1. UX Research with Limited Literacy Audiences Tips and case studies Mary Ann Petti, MPH, CHES + @MaryAnnPetti + @CommunicateHlth 2. Presentation overview Why care about literacy and health literacy? What we know about limited literacy users Sample UX research methods and case studies 10 tips for involving participants with limited literacy skills in UX research 3. a question? 4. Which of the following is the strongest predictor of a persons health status? Income Employment Education level Racial or ethnic group Literacy skills 5. Literacy An individuals ability to read and write. 6. Health Literacy An individuals ability to obtain, process, and understand basic health information and services needed to make appropriate health decisions. 7. Literacy vs. health literacy 8. Health literacy level by task 9. Why care? 10. Why care? Household decision makers 11. What we know about users with limited literacy skills 12. Prone to skipping information and focus on the center of the screen 1 13. Prone to skipping & focus on the center of the screen Gaze path of a participant with limited literacy skills who reads only the text that looks easy to read. Source: Colter, A and Summers, K (2014). Low Literacy Users. In Bergstrom & Schall (Eds.), Eye Tracking in User Experience Design (p. 339). Waltham, MA: Elesvier. 14. Easily overwhelmed and tend to have a limited short-term memory 2 15. Easily overwhelmed & limited short-term memory Gaze path of a participant who does not have limited literacy skills. Source: Colter, A and Summers, K (2014). Low Literacy Users. In Bergstrom & Schall (Eds.), Eye Tracking in User Experience Design (p. 335). Waltham, MA: Elesvier. 16. Easily overwhelmed & limited short-term memory Gaze path of a participant with limited literacy skills attempting to read every word. Source: Colter, A and Summers, K (2014). Low Literacy Users. In Bergstrom & Schall (Eds.), Eye Tracking in User Experience Design (p. 336). Waltham, MA: Elesvier. 17. Usually navigate in a linear fashion and back-track frequently 3 18. Are likely to access web content from a mobile device 4 19. Likely to access web from a mobile device 2 out of 3 adults in the U.S. own a smartphone. 1 in 5 adults in the U.S. rely on their phones for Internet access. 20. What we know Users with limited literacy skills are Willing to use the web to access health information Able to accomplish tasks when websites are designed well 21. ALL users benefit from improved readability and usability Success Rate Original Site Rewritten Site Lower literacy 46% 82% High literacy 68% 93% A health website compared to a revised prototype (designed to support users with limited literacy skills) High literacy users: 3x as fast with the revised site Source: Summers, K., & Summers, M. (2005). Reading and navigational strategies of Web users with lower literacy skills. Total Task Time Original Site Rewritten Site Lower literacy 22.3 min 9.5 min High literacy 14.3 min 5.1 min Satisfaction (1-5 scale, 5=best) Original Site Rewritten Site Lower literacy 3.5 4.4 High literacy 3.7 4.8 22. Research methods: Considerations when working with limited literacy audiences 23. Understand. Organize. Evaluate. 24. Case Study 1: Collaging 25. Collaging for positive patient-provider interaction Goal: Find out what matters most to patients when talking to a doctor about cardiovascular health Methods: Participants create a collage that represents the characteristics they would like to see in something, and the characteristics they would not like to see in something (in-person, n=8) 26. Sample Method: Collaging SUCCESSFUL METHOD! 27. This is how I feel free and full of energy. I want my doctor to understand that this is how I want to feel with his or her help. 28. Case Study 2: Tree Testing 29. Remote tree testing for content organization Goal: Evaluate how easy it is for limited literacy users to locate information on healthfinder.gov Methods: Users are given a task to complete using the sitemap researchers are on-site for technical assistance (in-person with web-based tool, n=40) 30. Practice! Go to my Twitter page: @MaryAnnPetti Click the link in the pinned tweet Take the 3-task test https://communicate- health.optimalworkshop.com/treejack/uxpabos15 31. Tree testing with professionals Task: Where would you go to learn what Wisconsin is doing to support Healthy People 2020? This chart represents an unsuccessful task on a website targeting low lit consumers 32. UNSUCCESSFUL METHOD 33. Tree testing with limited literacy users Task: Where would you find healthy snack ideas for kids? This chart represents an unsuccessful task on a website targeting low lit consumers 34. Case Study 3: Mobile Usability Testing 35. Mobile usability testing Goal: Evaluate mobile user experience of healthfinder.gov Methods: In-person mobile testing with 8 users Mr. Tappy & iPEVO camera Limit think aloud allow more room for free exploration 36. SUCCESSFUL METHOD! 37. Mobile usability testing 38. Health Benefits Health Benefits Mobile usability testing 39. 10 tips for involving participants with limited literacy skills 40. Top 10 tips Partner with community organizations to recruit special populations Screen for participants with limited health literacy using proxy measures Ask participants to bring their mobile phones if testing on mobile and be sure to have WiFI access 41. Top 10 tips Develop screeners, consent forms, and moderators guides in plain language Use cash incentives when possible Limit the number of tasks Be cautious using remote and online testing 42. Top 10 tips Pre-test your protocol with at least one participant with limited literacy skills Choose a moderator with experience conducting research with limited literacy participants Conduct testing sessions in a setting that is familiar and accessible to participants 43. Why should I do user testing? 44. A dollop of toothpaste on a toothbrush. 45. Its a swan. On a boat. Floating down a river. 46. Helpful resources 47. Thank you! Mary Ann Petti maryann@communicatehealth.com communicatehealth.com