Abstract
Purpose :
Blood pressure (BP) dysregulation is a known risk factor for glaucoma and home BP monitoring is increasingly common. However, little is known about glaucoma patients’ ability to use digital health devices. We performed a pilot mixed-methods study with glaucoma patients to evaluate digital health literacy and usability of a commercially available BP smartwatch monitor.
Methods :
Adult participants were recruited from the Diagnostic Innovations in Glaucoma Study (DIGS) and/or the African Descent and Data Evaluation Study (ADAGES) and were provided a BP monitor (Omron HeartGuide) to use at home. Baseline digital health literacy was assessed using the standardized eHEALS questionnaire. After one week, participants assessed the usability of the BP monitor and related mobile app using the Post-study System Usability Questionnaire (PSSUQ) and the System Usability Scale (SUS), standardized instruments for usability assessments in information technology. Variations in eHEALS and usability scores across demographic groups were evaluated with ANOVA. Open-ended responses about participants’ experience were analyzed thematically.
Results :
Among 39 participants, the mean (standard deviation, SD) age was 66.6 (8.7) years. Two-thirds (26, 66.6%) identified as female, 11 (28.2%) as African American, and 2 (5.1%) as Hispanic/Latino. The mean (SD) eHEALS score was 31.5 (4.9), reflecting excellent self-perceived eHealth literacy. Mean (SD) usability scores were 75.9 (17.9) and 2.3 (1.9) for the SUS and PSSUQ, respectively, indicating relatively high levels of usability (70-79th percentile). However, usability scores were significantly lower among older participants (p=0.009 for SUS, p=0.02 for PSSUQ; Fig. 1). Common themes in open-ended responses included difficulty using the monitor due to lack of technological skill, the watch not fitting properly, and not knowing how to troubleshoot problems.
Conclusions :
We identified challenges with using commercially available home BP monitors and mobile apps among glaucoma patients, particularly with increasing age. Glaucoma patients present unique considerations for digital health design, such as older age and visual impairment. Understanding glaucoma patients’ digital health literacy and user experience is important for inclusive design and future interventions.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.