Evaluating a Mobile Application Against

Dating Violence in African American Adolescents

Vipavee Thongpriwan, Ph.D., R.N., NursingYi Hu, Ph.D., Behnam Azimi PhD student, Electrical Engineering

Jean Bell-Calvin, MS, RN, PHCNS-BC, NursingAaron Buseh, PhD, MPH, MSN, Nursing

University of Wisconsin-Milwaukee

Presenter Disclosures

(1) The following personal financial relationships with commercial interests relevant to this presentation existed during the past 12 months:

<Vipavee Thongpriwan>

< “No relationships to disclose”>

Background

• Limitation of mobile apps designed for and used by adolescents aimed at preventing DV

• A tailored app to assist adolescents increase their awareness and recognition of violence is essential

• We have developed a mobile app called Better Me

• The Better Me app has the potential to be used as a tool to prevent dating violence

The Better Me app• is developed based on

– Cognitive Behavioral Interventions [1]

– The Conflict in Adolescent Dating Relationship Inventory (CADRI) [2]

• has five main tabs– My Relationship– Chart– Calendar– Get Help– Setting

Purpose of the Study

• To examine the usability of the app in African-American adolescents– Content – Features and functionality– Usability – Intentions to use in the future

Methods

• A descriptive, cross-sectional research design

• Participants– A convenience sampling method was used

to recruit 19 African American adolescents (10 girls, and 9 boys), ages 13-17 years old

Recruitment

• Informed consent of the parent/guardian and adolescents was required

• Four recruitment strategies – Referral– School and community events– Flyer– Media

• Nursing center website • Facebook

Instruments

• A demographic questionnaire• A semi-structured interview guide • A 5-point Likert System Usability Scale (SUS) [3]

– 10 statements– Scores range from 0 to 100– “I thought the app was easy to use.”– “I would imagine that most people would learn to

use this app very quickly.”– “I felt very confident using the app.”

Data Collection

• Location: A private room at the Community Nursing Center in the study area

• Duration: 45-60 minute• Participation Activities:

– Try out the app– Complete the SUS and a demographic

questionnaire– Participate in an interview

Data Collection

• A think aloud protocol– Use an App Testing Script

• Entering Information in the My Relationship• Using the Calendar • Viewing the Charts• Using the Getting Help• Working with the Setting

• An individual audiotaped interview

Data Analysis

• Data from the demographic were analyzed descriptively.

• A score for the SUS questionnaires was calculated using the SUS guideline [4]

• The audio-taped interviews were analyzed using the content analysis method [5]

Results

• Content– Clear and understandable– Some words might be difficult to understand

• “I don't know what anxious means.” • “ I don't know what manic is.” • “I know the words but I sometimes get them

mixed up like manic, and elated, and euphoric.”• This one “Threatened to tear down something I

value” I don’t know what it means.

Results

• Features and Functionality• “It's self-explanatory. You just play around with it...”• “When I put in information into the My Feelings, or

My Partner’s Behavior, or Events it goes into the chart and calendar.”

• My Relationship - the most desirability• Chart - the least desirability • Get-Help and Reminder – the most confusing

feature

Results

• Usability – A SUS score above a 68 is considered above

average – In our study, the SUS score was a 78 (a

percentile rank of 83%) indicating an excellent usability testing [3]

Results

• Intentions to Use in the Future– “if I’m in a relationship, and I’m in a bad

situation that I really need help. I will use it.”

– “If this is not the most used app, people don't know though ”

– “I don’t think people will be afraid to use it. It doesn’t ask you like your name…”

Results

• Suggested Improvements – User interface

• Make it more customize• Remove the math symbols

– Change words that are unclear– Charts and Get Help

• Make it readable and easy to understand

– Add a guideline for breaking up– instructions

Future Plans• Use multiple approaches

– Ask for feedback from experts

• Revise the app based on the findings • Include local domestic violence agencies into the app• Examine the practicality of using the app in

participants’ real life conditions• Explore the feasibility of using the app as a tool of

change in knowledge and attitude toward dating violence

Key Lessons Learned

• It is essential to validate whether there is a real need for an app early in the design and development process

• Informed consent process should be clear and effective as much as possible

• Recruiting male adolescents to participate in the study is challenging

• Ways to handle “no show”

References1. Stuart, G.W., Principles and Practice of Psychiatric Nursing

2012, Elsevier, Mosby: St. Louis, MO. p. 816.2. 14. Wolfe, D.A., et al., Development and validation of the

Conflict in Adolescent Dating Relationships Inventory. Psychological assessment, 2001. 13(2): p. 277-93.

3. Sauro, J. Measuring Usability with the System Usability Scale (SUS) 2011; Available from: http://www.measuringusability.com/sus.php.

4. Bangor, A., P.T. Kortum, and J.T. Miller, An empirical evaluation of the System Usability Scale. International Journal of Human-Computer Interaction, 2008. 24(6): p. 574-594.

5. Sandelowski, M., Whatever happened to qualitative description? Research in Nursing & Health, 2000. 23(4): p. 334-40.

UW-Milwaukee

www.nursing.uwm.edu

College of Nursing