PSYCHNOLOGY JOURNAL

The Other Side of Technology
EDITORS-IN-CHIEF
Luciano Gamberini Department of General Psychology, Padova University, Italy. Giuseppe Riva Catholic University of Milan, Italy. Anna Spagnolli Department of General Psychology, Padova University, Italy.

EDITORIAL BOARD
Mariano Alcañiz Raya: Medical Image Computing Laboratory Universidad Politecnica de Valencia. Valencia, Spain. Cristian Berrío Zapata: Pontificia Universidad Javeriana. Bogotà, Colombia. Rosa Baños: Universidad Politecnica de Valencia, Department of Personalidad, Evaluation y Tratamientos Psicólogicos. Valencia, Spain. David Benyon: School of Computing, Napier University, Edinburgh, UK. Cristina Botella: Departamento de Psicología Básica, Clínica y Psicobiología, Univeritat Jaume I. Castellón, Spain. Antonella de Angeli: Centre for HCI design, School of Informatics, University of Manchester Jonathan Freeman: Goldsmiths College, University of London. United Kingdom. Christine Hine: Department of Sociology, University of Surrey. Guildford, United Kingdom. Christian Heath: Management Centre, King's College. London, United Kingdom. Wijnand Ijsselsteijn: Human-Technology Interaction Group, Department of Technology Management, Eindhoven University of Technology. The Netherlands. Matthew Lombard: Department of Broadcasting, Telecommunications and Mass Media, Temple University, Philadelphia, PA, USA Angela Schorr: Medienpsychologischen Labor, Universität Siegen, Germany. Alexander Voiskounsky: M.I.N.D.Lab Moscow, Psychology Department, Moscow State University. Russia. John A Waterworth: MUSE research group, Umeå University. Northern Sweden.

CONSULTING EDITORS
Hans Christian Arnseth: Department of Educational Research, University of Oslo, Norway. Marco Casarotti: Department of General Psychology, University of Padova, Italy. Roy Davies: Department of Design Sciences, Lund University, Sweden. Andrea Gaggioli: Faculty of Medicine of the University of Milan, Italy. Pietro Guardini: Department of General Psychology, Padova University, Italy. Frode Guribye: Intermedia Center, University of Bergen, Norway. Raquel Navarro-Prieto: Internet Interdisciplinary Institute Universitat Oberta de Catalunya, Castelldefels, Spain. Stephan Roy: Hospital Sainte Anne, Paris, France.

EDITORIAL ASSISTANTS
Laura Sartori, Fabiola Scarpetta: Dep. of General Psychology, Padova University, Italy.

PSYCHNOLOGY JOURNAL, PNJ Published online since Summer 2002 Web Site: http://www.psychnology.org Submissions: articles@psychnology.org

TABLE OF CONTENTS

Table of Contents……………………………………………………………. p. 201

SPECIAL ISSUE: Designing Technology to meet the needs of the Older User Editorial Preface……………………………………………………………... p. 203
Eva and John Waterworth

A Review of Memory Aid Devices for an Ageing Population……………. p. 205
Niamh Caprani, John Greaney and Nicola Porter

An investigation into Older People’s Browsing Activities………………... p. 245
Prush Sa-nga-ngam and Sri Kurniawan

Inclusive Design and Human Factors: Designing Mobile Phones for Older Users…………………………………………………………………... p. 266
Matthew Pattison and Alex Stedmon

Project Presentation Cognition, technology and games for the elderly: An introduction to ELDERGAMES Project……………………………………………………... p. 285
Luciano Gamberini, Mariano Alcaniz, Giacinto Barresi, Malena Fabregat, Francisco Ibanez and Lisa Prontu

Other contents “Augmented itineraries”: Mobile services differentiating what museum has to offer………………………………………………………… p. 311
Maria Cristina Brugnoli, Federico Morabito, Giancarlo Bo and Elena Murelli

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Editorial Preface The elderly population is growing fast in most developed countries. At the same time, birthrates are low, and the overall effect is that the elderly form an increasing proportion of the population. This raises a variety of problems for individuals, for families, and for societies as a whole. Elderly people often suffer from mobility, memory, communication and general health problems. They tend to become both physically and socially isolated, which leads to distress and poor mood states, all of which contribute to a worsening of their quality of life and health. Despite the potential of recent technology to address needs of older users in areas such as social communication, information and entertainment, they remain largely excluded. Many older people find themselves bewildered by recent developments such as mobile phones, DVD players, set-top cable TV boxes, and the internet. There is an urgent need to address this situation, by targeting the design and development of technologies and systems to help increase the quality of life and enhance the functional independence of older people. This can lead to improvements in quality of life for both the elderly and their relatives, and a reduction in the societal costs. But the technology must be designed in ways that address the psychological needs and capabilities of older people, who do not form an homogenous group. There is thus an urgent need for more research on the topic of this special issue: Designing technology to meet the needs of the older user. The three themed papers accepted for publication, after anonymous peer review, provide a useful cross-sectional view of research approaches as well as covering three key topics in the field: memory support, internet browsing behaviour, and mobile phone design. The research approaches represented are, firstly, the creation of new technologies to compensate for specific forms of cognitive decline in the elderly; secondly, an examination of how and for what older people actually use the internet today; and thirdly, a proposed design approach aimed at increasing the inclusivity of product developments, thus reducing exclusion arising from technological advances. The survey paper, A Review of Memory Aid Devices for an Ageing Population, by Niamh Caprani, John Greaney and Nicola Porter, provides a very useful and timely review of memory aid devices for the elderly. The focus is on prospective memory, in other words remembering to complete intended acts. This is a key topic, because independent living depends on it. If the plan is to heat food for dinner, it is of obvious importance to remember to check its progress and remove from the heat at the appropriate time. Prospective memory often declines with age, especially in the over 80s - the fastest growing demographic group. The good news from this survey paper is that electronic memory aids have the potential to meet the needs of this population and help with this problem. An investigation into Older People’s Browsing Activities, by Prush Sa-ngangam and Sri Kurniawan, looks at the internet browsing behaviour of older people in three different countries: Thailand, the United Kingdom, and the United States. The paper presents new quantitative data based on questionnaire responses, covering various aspects of internet experience and current browsing behaviour. Exploratory Factor Analysis is used to extract usage patterns from a large set

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of interactive tasks and activities. The results are interpreted in terms of the following research questions: What and how do older people browse online? What functions in a standard browser do they use? And: What additional functions would make such a browser more useful for this group? Inclusive Design and Human Factors: Designing Mobile Phones for Older Users, by Matthew Pattison and Alex Stedmon, addresses the key topic of mobile phone use by older users, from a design perspective. Increasingly, participating in everyday social interaction and accessing timely information means carrying and using a mobile phone. But the way these devices are designed seems more directed to the young and would-be-

fashionable than towards the needs of users, and especially of older users. The paper reviews evidence and suggestions about what the requirements of this large and expanding group of users actually are, how current mobile phone designs match up (or fail to), and also looks at some specific products designed to meet these requirements. The authors suggest that an integration of effective human factors work with an inclusive design ethos within the product development process will maximise the benefits of technological advances and minimise exclusion. We are very happy to welcome you to this special issue.

Eva and John Waterworth Guest Editors of the Special Issue Umeå University, Sweden

As is customary, the journal includes also two reports from funded research projects. The first contribution of this type is also in line with the topic of the special issue, and was written by Luciano Gamberini, Mariano Alcaniz, Giacinto Barresi, Malena Fabregat, Francisco Ibanez, Lisa Prontu. The project, called ‘Eldergames’ plans to build a mixed reality gaming platform for elderly users; it aims to exploit the beneficial effects of playing games to compensate the decrease in some cognitive abilities due to aging. The contributions, titled Cognition, Technology and Games for the Elderly: an Introduction to ELDERGAMES Project, presents findings from psychology literature that substantiate the project’s claims and suggest

specific ergonomic requirements for elderly users. The second contribution, which falls within the ‘Other contents’ section, is called “Augmented itineraries”: Mobile services differentiating what museum has to offer and is authored by Maria Cristina Brugnoli, Federico Morabito, Giancarlo Bo, Elena Murelli. It describes a field study conducted with the prototype of a wireless device (‘MOBILearn’), which uses the opportunities disclosed by a networked, portable tool to provide museum visitors with customizable and interactive information. Therefore, we join our guest editors Eva and John Waterworth and welcome you in this issue 4(3) of PsychNology Journal.

Luciano Gamberini, Anna Spagnolli, Giuseppe Riva Editors-in-Chief

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PsychNology Journal, 2006 Volume 4, Number 3, pp. 205-243

A Review of Memory Aid Devices for an Ageing Population
Niamh Caprani , John Greaney and Nicola Porter

School of Creative Technologies, Institute of Art, Design and Technology Dún Laoghaire, Dublin (IRELAND)

ABSTRACT
The trend for designing memory aids for cognitively impaired elderly individuals is fast growing. In an effort to assist elderly people to carry out tasks of everyday living and to relieve caregivers, several memory aid technologies have recently been introduced. These devices range from everyday technologies such as handheld PDA’s to integrated sensory cueing devices. Based on the published literature describing these devices, this review will look at how these memory aids are designed to assist the user and whether they meet the needs and requirements of the older user. From the evaluations of these devices, it was shown that participant performances with the support of the memory systems were significantly improved compared to performances where the participants used internal strategies for remembering. These results show that electronic memory aids do have the potential to support memory in older individuals. This review will provide an insight into prospective memory and ageing, and the compensation devices which are designed to support memory decline due to ageing. There are three goals for the present review: (1) to outline the needs of older adults, (2) to review current memory aid devices, and (3) to consider how these devices meet the users needs.

Keywords: compensatory memory device, older adult, cognitively impaired, dementia Paper Received 27/07/2006; received in revised form 31/10/2006; accepted 12/12/2006

1. Introduction The interest in designing technology for older adults is increasing. This is in part due to the increasing life expectancy of people and the rapid ageing of society that is predicted in the 21st century. Demographic studies have estimated that the percentage of older adults
Corresponding Author: Niamh Caprani IADT DunLaoghaire, Ireland, Phone: 00353 12144921 E-mail: niamh.caprani@iadt.ie

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in Ireland will have doubled from the year 2000 to the year 2050. The fastest growing subgroup represents those over 80 years of age, increasing by 5.2% in 50 years. According to population projections this ageing trend will be seen across Europe, with older adults almost 35% of the population by 2050 (US Census Bureau, 2005). These statistics emphasise how important it is that technology developers focus their attention on the older user. Designing for older adults requires developers to take into consideration their capabilities and limitations including psychosocial needs and their acceptance of technological supports. One area of recent interest is the design of prospective memory aids for the older user. Prospective memory (PM) can be defined as the ability to remember to remember (Winograd, 1988). This involves remembering to do things at the right time and PM tasks are pervasive to daily living (Driscoll, McDaniel, and Guynn, 2005). PM tasks could be essential actions such as taking medication to everyday tasks such as remembering to buy milk. PM problems are common with ageing (Maylor, 1996b) and elderly individuals have to develop strategies to cope with this impairment, usually in the form of external aids (Maylor, 1993a). An external memory aid is defined as any device that facilitates memory in some way (Intons-Peterson and Newsome, 1992). This impairment is emphasised in individuals suffering from dementia (Papagno, Allegra, and Cardaci, 2004) and as ageing is the highest risk factor for developing dementias (Keller, 2006), developers are aware that technological supports will be needed to provide relief for carers. Prospective memory aids which have been commercially released include Cellminder, ISAAC, and NeverMiss DigiPad (for review see Horgas and Abowd, 2004; LoPresti, Mihailidis, and Kirsch, 2004). Although PM aids have been a major focus for designers in recent years retrospective memory (RM) aids, supporting the acquisition of past information, have not been neglected. New developments in this area include conversational tools for individuals with dementia in the form of a touch screen reminiscence device (Alm, Ellis, Astell, Dye, Gowans, and Campbell, 2003) and a retrospective cooking display for absent-minded individuals (Pollack et al, 2003). Pollack (2005) divided cognitive support systems into 3 categories: assurance systems, compensation systems and assessment systems. According to Pollack an assurance system is technology that monitors the individual in an environment such as their home, detecting changes in activity and health for example, and reporting information to family and carers (e.g., the Digital Family Portrait; Mynatt and Rogers, 2002); a compensation system is one that uses strategies to accommodate the

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user’s cognitive impairments (e.g. Autominder, Pollack et al. 2003); and an assessment system is technology which continually assesses the user’s cognitive status in a nonclinical setting (e.g., Wired Independence Square; Carter and Rosen, 1999). This paper will specifically address compensation systems for individuals with cognitive impairment. These systems will include electronic memory aids for individuals with memory problems due to brain injury in rehabilitative care and memory support systems for older individuals with declining memory abilities. There are three goals for the present review: (1) to outline the needs of older adults, (2) to review current memory aid devices, and (3) to consider how these devices meet the users’ needs.

