title: Older Cancer Patients' User Experiences With Web-Based Health Information Tools: A Think-Aloud Study.
abstract: Health information is increasingly presented on the Internet. Several Web design guidelines for older Web users have been proposed; however, these guidelines are often not applied in website development. Furthermore, although we know that older individuals use the Internet to search for health information, we lack knowledge on how they use and evaluate Web-based health information.
  
  
  
  This study evaluates user experiences with existing Web-based health information tools among older (≥ 65 years) cancer patients and survivors and their partners. The aim was to gain insight into usability issues and the perceived usefulness of cancer-related Web-based health information tools.
  
  
  
  We conducted video-recorded think-aloud observations for 7 Web-based health information tools, specifically 3 websites providing cancer-related information, 3 Web-based question prompt lists (QPLs), and 1 values clarification tool, with colorectal cancer patients or survivors (n=15) and their partners (n=8) (median age: 73; interquartile range 70-79). Participants were asked to think aloud while performing search, evaluation, and application tasks using the Web-based health information tools.
  
  
  
  Overall, participants perceived Web-based health information tools as highly useful and indicated a willingness to use such tools. However, they experienced problems in terms of usability and perceived usefulness due to difficulties in using navigational elements, shortcomings in the layout, a lack of instructions on how to use the tools, difficulties with comprehensibility, and a large amount of variety in terms of the preferred amount of information. Although participants frequently commented that it was easy for them to find requested information, we observed that the large majority of the participants were not able to find it.
  
  
  
  Overall, older cancer patients appreciate and are able to use cancer information websites. However, this study shows the importance of maintaining awareness of age-related problems such as cognitive and functional decline and navigation difficulties with this target group in mind. The results of this study can be used to design usable and useful Web-based health information tools for older (cancer) patients.
authors.affiliation: Amsterdam School of Communication Research/ ASCoR, Department of Communication Science, University of Amsterdam, Amsterdam, Netherlands. S.Bolle@uva.nl.
authors.forename: Sifra
authors.identifier: 0000-0002-7393-9057
authors.initials: S
authors.lastname: Bolle
authors.forename: Geke
authors.identifier: 0000-0003-0480-9336
authors.initials: G
authors.lastname: Romijn
authors.forename: Ellen M A
authors.identifier: 0000-0002-8145-8595
authors.initials: EM
authors.lastname: Smets
authors.forename: Eugene F
authors.identifier: 0000-0002-5563-935X
authors.initials: EF
authors.lastname: Loos
authors.forename: Marleen
authors.identifier: 0000-0001-5334-1085
authors.initials: M
authors.lastname: Kunneman
authors.forename: Julia C M
authors.identifier: 0000-0002-2259-5864
authors.initials: JC
authors.lastname: van Weert
mesh_terms: D000367:Age Factors; D000368:Aged; D005260:Female; D006801:Humans; D020407:Internet; D008297:Male; D009369:Neoplasms / Q000523:psychology* / Q000628:therapy; D017741:Survivors / Q000523:psychology*; D017216:Telemedicine / Q000379:methods*
keywords: aging; cancer; eHealth; think aloud; usability; user experience