Objective: To evaluate usability, functionality, and interface design to inform improvements for future iterations of the GEORGE® app for use in research.

Background: GEORGE® is an Android app for Huntington’s disease (HD), developed at the University of Rochester. Over 6 months in 2019, a pilot study was conducted to assess the feasibility of using the app to quantify HD symptoms and daily symptom variability. While the pilot study demonstrated efficacy of the app, it also identified several areas impacting user engagement. A user experience (UX) evaluation was completed to identify specific user pain points involved.

Method: A mixed-method UX evaluation was conducted during and following the pilot study and involved 11 in-person study participant interviews, 21 observations in-clinic or via video recording, a survey, a heuristic evaluation, and a qualitative coding process to identify and categorize common themes for analysis. Pilot study participants voluntarily engaged in this multi-method evaluation. This approach provided a wealth of detail and context-rich insights through triangulation of the data to identify the most pressing design issues.

Results: The GEORGE® UX evaluation process uncovered four categories of usability issues: (1) variability in capacity for mobile-specific gestures, (2) cognitive load associated with app use, (3) lack of clarity associated with visual design elements, and (4) confusion with wording, presentation, and placement of content. These findings yielded recommendations to improve the UX, which included facilitating multimodal data entry, providing text reminders, and enlarging buttons/touchable areas.

Conclusion: The findings from this evaluation have implications for the design and use of mobile apps for HD and other neurodegenerative disorders. They provide insights into the nature and scope of potential usability issues as advances in digital technology contribute to the development of new, innovative design solutions. The value of a user-centered approach lies in the knowledge and perspectives gained from participant experiences. The “patient voice” enhances every aspect in the design and development of health-related apps for use in research. Importantly, participant satisfaction and sustained engagement support the generation of valid, high-quality research data.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/a-user-experience-evaluation-of-a-huntingtons-disease-app-implications-for-mobile-first-design/