2. Memory and Ageing

2.1. The ageing process From birth our physical and cognitive capabilities grow and age. While some capabilities continue to develop throughout our lifetime (i.e., semantic memory or memory for factual knowledge), others decline with increasing age (i.e., episodic memory or memory for specific recent events in the past). Although elderly people today are fitter and healthier than elderly people in the past, the physical characteristics of ageing have not changed however much delayed. Physical changes that occur in the body with increasing age include the gradual depletion of functional abilities due to the decline of muscle strength, muscle power, flexibility, balance and cardio-respiratory endurance. Sensory capabilities are also affected with ageing; the most common being vision and hearing problems although taste, smell and touch sensations are also dulled with age (Huppert, 2003). Cognitive capabilities refer generally to our mental abilities by which we pay attention to the world, interpret the information around us, learn and remember, solve problems and make decisions (Huppert, 2003). Age-related differences in cognitive functioning can be seen to stem from the reduction of cognitive resources available impairing older adults’ ability to carry out cognitively demanding processes (Craik, 2000; Kester, Benjamin, Castel, and Craik, 2002). Age-related changes in mechanisms of cognitive ageing (i.e., speed of information processing, working memory function, inhibitory function and sensory

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function) are also believed to mediate the age-related decline observed in a wide range of cognitive tasks that measure cognitive behaviours such as attention, memory, reasoning and problem solving (Craik, 2000). These mechanisms are responsible for the age-related speed decline of performance for mental processes (speed of information processing), the reduction of on-line cognitive resources available at any given time to process, store, retrieve and transform information (working memory), difficulties focusing on target information and inhibiting attention to irrelevant information (inhibitory function) and problems processing information from the senses (sensory function; see Craik, 2000). To briefly portray the complexity of the question concerning whether cognitive functioning declines with age, I refer to Rogers (2000) statement concerning attentional functioning in older adults: Aspects of attention that remain intact for older adults are: selective, focused, divided, and the transition from attention-demanding to automatic processes. Aspects of attention that decline for older adults are: selective, divided, and the transition from attention-demanding to automatic processes. (p. 69) As we can see, apart from focused attention, there are the same aspects of attention in both groups. As Rogers notes, age-related differences in performance for cognitive tasks vary significantly depending on the context of the task.

2.2. Ageing and memory As with attentional functioning there are some aspects of memory that remain intact in older adults while others decline. Tulving and colleagues identified the main areas of memory as procedural memory, perceptual representational system, primary memory, working memory, episodic memory and semantic memory (Craik, 2000). Procedural memory is a term used to describe the memory system associated with the learning and retention of a wide range of motor, cognitive and academic skills. Procedural memory is relatively unaffected by ageing as the skills required are largely automatic and require minimal cognitive resources to process. Perceptual representational system (PRS) refers to the memory system responsible for the processing of sensory and perceptual information coming from the different modalities. Their function is to analyse, interpret and briefly hold incoming sense data. There is relatively little research conducted in the area of age-related PRS decline

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however it is believed that the age decline in sense functioning may affect PRS (see Craik, 2000, for review). Primary memory, which can be likened to short-term memory, refers to information still in the mind, whereas working memory on the other hand is the term used to describe information held in the mind but that is only retained temporarily. There are minimal age differences for primary memory however the age difference for working memory is significant (Craik, 2000; Kester et al., 2002; Park, 2000). Craik explains this difference by claiming that if a task requires immediate repetition of a small amount of material there is minimal age differences. If the task requires active manipulation of stored information or rapid alteration between storage and processing of incoming information is required then there is a greater age-related difference expected. Episodic memory refers to the ability to recall specific events that have happened relatively recently (Kester et al., 2002). Laboratory tasks that measure episodic memory include the free-recall of words, sentences and stories. Older adults perform comparatively poorer than younger adults on these tasks. This is thought to be because free-recall demands more attentional resources than does recognition. Older adults show more of an age-related decrement for episodic memory than for other types including primary memory, procedural and some areas of semantic memory (Craik, 2000). Finally, semantic memory refers to our memory for factual knowledge. There is ample evidence to suggest that older adults show minimal decline in vocabulary, knowledge of historical facts, knowledge of concepts and production of category exemplars (Hedden, Lautenschlager, and Park, 2005; Kester et al., 2002). Charness (2000) claimed that older adults might compensate for their decline in memory and cognition by using this preserved knowledge base. Certain aspects of semantic memory are affected by ageing including word finding and name retrieval failures (Craik, 2000). Automatic processes that require little cognitive resources are relatively preserved in older adults whereas attention-demanding tasks are greatly impaired with ageing (Park and Hall Gutchess, 2000). Park and Hall Gutchess suggest that older adults are not significantly affected by the decline in memory abilities because many tasks that they carry out, which may have initially been attention-demanding in the past have become automatic and are performed with no conscious awareness, for example the task of driving.

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2.3. Retrospective and prospective memory Memory functions can be divided into two categories by temporal direction: retrospective memory (RM) and prospective memory (PM). RM involves remembering learned information from the past (Guynn, McDaniel, and Einstein, 1998) and has been intensely studied for more than one hundred years starting with researchers such as William James and Hermann Ebbinghaus. Examples of everyday retrospective memory tasks include retrieving a phone number from memory, recognising a familiar place or recalling details of a dinner party. The majority of the literature published on age-related changes in memory is mainly concerned with retrospective abilities of older people. The past few decades have shown a gradual upsurge of interest into people’s memory for future intentions, known as prospective memory. There are various definitions of PM. Guynn et al. describe PM as remembering to do an activity in the future whereas, Cohen and O’Reilly (1996) describe it as the activation of representations of a planned action at a planned time, as well as the context of where this action is to take place. Finally, Maylor (1998) describes PM as remembering at some point in the future that something has to be done, without any prompting in the form of explicit instructions to recall. Because the interest in PM research is gradually growing, specifically in the area of older adults (Einstein and McDaniel, 1990; Einstein, McDaniel, Manzi, Cochran and Baker, 2000; Huppert and Beardsall, 1993; Huppert, Johnson, and Nickson, 2000; Maylor, 1993a,1996a,1998), the main focus of this section will be on PM. This does not mean that RM will not be discussed however as RM plays a significant role in PM processes (McDaniel and Einstein, 1992).

2.4. Prospective memory Theorists have developed several frameworks to try to explain what processes are involved in PM. Dobbs and Reeves (1996) claimed that there are six components of PM. These are: (1) metaknowledge (the general knowledge about tasks of remembering and the personal knowledge about one’s abilities and behaviours), (2) planning (construction and implementation of a future plan), (3) monitoring (remembering at the appropriate time or event that a task is to be done, (4) content recall (remembering what is to be done), (5) compliance (one’s willingness to execute the task), (6) output monitoring (remembering that the task has been executed). It is suggested that altering the nature of the PM task could consequently alter the components necessary to complete the task (e.g. setting an

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alarm would eliminate the necessity of monitoring stage). Craik and Kerr (1996) agreed that these components are necessary for successful prospective remembering however they claim that the critical and defining components involved in the processes are the planning and monitoring stages. Ellis (1996) further suggested that prospective remembering consists of five general phases: (1) formation and encoding of intention and action, (2) retention interval, (3) performance interval, (4) initiation and execution of intended action and (5) evaluation of outcome. These frameworks emphasize the multidimensional nature of PM tasks. Prospective memory is a complex memory function as it consists of the ability to remember to do future tasks at the right time and also the ability to remember what tasks need to be done and whether the task has previously been completed. McDaniel and Einstein (1992) proposed that PM consists of the interaction of multiple components, those being a prospective component and a retrospective component. The processes supporting the prospective component provide the ability for the individual to recognise a cue as a stimulus that requires further action, whereas the processes supporting the retrospective component allow the individual to retrieve information associated with the cue from memory, providing the relevant information to complete the task. Estimates of prospective and retrospective components of PM for younger and older adults (West and Craik, 2001) indicate a clear age-related decrease in estimates of the prospective component. It was seen from comparing estimates of studies that age-related differences were greater for the prospective component than the retrospective component regardless of the number of cues and intentions that were included in the task (West, Jakubeck, and Wymbs, 2002). It was suggested that these findings indicate that age-related decline in prospective efficiency can result from failures to detect PM cues and also failures to retrieve the meaning associated with the cue from memory. Furthermore, Maylor, Smith, Della Sala and Logie (2002) demonstrated that not only did young participants outperform older participants in laboratory controlled PM tasks (i.e. responding to cues in a film), Alzheimer’s disease patients showed significant deficits in the PM component of PM tasks in comparison to age-matched controls. To further explain PM, a distinction has been made between event- and time-based PM (Einstein and McDaniel, 1990). Event-based PM involves remembering to perform a particular behaviour when prompted by an external cue, such as remembering to phone a

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friend when you see a picture of her. Time-based PM involves remembering to perform a particular behaviour at a specific time or after a certain amount of time has passed, for example meeting a friend at 2pm for lunch or taking medication ten minutes after eating. Time-based PM is believed to be more sensitive to age-related decline as compared to event-based PM (Einstein and McDaniel, 1990; Driscoll, McDaniel, and Guynn, 2005; Park, Hertzog, Kidder, Morrell, and Mayhorn, 1997). This is thought to be because timebased PM relies more on internal control mechanisms and self-initiated mental activities, such as time monitoring (Henry, McLeod, Phillips, and Crawford, 2004). Maylor et al. (2002) compared these components to the priming and free-recall components of RM, where event-based PM (like priming) uses a cued response and time-based PM performance (like free-recall) uses a self-initiated response. 2.5. Prospective memory and ageing Prospective memory is vital for everyday living and failures in PM can result in a range of consequences, from missing appointments to forgetting to take medication (Groot, Wilson, Evans, and Watson, 2002). Initial studies examining age difference in PM found no significant age-related deficit (Einstein and McDaniel, 1990). Further naturalistic studies also found little age-related difference for PM tasks (see Maylor, 1993a for review of studies) however it was believed that this could be due to the use of external strategies rather than superior PM ability in older adults. More recent studies have produced the opposite outcomes with older adults displaying poorer performance compared to younger counterparts (Maylor, 1993b; Maylor et al., 2002; McDaniel, Einstein, Stout, and Morgan, 2003; West and Bowry, 2005). Einstein, McDaniel and colleagues (Einstein, Smith, McDaniel, and Shaw, 1997, McDaniel, et al., 2003) came up with some plausible explanations for the reason why older adults show an age-deficit on PM tasks. One explanation refers again to older adults’ limited resource capacity. Einstein et al. (1997) demonstrated in one of their studies that increasing the complexity of the background task while participants are carrying out a task of delayed intentions significantly affects older adult performance. Furthermore, when the background tasks demands were low, age differences were minimal. This finding coincides with Kidder, Park, Hertzog, and Morrell’s (1997) earlier study that found significant age-deficits in PM functioning when participants were engaged in a high demand working memory task. The second explanation of PM ageing (McDaniel et al., 2003) demonstrated that older adults do not strategically rehearse

