title: Accessibility needs and challenges of a mHealth system for patients with dexterity impairments.
abstract: Purpose State: An innovative mobile health system called iMHere (interactive Mobile Health and Rehabilitation) has been developed at the University of Pittsburgh to support self-care and adherence to self-care regimens for patients with chronic conditions. The goal of this study is to explore and to identify the accessibility needs and preferences of individuals with dexterity impairments when they use the iMHere system.
  
  
  
  Participants were asked to perform tasks after a one-week field trial. The time for a participant to complete each task, the number of possible errors a participant made and the number of errors a participant was able to self-correct were recorded and analyzed. The Telehealth Usability Questionnaire was collected to rate participants' experiences.
  
  
  
  Nine participants with various levels of dexterity abilities were included in the study. A statistically significant negative correlation was identified between participants' dexterity levels and their error ratios by using a Pearson product-moment correlation (r = -0.434, n = 36, p = 0.004). Approximately 51% of errors detected was self-corrected without any help, but other errors called for resolution from a researcher.
  
  
  
  Due to the diversity of participants' dexterity impairments, their needs and preferences differ one from another. Personalized design may be the key to approaching these challenges in improving accessibility. Implications for Rehabilitation An innovative mobile health system called iMHere has been developed to support self-care and adherence to self-care regimens as part of rehabilitation for patients with chronic conditions. Before populations with these limitations can harness the potential of mHealth, accessibility of mHealth has to be addressed to ensure its quality and value. Dexterity limitations are commonly associated with chronic disease, accidents or aging. The study presented here identified the potential issues and barriers to accessibility related to user interface components for persons with dexterity impairments. The findings should be of interest for those working with mobile health, accessibility, smartphone apps, wellness and self-care.
authors.affiliation: a Department of Health Information Management.
authors.forename: Daihua X
authors.initials: DX
authors.lastname: Yu
authors.affiliation: a Department of Health Information Management.
authors.forename: Bambang
authors.initials: B
authors.lastname: Parmanto
authors.affiliation: b Department of Physical Medicine and Rehabilitation , and.
authors.forename: Brad E
authors.initials: BE
authors.lastname: Dicianno
authors.affiliation: a Department of Health Information Management.
authors.forename: Valerie J
authors.initials: VJ
authors.lastname: Watzlaf
authors.affiliation: c Department of Rehabilitation Science & Technology , University of Pittsburgh , Pittsburgh , PA , USA.
authors.forename: Katherine D
authors.initials: KD
authors.lastname: Seelman
mesh_terms: D000293:Adolescent; D000328:Adult; D002908:Chronic Disease / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D063731:Mobile Applications; D009048:Motor Skills; D010349:Patient Compliance; D017010:Reminder Systems; D012648:Self Care; D000068997:Smartphone; D017216:Telemedicine / Q000379:methods*; D014584:User-Computer Interface; D055815:Young Adult
keywords: Accessibility; dexterity impairments; mobile health; people with disability; smartphone applications