, randomly assigned to intensity level 1 or 2 (n = 10/10). All patients were confronted with both tasks in the respective intensity, repeated up to three times in case of failure. Results: As result of discussions in interdisciplinary working groups, we decided for a “wizard-of-oz setting”, which means controlling the smartwatch manually by a smartphone used as remote control. Systematic debriefing revealed obstacles in all study phases. On user side the problem of varying use of glasses and hearing aids couldn’t be overcome. On the technical side pairing problems (connection of phone and watch), automatically reduced brightness of smartwatch display and complicated maintenance of hardware were critical problems. Patients were committed to give feedback and felt not stressed due to the study. Still, filling in the questionnaires with Likert scales was challenging for many participants due to alternation of positively and negatively worded items. Conclusion: Studying effects of smartwatch-based interventions in patients with cognitive decline with user-centered design requires intensive interdisciplinary work. Comparison of the video-taped, observed behavior with self-reported behaviors in questionnaires might elucidate chances and limits of user-centered approaches and will be our next objective.