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the intention of the task over the delay interval, thus maintaining the intention in working memory, whereas younger adults do spontaneously rehearse this intention. They found that when specifically instructed to rehearse the intention over the delay period older adults are more likely to remember to carry out that intention compared to older adults who were not instructed to rehearse. Younger adults showed no performance difference when instructed to rehearse compared to those who were not, indicating that rehearsal was an unconscious automatic process for them. It is believed that difficulties in PM tasks could be an early indicator for the onset of Alzheimer’s disease (Huppert and Beardsall, 1993, Huppert, Johnson, and Nickson, 2000). Huppert and Beardsall proposed that in contrast to RM tasks where participants with mild Alzheimer’s perform at a level between normal and more demented participants, individuals with mild Alzheimer’s perform just as poorly as demented participants on PM tasks (such as remembering to deliver a message). This finding suggests that remembering to execute intended actions may be particularly disrupted in the early stages of Alzheimer’s disease, however the validity of the tasks are under question (Maylor, 1996a; Maylor et al., 2002). Both prospective and retrospective abilities are required for successful functioning in everyday life (Maylor, 1996a). However, it has been suggested that PM failures have a greater impact on the lives of individuals suffering from Alzheimer’s disease and their carers compared to RM failures and therefore are more likely to be reported as an early indicator of the disease (Smith, Della Sala, Logie, and Maylor, 2000). This report was part of a questionnaire study investigating the frequency of prospective and retrospective failures in a sample of participants divided into five groups – patients with Alzheimer’s disease (rated by carers), carers of the patients, normal elderly and young participants and married couples. All groups rated PM failures as more frequent than RM failures. Furthermore, carers rated patients’ PM failures as significantly more frustrating than retrospective failures. This data highlights the effect that these failures have on patients with Alzheimer’s disease and their carers and underlines the potential advantage of a PM aid for elderly individuals with Alzheimer’s disease. Furthermore, research has shown that spouses of Alzheimer’s disease patients acting as primary caregivers are at an increased risk of chronic stress and consequently advanced cognitive decline compared to noncaregiver counterparts (Vitaliano, Echeverria, Yi, Phillips, Young, and Siegler, 2005). This

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finding again emphasises the need that Alzheimer’s patients and their caregivers have for technical assistance in the home. 2.6. Prospective memory and external aids Initial studies of prospective memory concluded that older adults outperform younger adults in tasks of delayed intention, such as sending a postcard (e.g., Moscovitch, 1982, see Craik and Kerr, 1996). It was later believed that this superior performance might be due to the use of external strategies by the older participants. Einstein and McDaniel (1990) defined external strategies as some manipulation of the external environment. There are various forms of external aids available and these can be generally categorised as environmental and portable memory aids (Kapur, Glisky, and Wilson, 2002). Of the environmental aids surrounding us, some examples include proximal environmental aids such as wall-charts, alarms and items in conspicuous places, and distal environmental aids such as road traffic signs, name badges and uniforms. Portable aids are aids that are clearly visible and easily accessible and include items such as post-it notes, diaries and electronic organisers. It has been hypothesised that older adults are more likely to use external aids to help them remember because they are more highly motivated and may be more aware of their memory impairments compared to younger adults (Harris, 1984). Many studies have found that younger as well as older adults benefit from the use of external aids, and also that individuals are more likely to use external rather than internal strategies to remember intentions (Einstein and McDaniel, 1990; Kapur et al., 2002). 2.7. Interventions research with older adults Memory interventions are a means of effectively improving memory functioning in individuals such as older adults, often using memory training strategies (Camp, 1998). According to Camp, some of the training strategies which are used in cognitive ageing research include mental imagery mnemonics training, use of external aids and multifactorial training (involves the use of multiple training strategies including imagery and method of loci, external aids, attentional skills, and relaxation training). A method that has been found to be effective for improving the memory functioning of dementia patients is a rehabilitative intervention called ‘spaced retrieval’ (Camp, Bird, and Cherry, 2000). Spaced retrieval involves the learning of new information over increasingly longer time periods and has been shown to improve a person with dementia’s ability to remember

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face-name associations, object names, location of objects and using strategies such as external aids (Camp, 1998; Camp, Bird, and Cherry, 2000). Another method of intervention, which is the main focus of this paper, is compensatory memory devices for older adults. These devices are used as external aids to support the individual’s memory with technology that is designed to meet their specific needs. 2.8. Elderly attitudes towards technology When considering the design of technology for a target population it is important to initially consider how easily the device will be accepted and adapted into the individual’s lifestyle. This is especially important when designing for the elderly user as physical, cognitive and psychosocial factors influencing user attitudes need to be considered. Although it has been established in past studies that elderly people have memory problems when compared to their younger counterparts and benefit from external aids (Maylor, 1993a), the attitude of the individual towards memory aids may influence their usage and ultimately the benefit of the aid. Several studies carried out exploring the effect of attitude on computer use (see Czaja et al., 2006) found that older adults with a more positive attitude towards computers are more likely to use a wider range of technologies. A questionnaire study was carried out to investigate community dwelling elderly individuals’ attitudes towards technology and memory aids (Cohen-Mansfield, Creedon, Malone, Kirkpatrick, Dutra, and Herman, 2005). The results of this study portrayed

interesting findings highlighting the preferences and general experience older users have with technological devices. Of the 100 elderly participants questioned, 58% said that they would be interested in using an electronic memory aid, provided it worked as it should and was affordable. The results showed that the type of person most likely to use an electronic memory aid was an individual with a high level of education, a need for external aids (i.e., problems remembering to do future tasks) and with experience using other electronic devices (e.g. calculator, computer, television, microwave etc.). All participants reported to use at least one external aid regularly with the most popular aids being calendars, address books, paper notes and alarm clocks. Participants stated that they would require an electronic memory aid to accommodate visual and fine motor problems. Where some favoured small, portable devices for easy concealment others favoured larger devices that had a large screen, large buttons and was not easy to lose. These finding are consistent with a previous study investigating older adults’ use and attitudes toward technology

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(Goodman, Syme, and Eisma, 2003). This research showed that there is an age-related decrease in everyday technology use with the exception of telephones, televisions and microwaves. Some of the problems reported by the participants as to why they do not use modern technologies included feelings of frustration and confusion when using electronic devices, a lack of understanding, fear of being too old to learn how to use new devices, the cost of devices and physical difficulties impeding usage. It can be concluded with some degree of confidence from the above studies that these issues are important to the older user and should consequently be considered when designing technology for elderly individuals. Therefore an evaluation of current memory aids for older adults will be based on their cognitive features (usability, learnability), accommodation to physical needs (visual, hearing and fine motor problems) and accommodation to social needs (affordability, size, appearance).

3. Memory Aid Devices

Compensation systems are described as memory aid devices that are designed to support the cognitive impairments of individuals and consequently improve performance (Pollack, 2005). Recent research has shown an increase in the use of memory compensation systems to examine their effectiveness in the rehabilitation of traumatic brain injury patients (Flemming, Schum, Strong, and Lightbody, 2005; Kim, Burke, Dowds, Boone, and Park, 2000; Thöne-Otto and Walther, 2003; Van den Broek, Downes, Johnson, Dayus, and Hilton, 2000; Wilson, Evans, Emslie, and Malinek, 1997). The methodologies used in these studies have included case studies following brain injured patients treatment using the technology (Wilson, Evans, Emslie, and Malinek, 1997) and also clinical trials where patients were trained to use the electronic memory aid and then measured on various PM tasks (Thöne-Otto and Walther, 2003). All of these studies yielded positive effects on memory performance with the help of the aid (e.g., participants were more likely to remember to take medication and meet appointments on time with the help of an electronic aid compared to without an aid). Since this progression researchers are now turning their focus to how these memory aids can be adapted and developed for another target user, the older adult (Thöne-Otto and Schulze, 2003). Compensation systems that have been developed for research with older adults range from simple reminders systems to home robotic support systems (see LoPresti, Mihailidis, and Kirch,

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2004; Pollack, 2005). These technologies are more concerned with supporting the users’ abilities rather than strengthening them. A summary of the information concerning the electronic memory aids reviewed in this paper can be seen in Table 1 followed by a comparison of the types of memory supported by these devices in Table 2.

Device Author

NeuroPage Hersh and Treadgold (1994) Pager

MEMOS Schulze et al. (2003) Handheld Computer, central server

MemoJog Szymokowia k et al. (2004) PDA. Remote access from PC with internet

COACH Mihailidis et al. (2000) Integrated speaker, camera and sensors. PC to monitor from distance Moderate to severe dementia Instructs user to carry out procedural actions when necessary

Autominder Pollack et al. (2003) PDA on mobile robot

Cooks Collage Mynatt et al. (2005) Integrated flat screen, cameras

Platform

Primary User

Brain injured

Brain injured/Seni ors Alert user to perform future tasks

Function

Alert user to perform tasks

Memory Impaired young to older adults Alert users to perform future tasks. Holds personal information

Normal to memory impaired older adult Adaptive reminder that alters schedule based on users actions

Young to older adult with memory impairment Displays snapshots of users previous actions to refer to while cooking

Table 1: Comparisons of Electronic Memory Aids

Memory Supported Prospective Retrospective Event-Based Time-Based

NeuroPage

MEMOS

MemoJog

COACH

Autominder

Cooks Collage

Table 2: Comparison of Differential Memory Supports between Memory Aids

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3.1. Neuropage [Hersh and Treadgold, 1994]

3.1.1. User group One of the earliest electronic memory aids introduced for memory impaired individuals was Neuropage, a portable paging system designed by the engineer father of a brain injured patient along with a neuropsychologist (Hersh and Treadgold, 1994). Neuropage was designed as a cueing system to help support PM failures in individuals with cognitive impairment. The aim of the memory aid was to maintain the individuals independence by reminding them to carry out everyday tasks such as making appointments. The popularity of Neuropage for treatment and therapy purposes arose from its simplicity and ease of use for individuals after injury. 3.1.2. Description of memory aid The device itself is a small pager which can be carried via a belt attachment. Very little learning is involved in the memory aids’ use as any schedule information is entered through a paging company. Users are issued reminders at particular times through an adjustable alarm/vibrator alert with an explanatory text message. The user can control the pager with a single large button, which makes it suitable for individuals with motor difficulties. These functions ensure that the electronic memory aid is highly usable, requiring very little input or learning from the user. The simplicity of Neuropage is a key benefit to memory impaired users and non-technology experienced users, however there are areas in which additional functions could improve its potential. For example, schedules are entered and changed through a paging company, which could act as a restriction preventing the user or carer from updating their plans directly into the system. Another issue which has not been considered in the design of Neuropage is the unpredictability of daily life. There are many situations when a user might receive a reminder at an unsuitable time, therefore the device would benefit from a reminder delay or task postponement function so that the user can be reminded at a time when they can successfully carry out the intended task. The system provides a certain level of assurance to a carer of an individual using the system, however there is no way for them to know whether a task has been carried out. For this reason it might improve the memory aid if a task confirmation was included in the design to let the carer know if an important intention was not met. Although it would be ideal to include advantageous functions, designers are also restricted

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to the technology’s integrated abilities. It can be seen from the discussion of subsequent memory aids that more recent devices have taken these issues into consideration.

