Older adults' use of an online decision support system: Usability and stability of assistive technology recommendations

Online decision support systems (DSS) may help older adults self-select assistive technology (AT) by offering recommendations. User interactions with DSSs may change the recommendations they receive. Objective: We evaluated recommendations stability and usability of an online DSS. Methods: Middle-aged and older adults (n = 43) were observed while using the DSS. The stability of DSS recommendations (ATs and advice) was compared between two time points, using a three-point scale: no, partial, or full agreement. Usability was coded, referencing ISO standards. Results: Half (51%) of participants received AT recommendations from the DSS in both sessions, with full (14%) or partial (12%) agreement. All but one participant received advice, and almost all of them had full (40%) or partial (56%) agreement between sessions. Many of the usability issues appear to be the result of the users inaccurately measuring their environment, challenges in understanding the questions being asked, and improperly making selections from the system. Discussion: Strict AT matching rules versus generic advice, and usability issues, likely reduced the matching rate and stability of AT recommendations. Conclusion: It appears that some users may require assistance with the system, and we suggest changes to the DSS format and content to improve stability and usability.