In the Netherlands, Blanson Henkemans and coworkers developed an adaptive computer assistant for the supervision of diabetics' self-care, to support limiting illness and need for acute treatment, and to improve health literacy. The assistant monitors self-care activities logged in the patient's electronic diary and then provide context-aware feedback. The objective of the study was to evaluate whether older adults could make use of the computer assistant and to compare an adaptive computer assistant with a fixed one, concerning its usability and contribution to health literacy. A laboratory experiment was conducted in the Georgia Tech Aware Home where 28 older adults participated in a usability evaluation of the computer assistant, while engaged in scenarios reflecting normal and health-critical situations. The assistant was evaluated on effectiveness, efficiency, satisfaction, and educational value. The moderating effects of the subjects’ personal characteristics were also examined. It was found that logging self-care tasks and receiving feedback from the computer assistant enhanced the subjects' knowledge of diabetes. The adaptive assistant was more effective in dealing with normal and health-critical situations, and, generally, it led to more time efficiency. Subjects' personal characteristics had substantial effects on the effectiveness and efficiency of the two computer assistants.

VALUE OF STUDY TO READER. The authors concluded that older adults were able to use the adaptive computer assistant. In addition, it had a positive effect on the development of health literacy. The assistant has the potential to support older diabetics' self-management while maintaining quality of life. It certainly appears to be a nice technique for assisting patients to self-monitor their condition. For this reason, it is hoped that similar research is conducted with other populations of chronically ill patients.

OA Blanson Henkemans et al. Usability of an Adaptive Computer Assistant that Improves Self-care and Health Literacy of Older Adults. Methods of Information in Medicine, 2008;47:82