3.1.3. Evaluation It cannot be ignored that Neuropage is a remarkably simple solution for reducing memory errors, a complicated area in neuropsychology. Although the device is primarily aimed at younger brain injured patients, an evaluation of Neuropage showed that older adults with brain injury also benefit from its use. Wilson et al. (1997) carried out a study in which fifteen participants’ PM performance was evaluated before, during and after using the paging system. Performance was rated depending on the participants’ success for executing certain daily tasks (e.g. remembering to take their medication, remembering to pack their lunch). The participants’ ages ranged from 19 to 66 years. The results of this study showed that all participants benefited significantly from the device with the mean success rate for performing prospective tasks rising from 37% before treatment, to 85% during treatment and falling slightly to 74% after treatment. These finding predict that despite the systems limits, it has the potential to support an independent lifestyle in memory impaired individuals of varying ages, reducing PM problems and assisting in activities of daily living. 3.2. Mobile Extensible Memory Aid System [MEMOS, Walther, Schulze and ThöneOtto, 2004]

3.2.1. User group A computerised PM aid, MEMOS, was designed to facilitate the memory impairments of patients with head injury. MEMOS combines the use of a central server which communicates with a personal memory assistant (PMA) over a wireless cellular phone network. 3.2.2. Description of memory aid The central server was developed to enable a therapist or caregiver to supervise the actions of brain injured patients outside a clinical environment. The adaptive framework of the system allows therapists to manage the treatment of the patient according to their

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present state. The system allows the caregiver to encode and input data which transfers to the patients PMA. A web-based architecture was chosen in the design to enable caregivers to access the system over a web-server, which means they can access the information from any computer with an Internet connection and browser. The PMA was designed specifically for patients with memory impairment. To accommodate for this cognitive deficit the size and usability of the device were taken into consideration making it easy to handle and fault tolerant. The PMA was designed with a few soft, clearly labelled buttons with a large display screen for text information. The device allows patients to leave a voice message relating to future appointments or tasks which they wish to be reminded of, which is then transferred to the central system for the carer to encode and input. The PMA works to support the patient in everyday living tasks sending reminders for appointments, events and other prospective tasks, providing them with feedback and step-by-step guidance. To maximise MEMOS’ relevance for supporting PM tasks Thöne-Otto and Walther applied Ellis’ theoretical framework of PM (1996, as cited in Thöne-Otto and Walther, 2003) into the design. As previously mentioned, Ellis claimed that the process of PM takes place over five stages: formation and encoding, retention interval, performance interval, initiation and execution and evaluation of output. This application to the model can be seen through the following: • • • • Formation and encoding: the patients can speak their appointments into the

device which can then be decoded by a carer from the central system. Retention interval: system restricted to time-based information Performance interval: alarm can be adapted for the individual with a large

display for information. Initiation and execution: users are guided through intended action through

step-by-step instructions. The device is programmed so that completed actions have to be confirmed and steps can be adapted on request. • Evaluation of outcome: direct contact can be made to carer if confirmation

is missed. System searches for future appointments which may conflict if an intended action is postponed.

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3.2.3. Evaluation An evaluation of MEMOS was carried out with six patient participants. For this study Walther, Schulze and Thöne-Otto (2004) compared patients’ performance using commercially available electronic memory aids (palm pilot and mobile phone) with performance using the PMA from MEMOS. Participants were required to execute six experimental tasks over different phases of the study, a two week baseline period, followed by two weeks using one of the commercial aids and then two weeks using the other. The next phase took place approximately a year later where participants were again tested during a baseline period followed by a two-week period using MEMOS. Overall the results from these tests showed all the electronic devices improved participant task performance when compared to baseline performance however performance was highest for the PMA. The design of MEMOS is currently under evaluation to adapt it to accommodate its usability for older users (Thöne-Otto, and Schulze, 2003).

3.3. Memojog [Szymkowiak, Morrison, Shah, Gregor, Evans, Newall et al., 2004]

3.3.1. User group Another mobile memory aid, Memojog, was introduced by Szymkowiak et al. (2004) to support user’s memory for prospective tasks. Memojog contains many features similar to the MEMOS device (Thöne-Otto, and Schulze, 2003). One distinct difference however is that Memojog was specifically designed with features to accommodate the limitations and requirements of the older user.

3.3.2. Description of memory aid Memojog is composed of three main elements which contribute to its function; a PDA device for the elderly user, a central server and a database that can be accessed through any computer with Internet access. Any information including the input of action prompts or changes to the users schedule can be entered from either the PDA or web based database, both of which communicate with the central server by the user, caregiver or care professional. Alternatively the user can contact an administrator who can then make any

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necessary changes to the user’s schedule. Text based action prompts with an accompanying alarm are issued to the user to remind them of prospective tasks. These reminders can be accepted, postponed or ignored by the user. If the user accepts the reminder it is assumed that they are reminded and are able to execute the action at that time. If the user chooses to postpone the reminder, another reminder is issued after a certain amount of time. Finally, if the user was not alerted to the reminder or fails to either accept or postpone it, the caregiver or care professional is informed by data transmitted back to the server concerning the user’s response. A contributing social benefit of Memojog is that it is equipped to store personal information for the user, with applications such as a phone book, address book and a store for birthdays, etc.

3.3.3. Evaluation Two field evaluation sessions were executed with a group of older adults and their carers. The participants were trained to use the device and were subsequently required to use it for 12 weeks. In the first evaluation four participants (mean age of 60) with memory impairments were asked to perform 10 selected tasks using Memojog and were also asked to rate how difficult they considered each task to be on a 7 point scale. This procedure took place directly after training and again three weeks into the participant’s use of the device. On average participants rated the device no more difficult than a rating of neutral (4 on the scale of 7). Participants were happy with the hardware of the device, were impressed with the multi-functional aspect for storing personal information and reported that they appreciated that the device reminded them of tasks accurately. This is particularly important, as any errors would reduce the users trust in the device. Of the negative comments recorded, the most significant was the user’s ability to obtain coverage when changing or updating their schedule. This is frustrating to the average user but could cause considerable confusion to a memory impaired elderly user. Some users also found problems with the alert function of the device. The authors acknowledged that a multimodal input/output mode would be more appropriate to the older user, especially for those with hearing and visual impairments; however this technology was not available on the PDA hardware used for the memory aid. Similarly, users found difficulty with the touch screen keyboard but yet again this was an integrated part of the PDA device. The second evaluation of Memojog yielded similar results. Participants in this trial however also found difficulty using the touch screen on the PDA device, as it was not

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sensitive enough requiring several interactions to produce a response. These evaluations produced results which imply that elderly individuals can successfully use modern electronic devices without any major difficulties.

3.4. Autominder [Pollack, Brown, Colbry, McCarthy, Orasz, Peintner et al., 2003]

3.4.1. User group One of the most advanced technological designs in this paper was developed as an adaptive PM aid called Autominder (Pollack et al., 2003). Autominder was designed on a mobile robot platform with an integrated screen display for older adults to help them adapt to cognitive decline and assist them with tasks in their home environment. Pollack and her colleagues predict that Autominder has the potential to prolong an older adult’s independence and prevent early institutionalisation for users with memory impairment. 3.4.2. Description of memory aid Autominder is described as an intelligent cognitive orthotic system (i.e., assistive technology for cognition), which issues prompts about prospective tasks to the user at appropriate times. The difference between Autominder and previous PM aids is that it has the ability to adapt the user’s schedule depending on the behaviour detected by sensors installed throughout the home. The device reasons about whether and when to issue reminders to the user based on their observable actions and task execution. For example, if an individual is required to drink five glasses of water a day the device will be programmed to issue a reminder to cue the user to drink their water. If however the device observes that the user has entered the kitchen, opened the glasses cabinet and turned on the water tap, it reasons about whether the user has already had the required drink and decides whether or not it is appropriate to remind the user to drink some water. The benefit of this intelligent memory aid is that it prevents the user from being reminded about tasks that they have already carried out, which may be frustrating or confusing to individuals with memory impairment. The architecture of Autominder is composed of three main components; the plan manager, the client modeller and the personal cognitive orthotic (Pollack et al., 2003). The plan manager is responsible for the storage of the daily activity schedule of the user and

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updates this schedule when appropriate, identifying and resolving conflicting activities. The second component, the client modeller, is responsible for monitoring the user’s behaviour using information from the board sensors and storing assumptions about the execution status of these activities in the client model. The final component, the personal cognitive orthotic (PCO) is responsible for the reasoning between what the user is supposed to do and what they are doing and whether or not to issue reminders. Most people’s daily lifestyles are flexible, and whether or not schedules are planned, activities are likely to be cancelled or modified throughout the day. The authors claim that Autominder contains the intelligent architecture to adapt to a persons unpredictable daily plan, relieving the user from personally altering their new schedule into the system where it is not necessary. The device’s adaptive nature deciphers whether to modify or delete planned activities based on the information received from the integrated sensors. The device may ask for verification of the user’s actions if it cannot make this decision and to avoid assumption failure. This suggests however that the observable information is not always reliable. Assumption failure if it occurred may lead to various problems, especially for those with severe memory impairment. This failure could cause confusion to the user, disrupting their routine and may produce trust issues towards the device. As noted previously, Autominder is a very advanced and intelligent technology mediated memory aid with impressive abilities for helping older adults in their home. For the older user this quality may appear intimidating however, as elderly individuals who have not grown up with technology, or worked with it may feel apprehensive and wary of a mobile robot to act as a memory aid. As the population grows older more people will have experience using and relying on technology (i.e., PC’s, mobile phones etc.), therefore the acceptance of Autominder into people’s homes may increase in years to come. According to Pollack (2005), preliminary field tests have been carried out with older adult and brain injured users however systematic studies investigating the effectiveness of Autominder have not yet been completed.

3.5. Coach [Mihailidis, Fernie, and Cleghorn, 2000]

3.5.1. User group Dementia is a progressive disease that affects individuals cognitively and consequently limits their abilities for executing everyday tasks, eventually forcing them to

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become heavily dependent on their carers to assist them in the later stages of the disease. Technological devices have been developed to assist individuals with memory impairments however they are usually limited to users with early dementia (Szymkowiak et al., 2004), as it is believed that these users still have the potential to learn new techniques and are more willing to try new strategies to help them manage symptoms. An alternative to this idea was introduced as a computerized cognitive orthosis called COACH (Mihailidis, Fernie, and Cleghorn, 2000). COACH was designed as an instructional memory aid for users with mild to severe dementia to help them perform everyday tasks in the home with less dependence on their carers. The initial prototype of COACH was designed to assist individuals with a hand-washing task in a bathroom setting. Although procedural memory for tasks such as hand washing is relatively preserved in individuals with dementia, degeneration is displayed in the late stages (Bourgeois, 2002). COACH encompasses both prospective and retrospective memory in that it provides cues to initiate future actions but it is required for procedural tasks. Aside from promoting independence for the user, COACH could provide assistance in place of a carer in a bathroom environment avoiding any possible embarrassment.

3.5.2. Description of memory aid The architecture involved in the workings of COACH consists of a video camera installed in the washroom which monitors the user’s progress, a speaker inside the washroom which issues pre-recorded prompts to the user and a computer outside the area for the carer to track the user’s progress. It was observed during baseline testing that dementia sufferers often needed verbal prompts from their carers for different stages of the hand washing task and sometimes needed the carer to help them physically, such as putting the towel in their hands. The aim of the device was to substitute the carer’s prompts for computerized prompts. The system works by tracking the user’s actions and issuing cues from the speaker only when it is detected that the user had either not initiated a task or had initiated a task out of sequence (e.g. using the soap before wetting their hands). This reduces the possibility of the person becoming over-reliant on the device. A second prompt is issued if the first was ignored. If this is again ignored the carer is alerted to the remote computer, informing them that the person is in need of assistance and for what stage in the sequence of the task.

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3.5.3. Evaluation The main benefit of COACH is that it is not cognitively or physically demanding on either the user or the carer. There is no learning involved in its use and no input required. The output is hearing dependent only, which means that the user does not have to read text from a screen or manipulate small buttons on devices they are not familiar with. Findings from a study examining the effectiveness of COACH found that nine out of ten participants improved task performance and completion for hand washing (Mihailidis and Davis, 2005). A few problems presented themselves during the study however. For example it was observed that some individuals showed signs of agitation from the computerized recording. This problem could possibly be resolved by simply substituting the computerized voice with a human voice. It was also found that on occasions the prompts were issued too quickly or were issued for tasks already executed. This problem may have been resolved after the evaluation as it is claimed that the device adapts to the idiosyncrasies of the users performance. Overall COACH could be a valuable computerized memory aid to assist individuals and their carers in their home environment.

3.6. Cooks Collage [Tran and Mynatt, 2003]

3.6.1. User group As can be seen from the previously discussed electronic memory aids, designers have focused their attention primarily on prospective aids for memory impaired users reminding them to carry out activities of daily living, generally to make appointments on time, to take medication appropriately and to carry out any other necessary tasks in their day to day lifestyle. Tran and Mynatt (2003) developed a slightly different type of memory aid compared to these in that it focuses on just one activity of daily living; cooking.

