Journal of Medical Internet Research - International Scientific Journal for Medical Research, Information and Communication on the Internet

Although an increasing number of Web sites are devoted to providing health information to older adults, many sites have usability problems unique to this population. The purpose of this study was to explore the usability of three health-promoting Web sites specifically designed for use by older adults. This descriptive study used two usability assessment methods: (1) a heuristic evaluation by four experts in Web usability and gerontology and (2) a usability test by 10 senior Web users with a mean age of 73.9. The design aspects identified as inappropriate for seniors by experts were as follows: small font size, too much information on one page, and a failure to provide instructions. The older adults in this sample preferred a simple design with clear instructions. During testing, these individuals expressed great interest in online health information. However, they needed instructions on how to search for credible health information online. Some usability-testing methods might need to be modified for older adults' specific needs.

Introduction: The high prevalence of chronic illnesses is a serious public health problem in the United States, and more than 70 million older adults have at least one chronic illness. Patient portals (PPs) have an excellent potential to assist older adults in managing chronic illnesses; however, older adults' PP adoption rates have been low. Lack of support for older adults using PPs remains a critical gap in most implementation processes. The main aim of this study was to assess the impact of an older adult friendly Theory-based Patient portal e-Learning Program (T-PeP) on PP knowledge, selected health outcomes (health decision-making self-efficacy [SE] and health communication), PP SE and use, and e-health literacy in older adults. Materials and Methods: A two-arm randomized controlled trial was conducted with older adults ( N = 272) who had chronic conditions. Participants were recruited online, and data were collected at baseline, 3 weeks, and 4 months. The main intervention effects were tested using linear mixed models. Results: The average age of participants was 70.0 ± 8.5 years, and 78.3% ( n = 213) were white. At 3 weeks, the intervention group showed significantly greater improvement than the control group in all outcomes except PP use. At 4 months, the intervention effects decreased, but PP SE remained significant ( p = 0.015), and the intervention group showed higher frequency of PP use than the control group ( p = 0.029). Conclusion: The study findings showed that the T-PeP was effective in improving selected health and PP usage outcomes. Further studies are needed to test the long-term effects of T-PeP using more diverse samples.