title: Usability evaluation of an online, tailored self-management intervention for chronic obstructive pulmonary disease patients incorporating behavior change techniques.
abstract: BACKGROUND
  An eHealth intervention using computer tailored technology including several behavior change techniques was developed to support the self-management of chronic obstructive pulmonary disease patients.
  
  
  OBJECTIVE
  The goal of this study was to evaluate and improve the usability of the eHealth intervention.
  
  
  METHODS
  We conducted a usability evaluation with 8 chronic obstructive pulmonary disease patients, with a mixed methods design. We improved the usability through iterative cycles of evaluation and adaptation. Participants were asked to think aloud during the evaluation sessions. Participants then completed a semi-structured interview. The sessions were observed and recorded. Descriptive statistics and content analysis were used to uncover usability issues.
  
  
  RESULTS
  Areas for improvement were layout, navigation, and content. Most issues could be solved within 3 iterations of improvement. Overall, participants found the program easy to use. The length of the program urged us to further analyze the appreciation of behavior change techniques. Some were perceived as helpful and easy to use, while others evoked frustration.
  
  
  CONCLUSIONS
  The usability study identified several issues for improvement, confirming the need for usability evaluation during the development of eHealth interventions. The uncovered strengths and limitations of behavior change techniques may lead to optimization of eHealth interventions, but further insight is needed.
authors.affiliation: CAPHRI, Department of General Practice, Maastricht University Medical Center, Maastricht, Netherlands. viola.voncken@maastrichtuniversity.nl.
authors.forename: Viola
authors.initials: V
authors.lastname: Voncken-Brewster
authors.forename: Albine
authors.initials: A
authors.lastname: Moser
authors.forename: Trudy
authors.initials: T
authors.lastname: van der Weijden
authors.forename: Zsolt
authors.initials: Z
authors.lastname: Nagykaldi
authors.forename: Hein
authors.initials: H
authors.lastname: de Vries
authors.forename: Huibert
authors.initials: H
authors.lastname: Tange
keywords: Internet intervention; chronic obstructive pulmonary disease; computer tailoring; self-management; usability testing