3.6.2. Description of memory aid Cooks Collage was developed as a retrospective memory aid for absent-minded individuals to refer to while cooking, to help cue them for their next cooking action. The technology consists of a flat screen monitor installed in the cooking area at user eye level. Two cameras are also installed in the kitchen to capture countertop images, which are transferred to the screen for the user to view. Displayed on the screen are six action images in time sequence with the most recent image at the bottom right hand corner of the

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screen, highlighted to make it stand out for the user. The idea behind this device is that the camera captures the cook’s actions, taking picture images whenever the cook adds a new ingredient into the mixture. If an ingredient is added a number of times throughout the process the frequency number of the action is displayed on the most recent image, with corresponding slim grey bars preceding the image. The user is required to display the ingredient clearly so that the system recognises it. The authors claim that with the help of this system the user should be able to scan the most recent action images and continue where they left off without any ambiguity or delay.

3.6.3. Evaluation Although Cooks Collage is ultimately designed for older adults, it was initially tested and evaluated on younger adults (Mynatt and Rogers, 2002). This process may be easier in the short term in terms of gathering participants, however the data collected may not be useful for the particular design. Cooks Collage was evaluated by sixteen undergraduate participants (Tran and Mynatt, 2003). The users were asked to cook something from a given recipe and their reactions to interruptions were observed. The participants’ action slips were also recorded along with their perceived performance. From this study it was found that the participants’ perceived performance was more accurate than their actual performance. The participants also underestimated the perceived effect of the interruptions. These results show that interruptions do potentially have an effect on a cook’s memory for what they are doing or have done during the process. There are many cognitive benefits to Cooks Collage in that it requires no input from the user and very little learning is involved. Images are presented sequentially in a left to right order which is a familiar display of information to most people. Only visual output is available to the user which might restrict its use for the elderly population, many of whom have visual impairments. However, the designers argue that any audio output would be absorbed into a noisy cooking environment (Tran and Mynatt, 2003). It is also argued that any form of interaction with the screen would only be an inconvenience taking into consideration a cook’s “messy hands”. On the other hand, the six images displayed may be too small for an elderly user to see any important detail i.e. the ingredient that they added. Therefore it may be useful if the user could temporarily enlarge an image of interest to see the details more clearly.

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More recent studies examining the usefulness of Cooks Collage and how users interact with it have focused on older users (Tran, Calcaterra, and Mynatt, 2005). A case study following one older and one younger adult showed that the older user was more dependent on the device after interruptions during cooking, using it to provide real-time feedback while the younger user mainly used it to confirm or verify their actions. It was also observed that both users developed different strategies while cooking with the memory aid. For example, the older user prioritised the cooking tasks over the interruption tasks whereas the younger user prioritised the management of interruptions. A number of limitations were noted regarding how users interacted with the device. For example, several counting errors were made by the device where the ingredient was not displayed clearly to the cameras which resulted in mistakes in the cooking. There was a time delay from when the user added an ingredient to when it was displayed on the screen; therefore the older user delayed her actions waiting for the system to catch up. It was also observed during the study that the younger user was unsure about a previous action but could not verify it with the memory aid as only the six most recent actions are displayed. These limitations could be frustrating to a user however further research and iteration could improve its usability.

4. Discussion

Ageing is one of the highest risk factors of cognitive decline and has been shown to be associated with the accumulation of pathologies contributing to the development of cognitive dementias, the most common being Alzheimer’s disease (Keller, 2006). Technology is ubiquitous in today’s society yet designers are only beginning to look into how these devices can help an ageing population. Ageing and dementia affects both retrospective and prospective functions of memory however research has shown that prospective errors can have more of an effect on an individual’s daily lifestyle compared to retrospective errors (Smith et al., 2000). With this in mind it is understandable why the majority of the memory aids reviewed here focus mainly on PM tasks. The overall purpose of the compensation systems discussed in this paper was to increase the user’s independence by assisting them with activities of daily living and consequently relieving their carers somewhat. Research has shown that both normal ageing (Maylor, 1993b) and elderly individuals suffering from dementia (Nolan, Mathews, Truesdell-Todd, and

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VanDorp, 2002) display enhanced performance on memory tasks when using external aids. These findings support the design of electronic memory aids for elderly individuals with cognitive decline. It is important for the successful design of a device for a number of factors to be considered. In the case of a PM aid, the designer should consider whether the device supports both the prospective and retrospective components of PM and whether the reminders issued are useful to the user. For the design of retrospective aids it should be considered whether the information displayed is accurate and of benefit to the user. These design issues can be applied to the devices discussed in this paper. For example, the device Memojog was designed to support both PM (issuing reminders to the user) and RM (storing personal information for the user to look up). The device supports the prospective and retrospective components of PM as it issues a reminder to the user alerting them that they have something to remember and it also gives a brief description of what that task is. The reminder is useful to the user as it is issued at a particular time in advance of when the task is to be executed and the reminder is displayed in a way that is clear and comprehensible. Above all, it is the user’s attitude and preference towards a device that predicts its success. This point was made apparent from findings brought about by Cohen-Mansfield et al.’s (2005) questionnaire study investigating elderly attitudes towards technology and memory aids. This study, supported by previous studies (Goodman et al., 2003), established that cognitive, physical and psychosocial factors are important to elderly individuals concerning the design of technology mediated memory aids. A summary of how the electronic memory aids, Neuropage, MEMOS, Memojog, Autominder, COACH, and Cook’s Collage meet the needs of the older user in terms of these factors is displayed in Table 3. Several questions could be considered to determine what features are appropriate and important for the design of an electronic memory aid for an older user in terms of these needs. 4.1. Needs of the older user 4.1.1. Cognitive needs Older adults are more likely to show memory failures than younger adults and ageing is one of the highest risk factor for the development of cognitive disorders (Keller, 2006).

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Therefore it is critical that an electronic memory aid device provides sufficient support to the intended user and is designed with an older user’s abilities and limitations in mind. To establish whether the electronic memory aids meet the cognitive needs of the elderly user several questions were put to the design: • • • • • What type of memory does the aid support and does it do this successfully? Is the device usable for the intended user and would a cognitively impaired

elderly user be able to interact with it? Is any input required from either the elderly user or carer? Can the user or carer obtain feedback from the device to inform them of

their position? Is there flexibility allowed by the device to suit the user’s current situation?

4.1.2. Physical needs The issues surrounding the physical needs of the user cover a wide range of usage issues. It is the physical design and the output information which is in question here. This includes how information is displayed (e.g. text, alarm, vibrator, voice etc.), how information is inputted (e.g. touchscreen, buttons etc.), and whether the system is mobile or portable: • • Does the device cater for visual/auditory/motor decline? Is the device or information from it easily accessible for the user or carer?

4.1.3. Psychosocial needs Goodman et al.’s (2003) study highlighted what social factors determine older adults attitude towards technology. They showed that older participants were less likely to use new technologies as they did not want to show an outward lack of understanding towards technology, and that they wanted to avoid feelings of frustration and confusion if they did not understand it. It was also reported that it was important for a device to be easily concealed and affordable. With these issues in mind the following questions should be considered when analysing technology for older users: • • • How much interaction is required of the user? Is any training needed for its usage? Is the size of the device appropriate for its intended use?

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Does the design of the device stand out from other technology devices? Is the cost of the device reasonable?

4.2. Evaluation of devices To evaluate the current memory aids the needs of the target user can be again divided into the three categories, cognitive, physical and psychosocial, and the questions outlined above can be put to their design.

4.2.1. Cognitive issues From the six memory aids reviewed, five of them support PM tasks. As PM tasks contain both a PM and a RM component (McDaniel and Einstein, 1992) the devices not only remind the user of future tasks but also store the information that is to be remembered. From the literature concerning the design of these systems and based upon the published evaluations, it appears that these technologies support the type of memory that was intended. The usability of each of the systems can again only be determined by these evaluations, which for all devices prove to be more beneficial to users’ performance on delayed intentions than internal strategies alone. In relation to whether or not the devices require input from the primary users, it can be seen from Table 3 that only MEMOS, Memojog and Autominder contain this function. This has both positive and negative effects, the former being that the user has control over what information is inputted into the device and the latter being that users may not feel confident entering information or it may be too complex, particularly in the case of cognitively impaired individuals. In general external memory aids act as a form of prosthesis or compensation for everyday memory function, providing cues to the users to initiate an action (Kapur et al., 2002) rather than improving the user’s memory. According to Harris (1984), “An active reminder obviates the need for monitoring because it eliminates the prospective aspect of the memory task leaving just the retrospective one” (p. 89). This is true of the five PM memory aids described here. The users are not required to time monitor during the delay period as the devices are programmed to alarm the user at appropriate times and thus the amount of attentional resources required to carry out the intention is reduced. These devices support time-based PM functioning, which is particularly beneficial to older user as

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it is age sensitive (Einstein and McDaniel, 1990; Park et al., 1997). Autominder and COACH also have the ability to support event-based PM functioning as they have the ability to adapt their reminders based on observation of the user’s actions. A positive attribute of the COACH system which is lacking in the other devices is that it only issues cues to the user when they are needed, reducing the chance of the individual becoming dependent on the system. As Dobbs and Reeves (1996) outlined in their framework of PM functions, the last phase of the process (output monitoring) requires individuals to remember whether a task has been performed. We already know that older adults have poorer PM compared to younger adults (Maylor, 1996b; Einstein, et al., 2000; West and Bowry, 2005) and that individuals with dementia are further affected (Huppert et al., 2000; Maylor et al., 2002), therefore it can be predicted that a PM aid with a feedback function would considerably benefit older users. From the literature we are told that MEMOS, Memojog, COACH and Cook’s Collage contain this function for either the primary user or caregiver to observe. Overall these memory aids are successful in their aim to support either the PM and RM of the target users and have emphasised the importance of clear and simple designs, particularly with Neuropage. Furthermore, more recent designs such as Memo’s and Memojog have taken on board issues that were not met in former designs again like Neuropage. Ideally, it would be more appropriate for older adults to use technical systems that they are familiar and comfortable with to help them perform daily activities, however this issue may be resolved in coming years as the number of technology users coming into late adulthood increases.

4.2.2. Physical issues As briefly outlined previously in this paper there are physical aspects that show agerelated declines in task performance with a decrease in both functional and sensory abilities (Huppert, 2003). Fisk, Rogers, Charness, Czaja, and Sharit, (2000) suggested that in order to enhance the likelihood that older adults will successfully adapt to technical devices, issues of visual and auditory perception should be stressed as these senses are the most affected by ageing. These issues are, to a point, acknowledged in the design of the current memory aids. All of the devices are dependent on at least one functioning sense. For example, Cook’s Collage requires functioning vision and COACH requires functioning hearing to make use of the aid. The other memory aids, such as Neuropage,

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MEMOS, Memojog, and Autominder use both visual and auditory output. All of these devices use sound adjustable alarms to obtain the user’s attention with Nuropage having the added function of a vibrator alert. Text is the most common form of reminder output, however it is suggested that Autominder might also make use of speech synthesis for relaying explanatory messages. In most of these cases the potential of the memory aid is limited by the systems hardware (Hersh and Treadgold, 1994; Szymkowiak et al., 2004), a problem which has to be expected when using commercial devices (e.g. pagers, PDA’s, mobile phones etc.). Szymkowiak and colleagues note that the use of commercially available PDA’s do not offer multi-modal output such as vibrator alert, speech output etc. They also suggest that the design for entering information could be improved as difficulties using the touchscreen keyboard were found, particularly when user’s wanted to increase the text size. In terms of motor functioning, all of the memory aids were integrated on devices suitable for portability in the cases of Neuropage, MEMOS, Memojog, and Autominder, or were easily accessible, such as Cook’s Collage and COACH. The portable memory aids used lightweight devices such as pagers and PDAs with the exception of Autominder, which was integrated on a mobile robot. It was also noted that a touch-screen function was the main mode of interaction for all devices apart from COACH. Neuropage used only one large button for user interaction increasing its ease of use. These functions enhance usability for users, such as elderly individuals, who might have fine-motor difficulty (Fisk et al., 2000).

4.2.3. Psychosocial issues It is predicted that if older adults accept and use technology mediated memory aids to support PM and RM memory functioning, they could sustain their independent lifestyles for longer. The design of the memory aids predicts whether the older adult will accept and use these memory aids. The first issue to be considered is the amount of interaction that is required of the user to use the memory aid and whether its benefit outweighs other external aids, such as calendars. Firstly, COACH and Cook’s Collage requires little or no interaction from the user. Neuropage requires only for the user to accept and read their reminder whereas MEMOS, Memojog and Autominder require the user or caregiver to enter the user’s schedule and to accept or postpone reminders. Autominder is designed to

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automatically alter the user’s reminders depending on observable behaviours, thus, reducing the user’s need to manually change their schedule into the device. Information can also be entered via an external computer by individuals such as care professionals, if either the primary user of caregiver does not feel confident to do so. These functions might decrease the apprehension elderly people feel towards technology (Goodman et al., 2003). From the literature it seems that all researchers allow training time for participants before the devices were evaluated. Although a device should ideally require little or no learning, training with an instructor, a video or manual would help familiarize the user with the system, increasing their confidence and comfort when using the memory aid alone. Another issue to be considered is whether the device will cause embarrassment to the user, amplifying their difficulties to the public. The portable memory aids discussed here are all small devices that can be easily concealed, with the exception of Autominder that is meant to be used in the home. They also use commercially available hardware systems which are ubiquitous in today’s society making them indiscernible as memory aids and also moderately affordable, important features to older users attitudes according to CohenMansfield et al. (2005) and Goodman et al.’s (2003) findings. Cohen-Mansfield and colleagues (2005) found that individuals who were most likely to use an electronic memory aid were those with a need for external aids and who had experience using electronic devices. They also found that all participants used at least one external aid. Therefore it follows that an important influencing factor predicting older adult’s use of electronic memory aids is their familiarity with technology. This highlight the importance of good training material incorporated before the memory aid devices are used. Each of the memory aids contained unique features of psychosocial importance that set them apart from the other designs. For example, COACH allowed late stage dementia patients more independence in the restroom, reducing social embarrassment; MEMOS allowed users to contact a caregiver in crisis situation; Memojog provided a function for users to store personal information such as family details; Autominder adapted to the user’s behaviour eliminating unnecessary repeated actions; Neuropage provided a simple solution for patients to help them gradually assimilate back into their normal lifestyle; and Cook’s Collage acts as an action reference taking some pressure off harassed absentminded cooks.

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5. Conclusion and Future Research

Much work has been accomplished in relation to PM and compensatory memory devices to support this function in both normal older adults and cognitively impaired older adults, as can be seen from this paper. The overall purpose of the systems is to prolong the individuals’ independence in their home. However, there is a fine line between the user being independent with the help of a memory aid and being over-dependent on the technology itself. For this reason, it is important that these technologies are designed to act as a support for the user rather than a substitute carer. Future research might take on board the limitations of the systems discussed to produce a device which has both multi-modal input and output to accommodate for agerelated physical and cognitive decline.

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236
Memory Aid Physical Cognitive NeuroPage Small and portable. Alarm/vibrator alert, with text: multimodal. Large button to control, easy to use even for motor impaired. Small screen. PM aid. Requires little user input. Input dependent on paging company, may act as limitation but useful for inexperienced tech user. No way for user to confirm action completed or delay reminder. MEMOS PM aid. Input entered by user via handheld computer or carer/professional carer via central server. Task confirmation function and reminder delay function. Emergency contact function. Little learning involved. Portable, lightweight device. Users can leave voice messages if they want to input data which is then decoded from central server. Quite a large screen for visual display with a few clearly labelled soft buttons. Alarm can be adapted for user. Small portable device. Quite a large visual display. Adaptable alarm. Keyboard integrated into hardware caused problems when inputting information. MemoJog PM aid. Requires schedule input from user or carer. Task confirmation function, carers contacted if task not confirmed. Minimal action steps. Coverage problems reported when modifying diary. May cause confusion to cognitively impaired users. Instructive memory aid. Encompasses prospective and procedural memory. Requires no input from user. Carer can observe users progress through computer. Short instructional prompts given only if action is not carried out of completed. Reduces dependence on aid. PM aid. Flexible reminder system which adapts the users schedule depending on the users actions and makes assumptions about these actions. Schedule inputted by carer with user. Could potentially make assumption failures and result in over reliance of system. RM aid for cooking. Interruptions, absentmindedness and action slips. Requires no input or learning. COACH Audio output from integrated speakers. Hearing dependent. Autominder Device set into mobile robot to be used in home environment. Works with visual display and sensors. Robot includes sensitive displays, microphones for speech recognition and speakers for speech synthesis. Screen can be implemented to suit height of user for viewing. No input required. Only visual output, i.e. visually dependent. Images may not be clear to an elderly user. Cooks Collage

Psychosocial

Very small device, therefore easily concealed. Promotes independence for activities of daily living.

Small portable ubiquitous device. Promotes independence for user. Assists as contact device in crisis situations (user confused or disorientated).

Small portable device. Holds personal information (family details). Carers not reliant on others to input data as device easy to use. Promotes independence for both user and carer.

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Promotes independence for user for procedural tasks which may be affected in late dementia. Reduces embarrassment for individual if help is need in washroom.

Adaptive functions allow user to change their routine without updating system. Automatic search for best schedule update. High technology device. Some elderly users may be apprehensive using it

Table 3: Evaluation of how electronic memory aids discussed in the literature meet the needs of the older user.

Promotes independent cooking. Could be seen an item of prestige. Can be used by people of all ages therefore users not seen as incapable if using.

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PsychNology Journal, 2006 Volume 4, Number 3, pp. 245-265

An Investigation into Older People’s Browsing Activities
Prush Sa-nga-ngam
♣ ♦♣

, and Sri Kurniawan ♣

School of Informatics, the University of Manchester (U.K.)

ABSTRACT
This paper presents quantitative data on browsing activities with 63 respondents aged 55 years old and over from three countries. The questionnaire explored frequently browsed topics, browser's functions used, browsing tasks performed, problems with standard browsers and features to add to a standard browser to make it more ageing-friendly. The study revealed various aspects of Internet uses, including the topics accessed and places of access, browsing tasks, problems and assistive features required. This study makes several contributions to the field. First, it provides comprehensive account of older persons’ browsing activities. Second, it uses Exploratory Factor Analysis to unravel the underlying factors beneath older persons’ browsing tasks. Finally, this is a cross-country study, which arguably makes the findings less susceptible to cultural bias.

Keywords: Ageing, web browsers, elderly, older adults, human computer interaction. Paper Received 27/07/2006; received in revised form 30/11/2006; accepted 12/12/2006.

1. Introduction According to the US Census Bureau, by 2030 the world’s older population would have increased by at least 50% (Mann, 2004). Previous research has shown that the Internet can potentially help older persons maintain their independence and improve their quality of life (Helander, Landauer, and Prabhu, 1997). It is therefore encouraging that older people’s adoption of the Internet rose quite dramatically in the past few years. A survey performed in February 2006 revealed that 72% of Americans aged 5159 years old, 54% of 60-69 years old, and 28% of 70-79 years old went online(Fox, 2006). In 2005, 42% of people 55-64 years old living in the UK and 14% of people aged 65 and older used the Internet (Richards, 2006). However, whilst this trend is echoed throughout most of the Western countries, it is not yet the case in other parts

Corresponding author: Prush Sa-nga-ngam School of Informatics, the University of Manchester PO Box 88, Manchester M60 1QD, UK Phone: +44-161-306-3744 Fax: +44-161-306-3324 e-mail: prush.sa-nga-ngam@postgrad.manchester.ac.uk

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of the world. For example, only 3.2% of Thai population aged 50 years old and older were online in 2004 (National Electronics and Computer Technology Center, (2005). A survey on older adults’ use of computers in 2003 shows that the World Wide Web and e-mail are the most commonly used applications (Goodman, Syme, and Eisma, 2003). However, the survey also shows that the use of the web and e-mail declines with increasing age due to decline in perceptual (visual and auditory), cognitive (attention and memory) and motor (mostly haptic) capabilities. Decline in visual acuity necessitates adjustment in the presentation of information (e.g. font, contrast, size) (Helander, Landauer, and Prabhu, 1997); while cognitive decline impairs user ability in interacting with complex systems; memorizing commands and text; and handling complex layouts (Salthouse, 1996). As some studies had shown, older persons face unique problems when using the Web. For example, even when older persons were able to complete most of information search tasks, they took more steps to find the information than did younger persons (Meyer, Sit, Spaulding, Mead, and Walker, 1997). A number of approaches aimed at addressing the problems faced by older people when interacting with the web were reported in detail in (Kurniawan, Evans, King, and Blenkhorn, 2006). The first approach concerns the application of accessibility guideline (e.g. W3C). However, even if a website is fully compliant with these guidelines, there is no guarantee that it will be usable for older users, mostly due to the large individual differences among older persons, which makes accommodating all users at the design stage difficult. The second approach uses a specially designed browser, which allows reformatting of web pages to account for impaired spatial ability or severe visual impairment (e.g. by linearising web pages, enlarging text and possibly diagrams, or voicing text) and creating a custom interface that can directly address ageing-related decline. An example of this system is BrookesTalk (Zajicek, 2001). The problem with this approach is that it requires significant development effort to cope with rapidly changing technology and it duplicates the features of standard web browsers. A closely related approach that suffers from similar technological difficulties is the use of a transcoding proxy server to reformat web pages on a machine between server and client (Fairweather, Hanson, Detweiler, and Schwerdtfeger, 2002). This approach is not popular with the older generation as they require additional installation (in the case of specially designed browser) or knowledge of the URL of the proxy servers (in addition,

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proxy servers cannot handle encrypted transmission such as when accessing secure sites, which makes most online shopping activities impossible). The third approach uses a standard web browser (such as Microsoft Internet Explorer or Mozilla Firefox) and its own accessibility features, often with added assistive systems such as a screen magnifier or a screen reader, especially for users with severe impairments (Blenkhorn, Evans, King, Kurniawan, and Sutcliffe, 2003). Unfortunately, screen magnifiers and screen readers provide minimal information about the global context (Kurniawan, King, Evans, and Blenkhorn, 2003). Various studies showed that using a standard web browser and its accessibility features is the most used and useful approach by older persons (as long as the websites were designed with accessibility in mind, such as by using relative font and table sizes) (Kurniawan, Evans, King, and Blenkhorn, 2006). However, there are some questions that the studies reviewed above did not answer thoroughly. Those are: 1. Does the applications that older persons use for browsing play a role in helping or hindering their effective use? A 2003 study on older adults' use of computer using a questionnaire and interviews with 353 participants over the age of 50 reports that difficulties with computer interactions are usually caused by the complexity of applications and their documentation, in contrast, only three participants mentioned physical difficulties (e.g. visual or motor) (Goodman, Syme, and Eisma, 2003). This forms one motivation of the reported study: the investigation of the use of various functions of a standard web browser. 2. How can this knowledge be translated into improving a standard browser to make it more ageing-friendly? The above questions can be broken down into three sub-questions: 1) What and how do older persons browse online? 2) What functions in a standard browser do they use? 3) What functions can be added to a standard browser to make it more ageingfriendly? This study aims to answer these questions using a questionnaire. Questionnaire was chosen purely due to practicality reason: it allows us to reach a large number of participants in a limited amount of time. As Tim Berners Lee stated, the web is designed as a universal space. Therefore, we felt that it would be useful to gather data from more than one country (ideally representing more than one continent). The data are gathered through paper questionnaire mailed or hand-delivered to elderly organizations in three countries: UK, USA and Thailand (the questionnaire was translated into Thai for respondents from

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this country). The questions in that questionnaire were derived, using content analysis technique, from various studies on older people and web browsing ( Kubeck, 1999; Hanson and Richard, 2004). The choice of paper questionnaire was made after consulting some instructors in senior centres, who indicated that older persons often hesitated to fill in online surveys due to privacy concerns. The questionnaire was then piloted with 2-3 respondents from each country. It was during this pilot study that the suggestion to use the word ‘Internet’ to represent ‘web browsing’ was made (as in ‘Internet experience’), as for many older persons the word ‘Internet’ was more familiar and was synonymous with ‘web browsing’. 2. Stimuli and Participants The questionnaire was printed on standard paper with black ink in Tahoma 18pt. It was distributed during the months of March-April 2006. The questionnaire is available from the contact author. The inclusion criteria for participating are that they had some Internet experience and that they were 55 years old or older at the time of the study. The respondents were 10 Thais (9F/1M), 40 British (25F/15M) and 13 Americans (8F/5M). Out of the 10 Thai respondents, nine were 55-59 and one was 60-64 years old. A quarter of the UK respondents were 70-74 with the remaining three quarters spread equally in other age brackets. Eight out of the 13 US respondents were 65-70 years old. Table 1 provides the breakdown of their Internet and computer experience, which were investigated through the following three questions: 1. How long have you used computers? (Options: 1 = Less than 6 months, 2 = 6-11 months, 3 = 12-23 months, 4 = 2-5 years, 5 = More than 5 years). 2. How long have you used the Internet? (Options: 1 = Less than 6 months, 2 = 611 months, 3 = 12-23 months, 4 = 2-5 years, 5 = More than 5 years). 3. Internet usage per week (Options: 1 = Less than 5 hours, 2 = 5-9 hours, 3 = 1019 hours, 4 = 20 hours or more). Thailand Computer Experience Internet Experience Weekly usage 4.6 (0.97) 3.8 (1.55) 1.8 (1.14) UK 4.4 (1.03) 3.7 (1.59) 2.5 (1.40) USA 5.0 (0.00) 5.0 (0.00) 3.7 (0.48)

Table 1. Respondents’ Computer and Internet Experiences. Numbers show Mean (S.D.)

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In term of computer experience, almost all respondents stated that they had used computers for more than 5 years (all of them, in the case of US respondents). All of the US respondents also stated that they had used the Internet for more than 5 years, while the Internet experiences of the UK and Thai respondents varied considerably. The weekly access frequency also varied; with the Thai respondents mostly accessing the Internet for less than 5 hours per week. The One-way ANOVA statistical analysis revealed that the only non-significant mean difference by country is on respondents’ computer experience. Please note that as there are only 10 respondents from Thailand and 13 from the USA, the statistical results should be treated as indications rather than conclusive evidence. Post-hoc analysis revealed that Thai and UK respondents were not significantly different in their Internet experience. However, the respondents from those three countries significantly differ in their weekly usage of the Internet.

3. Results 3.1 Internet Usage When asked where they usually accessed the Internet from (they could check more than one locations, which are home, friend’s or relative’s computer, library or community centre, work and other location that they needed to specify), 53 people checked home.
100% 80% Percentage 60% 40% 20% 0%

Fr ie nd /re la Li tiv br es ar y/ co m m un ity ce nt re

om e

H

W or k

Accesslocation

Thailand

UK

O
USA

Fig. 1. Access locations by country

th er s

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Figure 1 depicts the distribution of access locations by country. It is interesting to notice that unlike in the USA and UK, more Thai respondents accessed the Internet from work than those who accessed it from home. As expected, the one-way ANOVA revealed significant differences in the percentages of the respondents from these three countries that accessed the Internet from home and work.Forty-one people accessed the Internet using Broadband, the rest used either dial-up or LAN connections, showing that older persons are quite up-to-date with the current technology for connecting to the Internet. One section of the Internet usage questionnaire explored the reasons/topics for going online. Some of the options were adopted from an article that suggested the top 10 reasons of why older adults were online (Reaves, 2006) and another article from the Guardian newspapers that listed the online activities that older persons normally performed (The Guardian, 2004). The most frequently chosen reason for going online was to keep in touch with family, relatives and friends. The least frequently chosen reason was to check or research stocks and investments. Table 2 provides breakdown by country as well as the whole sample. Two thirds of the respondents use email clients (such as Outlook and Eudora); only a third used web-based email applications such as Hotmail or Yahoo!Mail. This is an interesting finding, as setting up email clients usually requires more effort than setting up web-based email applications, once again demonstrating that older persons are quite informed about advanced setting that might be required to perform certain online activities. Eighty nine percent used only their glasses to view web pages, indicating that the respondents are mainly older persons with mild visual impairments. Expectedly, 73% used Internet Explorer as their browser. Only two respondents did not know what their browser was called. Thailand Business Stay in touch News/Events Hobbies/ Interests Health info Online shopping Products/ services Stocks/ investments 2.9 (1.91) 3.4 (1.65) 2.6 (1.65) 3.7 (1.70) 3.7 (1.77) 4.9 (0.32) 3.8 (1.62) 4.8 (0.63) UK 3.9 (1.58) 2.5 (1.57) 3.4 (1.58) 3.0 (1.58) 4.1 (1.24) 4.1 (1.27) 4.0 (1.21) 4.4 (1.26) US 3.8 (1.69) 1.5 (0.88) 1.6 (0.87) 1.8 (1.01) 2.5 (1.20) 3.5 (0.88) 3.2 (1.01) 3.9 (1.71) Total 3.7 (1.67) 2.4 (1.56) 2.9 (1.62) 2.8 (1.60) 3.7 (1.44) 4.1 (1.17) 3.8 (1.26) 4.4 (1.30)

Table 2. Reasons for going online (1 = everyday, 2 = twice a week or more, 3 = once a week, 4 = once very 2-3 week, and 5 = once a month or less or never).

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3.2 Most Favourite Websites The respondents were asked to list as many favourite websites as they would like to. The three most frequently mentioned websites were Google (13), Yahoo! (9) and BBC (9). However, many answers did not refer to any specific URL but rather stated the domains of the sites, such as health, news, family’s and friends’ sites, sites for retirees, etc.

3.3 Browsing Devices and Windows When asked which input device the respondents used to manipulate their browsers or navigate, 58.7% answered that they only used mice while the rest stated that they used ‘both mice and keyboards’ or ‘only keyboards’ (very few respondents). The respondents were split almost equally between opening only one browser window at any one time (35%), opening 2-3 windows (41%), or opening 4 or more windows (24%). This contradicts a past study on design guidelines for ageing-friendly websites, which suggested that only one window should be open at any one time (Kurniawan, and Zaphiris, 2005). A third of the respondents browsed long pages by using the wheel in the middle of the mouse buttons. The rest either dragged or clicked the scrollbar or used Page Up/Down buttons.

3.4 Browsing Tasks To investigate the functions in standard browsers that older persons used, we performed a cognitive walkthrough exercise. A cognitive walkthrough is a usability technique where an expert (or a group of experts in this study) ‘walks though’ design to identify potential problems that a user might have using psychological principles. We came up with 27 browsing tasks: 1. Open new browser window 2. Print web pages 3. Preview web pages before printing 4. Check/alter the page setup before printing 5. Save web pages in your hard drive or diskette 6. Copy and Paste information between web pages or programs 7. Select and copy all web page contents to other programs

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8. Use search function to find information within a web page 9. Browse a website from saved items in Favourite or Bookmarks list 10. Add a website to Favourite or Bookmarks list 11. Organize your Favourite or Bookmarks list 12. Go back to previous page 13. Go to browser's default web page (Home page) 14. Stop and reload a webpage 15. Change text size 16. Change language preference 17. View HTML source of browsing page 18. View browsed web site (History) 19. View a web page in full screen 20. Show or hide any toolbar 21. Set your browser’s home page 22. Set proxy server 23. Set browser's advanced options e.g. set Java, ActiveX control 24. Change text and background colours 25. Turn off images 26. Learn from browser's help or tutorial 27. Close web browser For each task, we asked whether the respondents had ever performed it (stating whether it was performed using a mouse, a keyboard, or both). More than half of the respondents (36) never set proxy servers. This is interesting, as past study suggested one way of facilitating accessibility for older web users was through proxy servers (Kurniawan, Evans, King, and Blenkhorn, 2006). Another task that around half of the respondents did not perform was changing the language preference. We could assume that this was because most users would never need to change the language preference. This setting would need to be performed once if ever needed (it came as default for English, and the Thai language preference would have been set as the default by either administrators or computer stores in the case of Thai users). Most tasks were performed either using mice or mice in combination with keyboards. Using only keyboard was not very popular with the respondents, except, to a certain degree, using the CTL+P for printing web pages.

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3.4.1 Exploratory Factor Analysis of Browsing Tasks As there are many tasks being investigated here, it is rather difficult to see the patterns of tasks performed by the respondents. To investigate this underlying pattern, a multivariate data reduction technique called Exploratory Factor Analysis (EFA) was employed. EFA is a widely utilized and broadly technique to uncover the underlying structure of a set of variables. It is called ‘exploratory’ because there is no prior theory of how the variables would group together, which is the case of this study. In recently published studies, EFA was used for a variety of applications, ranging from developing an instrument for the evaluation of school principals (Lovett, Zeiss, and Heinemann, 2002) to sensitivity analysis of a large scale transportation simulation (Rousseau, and Bauer, 1996). After a successful EFA, a large number of variables are reduced to a smaller number of underlying factors. There are various ways to ‘extract’ variables into factors, the two most common being Principal Component Analysis (PCA) and Principal Axis Factoring (PAF). PCA was suggested as the extraction method for EFA while PAF is more appropriate for another type of factor analysis to confirm an established theory of the underlying structure of the set of variables, called Confirmatory Factor Analysis (CFA). After extraction, the researcher needs to consider how many factors to retain for further analysis. Both over-extraction and underextraction of factors retained for rotation can have deleterious effects on the results. The default in most statistical software packages is to retain all factors with ‘eigenvalues’ greater than 1, called the Kaiser criterion. Another popular method is through a scree test, which involves examining the graph of the ‘eigenvalues’ and looking for the natural bend or break point where the curve flattens out. It is common that each observable variable is related to more than one factor – and this is difficult to interpret. This interpretation can be simplified through a technique called a factor rotation, which can be oblique (where the factors are allowed to correlate) and orthogonal (where the factors are uncorrelated). A survey of a recent two-year period in PsycINFO yielded over 1700 studies that used some forms of EFA. Well over half listed PCA with an orthogonal rotation called varimax as the method used for data analysis, and of those researchers who reported their criteria for deciding the number of factors to be retained for rotation, a majority use the Kaiser criterion (Costello, and Osborne, 2005). It should be noted that this combination is the default option in SPSS, which might influence some studies. This combination was employed for the analysis of the data in this study. To improve the reliability of the analysis, the varimax rotation was confirmed with an oblique rotation

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called direct oblimin. Similarly, the Kaiser criterion was also confirmed by observing the scree plot. Only the results of the varimax rotation are reported in this study. To make the presentation cleaner, the factor loadings less than 0.5 were suppressed, as studies suggested that factor loadings less than 0.5 indicate weak relationship between the observed variables (in the case of this study, the browsing tasks) and the factors they load on (Costello, and Osborne, 2005). To ensure that the factor naming was sensible, two HCI researchers independently came up with factor names, and then agreed on one name per factor. Researchers had given guidelines for the minimum sample size needed to conduct factor analysis. Some have suggested the ratio of sample size to number of variables as a criterion: the recommendations range from 2:1 through 20:1. In light of this, the data from three countries would have to be merged to run the analysis properly. Several iterations were performed to see which variables do not group with any other variables or group only with one other variable (some studies pointed out that we should be careful interpreting factors with less than three variables). After several iterations, the final analysis with 17 variables (bringing the sample size to variable ratio to 3.7) resulted in five factors, accounting for 72.3% of the variance. The first factor is called the Technical Task factor. This factor represents tasks at a more technical level, such as viewing the HTML source of a webpage (with a very high factor loading of 0.81, indicating a very strong correlation between the Technical Task factor and the observed variable of ‘viewing HTML source’) or setting a proxy server. This group of tasks requires quite an advanced understanding of how a browser works, and requires some HTML coding skill. The second factor is Personalization Task. This factor concerns tasks that are performed to personalize how a page is rendered, either to compensate for users’ impairment or to match user preference, e.g., customizing colour or hiding images (perhaps to reduce page complexity). The third factor, the Navigation Task factor, is to do with navigating around the site, such as going back a page or going to the browser’s homepage. The third task (stop and reload a page) was a bit out of the way, as it is usually performed not to navigate around but rather to refresh pages that do not load. However, the two researchers could not come up with a better name for this factor. The fourth factor, appropriately named the Transfer Task factor, deals with tasks aimed at transferring information between websites and another place (which could be a favourite or bookmark list, another program such as a Word document, or a storage medium).

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Finally, the fifth factor is the Page Task factor. It is about the tasks that users do to the page itself, such as printing it, or searching within a page. Tasks Factors and their factor loadings Personalization Technical Navigation Transfer Page

J

view html source set browsers’ advanced control view history set browsers’ home page set proxy server change text and background colours turn off images change language preference go back a page go to browser’s home page stop and reload a webpage copy and paste information from a web page to other program browse a website from Favorite or Bookmarks list save web pages in your hard drive or diskette print web pages view page in full screen search within page

.81 .76 .73 .72 .66 .91 .90 .64 .85 .78 .71 .82 .79 .65 .84 .69 .69
Table 4. Task factors and variables that load on them

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3.5 Users’ Mental Models The next few questions aimed at capturing users’ mental model of the various components of a webpage/website. When asked about the object that gave away which website they were browsing, almost half of the respondents (46%) chose the website name shown in the address bar. The name shown in the title and the website’s logo or banner received 22% each. Very few respondents chose the website’s content. Please note that to ensure that the respondents understood what each website representation meant, a screenshot as displayed in Figure 2 was included.
Title

Address bar Logo or Banner

Contents

Fig. 2: The objects that give away the website users are browsing

In response to the question on what gave away that an object was a link, 48% chose ‘text with underline’ while 37% chose ‘text with different colour’. The other two options, ‘button image’ and ‘text or image in dropdown menu or sidebar’ did not get many votes. Users’ mental model on the page loading status was asked through questions on whether the browser’s status bar (see Figure 3) or the browser’s animated logo (see Figure 4) provides useful information. Seventy-one percent respondents stated that the browser’s status bar did provided useful information, while only 54% said so for the animated logo. This is an interesting finding, as essentially both objects represent the same process with only two major differences: their location and the fact that the browser’s status bar provides progress indicator.

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Status bar
Fig. 3: Browser’s status bar

Internet Explorer

Mozilla Firefox

Fig. 4: Browser’s animated logos

3.6 Problems with Current Browsers or Browsing Experience In this section, users were asked in open-ended fashion if they had experienced problems with their current web browser or while browsing. Fifteen respondents left the textbox empty, 25 said that they did not have any problem. The rest stated various problems that were categorised into six groups through content analysis: 1. Undesired content: advertisements, pop-up windows, spam and promotional emails 2. Connection: slow connection, low bandwidth, security concern over non-secure connection 3. Broken links (message 404, pages that did not load, etc) 4. Poorly designed pages 5. Compatibility, as exemplified by statements such as ‘Some websites only work with Microsoft browser’ or ‘Opera sometimes hangs and doesn't display Java correctly’ 6. Undesired actions: things such as ‘pages that refused to close’ or ‘websites that forced users to register’.

3.7 Assistive Features to Make Standard Browsers More Ageing-Friendly Finally, the features that should be added to a standard browser to make it more ageing-friendly were looked into. For each feature, the respondents were asked to rate from 1 to 5 with 1 = must have and 5 = unnecessary. Figure 5 lists the ratings of these features. As Figure 5 shows, the features that are high on the ‘must have’ list are

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blocking features (pop-up windows and advertisement). In line with user demographic, where most users only need glasses to view websites, the features that magnify and read the page did not receive high numbers of ‘must have’. The last question aimed at investigating a relatively new feature, which is an event or task reminder (very recently offered by some companies, e.g. Google calendar). Expectedly, this feature did not receive very positive ratings from the respondents, possibly because they had not encountered this feature before.

70 60 Number of respondents 50 40 30 20 10 0 Content filter Ads block Pop-up window block Page magnifier Page reader Event/task reminder 5 4 3 2 1

Existing features
Fig. 6: Users’ opinions on existing features

The respondents were also asked for any features that they would like to add to their current web browsers, in open-ended fashion. Only 13 respondents suggested additional features. The rest either left the textbox empty (23 respondents), answered ‘None’ (24 respondents), or stated that they were happy with their current browsers (3 respondents). These thirteen suggestions were categorised into four groups through content analysis (not in any particular order, as the number of proposed features were too small to differentiate by frequency): 1. Seamless integration between web browser and other applications, as exemplified by a statement of ‘Better integration with my mail client and UseNet news reader’ 2. Visual aids: things such as ‘easier/more-direct "zooming" in/out text AND graphics enlarging’

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3. Adaptive help: ‘smart help – sometimes I don’t know the exact term so anything that works on partial or misspelled keyword within the browser’ 4. Automatic removal of undesired content, such as automatic pop-up blockers and spam erasers.

4. Discussion and Conclusions The study sets out to answer three research questions: 1) What and how do older person browse online? 2) What functions in a standard browser do they use? 3) What functions can be added to a standard browser to make it more ageing-friendly? The questionnaire used in this study had resulted in some interesting findings, and some other expected ones in response to these three questions.

4.1 Internet Access Information The study started with inquiring the Internet access information of the respondents. The first interesting finding from this section was the Internet and computer experience information. Reports from national bodies from USA, UK and Thailand indicated that while Internet adoption among older persons in the USA and UK are reasonably high (considering that these older persons are baby-boomers, which did not grow up with Internet technology), the Internet adoption in Thailand among this age group is very low. However, whilst this trend was reflected in the respondents’ frequency of Internet use and Internet experience, it was not reflected in their computer experience, showing that the Thai users who participated had used computers for as long as their US and UK counterparts. It should be noted, however, that only 10 Thai respondents participated, and this group might not reflect the experience of other older Internet users from Thailand. Due to the nature of their job situations (i.e. it is expected that most respondents were retirees – the retirement age in Thailand is 60 years old and it is 65 in the UK and the US), most respondents accessed the Internet from home. Even though the data shows that 6 out of 10 Thai respondents accessed the Internet from work, given the small sample size, the Thai sample might not be representative of older persons in Thailand. The other reason why many Thai respondents access the Internet from work is perhaps related to the cost of Internet access, which is still relatively high in Thailand, and therefore, many Thai Internet users might prefer to access it from work. Regarding the reasons the respondents accessed the Internet, in general, activities that are related to products and services (such as online purchase, or researching or

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checking stocks or investments) were less frequently performed than personal activities such as accessing news, researching health topics or keeping in touch with relatives and friends. It should be noted that the UK and US respondents tended to perform activities related to products and services more often than the Thai respondents did, arguably because they had arrived at a more mature ‘online development stage’. As some demographic surveys suggested, older generation follows the same online developmental curve as younger people, starting with email and searching and eventually moving on to shopping and other activities that involve security and privacy concerns (Reaves, 2006), which is perhaps the case of many of the UK and US respondents but not necessarily the Thai respondents. The most favourite websites were clearly those supporting information seeking (Google, Yahoo! and BBC). Although this fact seems simple, it has its grounding in psychological phenomena of how people use the web as suggested by Maglio and Matlock (Maglio, and Matlock, 1998). The authors suggested that it is not unusual that people name key websites that they often visited in order to get to the target information. These sites are called anchor points by analogy to the notion of anchor points in the cognitive map literature. In addition, the authors also suggested that individuals relied on personal routines when trying to find information (on the analogy to cognitive maps of physical space, personal routines correspond to the familiar routes that an individual uses to get from one landmark to another), so once they have this set of anchor points (e.g. a particular search engine), they tend to stick with this set.

4.2 Browsing Tasks To answer the second research question, the respondents were questioned on a list of browsing tasks. Whilst the descriptive statistics of these tasks bring some useful information, the results are mostly expected (e.g., advanced tasks were more rarely performed than common tasks, or that most tasks were performed using a mouse). However, the factor analysis performed on those tasks revealed some interesting findings related to pattern of use. Essentially, the analysis found five unrelated underlying patterns of use. The most rarely performed factor, Technical Tasks, were perhaps mostly only performed by older persons who were expert users or programmers. The second most rarely performed factor was factor that deals with user personalization. Many studies pointed out that

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older persons are not likely to perform user personalization themselves due to lack of confidence (Kurniawan, Evans, King, and Blenkhorn, 2006). The transfer tasks, the factor that deals with moving information between websites and other electronic media were the next factor that was rarely performed. This is not surprising, because older persons are likely to have a mental model of paper archiving, where the necessary information from a website is transferred to a piece of paper (through printing) rather than to another electronic medium. The final two factors contain tasks that were performed quite often: page tasks (e.g. printing or searching within a page) and navigation (e.g. going back a page), for clear reason. These are the basic operations of web browsing. In summary, the pattern of use of older persons does not seem to be very different from that of younger persons, as suggested by established set of literature in web browsing for general population (e.g. Spink, Wolfram, Jansen, and Saracevic, 2001; Tauscher, and Greenberg, 1997). They rarely performed advanced functions and regularly perform basic functions. Arguably, the only set of functions that older persons perhaps use less often than younger persons would be personalization. However, this study has not compared the frequency of tasks of younger and older persons, and therefore, this statement should be treated as a speculative one.

4.3 Assistive Features To answer the final research question, the respondents were asked to describe problems with the current browsers, to choose from a list the assistive features that they felt had to be provided in a standard browser, and to suggest features to make a standard browser more ageing-friendly. Interpolating these three sections, we can conclude that the most mentioned assistive feature is an automatic function that would remove undesired content (such as pop-up windows and spams). This feature showed up in all three sections. Some other assistive features showed up less often, which range from visual aids to smart help to seamless integration with other applications. 5. Limitations of the Study There are naturally some limitations of this study, mostly related to the sample’s demographics. The respondents generally have very mild visual impairment (as most only wear glasses when accessing the Internet) and have a good understanding of the technology (as shown from their Internet and computer experiences and the types of tasks they performed while browsing) and therefore, this study might not reveal the

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issues faced by older persons with more severe impairment or less experienced in using technology. The study involved respondents from three countries, which were aimed at gathering views that are less culturally biased. Unfortunately, the proportion of the respondents by geographic location was unbalanced, with more than half of the respondents being UK-based, due to the location where the researchers were stationed and the choice of using paper-based questionnaire. An extension of this study, i.e. to complement this paper questionnaire with an online one, which will enable us to recruit more respondents from other countries, is currently in the planning stage. The gender split is quite typical of voluntary studies of older persons, especially those performed at ‘senior centres’, with more women participating than men, but would need addressing in future studies. The choice of using a questionnaire for data collection means that it is quite difficult to be flexible with the questions. Even though we consulted an expert older web user and ran a pilot study, our questionnaire still apparently resulted in rather restrictive set of features and activities that we could investigate. Another inquiry method such as focus group discussions and interviews would complement the data gathered from this questionnaire very well. Despite these limitations, however, the study has managed to answer the three research questions we set off with quite successfully. There are some information that prominently appeared, which could be used to inform design of additional feature to put into a standard web browser, such as undesired content filter. And involving respondents from different cultures had provided quantifiable evidence to the fact that some people might have suspected, that is, the US web users are at a much more advanced ‘online developmental curve’ (borrowing the term of the Reaves (2006) paper) than the UK web users, and both are definitely in a much more advanced curve compared to the Thai users, which are still at a level of performing online activities related to personal affair while the US and UK users already brave the online purchase or stock research. This study is a first step toward understanding older persons’ browsing activities and would need to be followed up with studies that involve design and evaluation of ageing-friendly web browsers, but hopefully it is a step in the right direction.

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5. References Blenkhorn, P., Evans, D. G. King, A., Kurniawan, S. H. and Sutcliffe, A. G. (2003). Screen magnifiers: evolution and evaluation. IEEE Computer Graphics and Applications, Special Issue on Perceptual Multimodal Interface 23, 5, 54-61. Costello, A. B. and Osborne, J. W. (2005). Best Practices in Exploratory Factor Analysis: Four Recommendations for Getting the Most from Your Analysis. Practical Assessment, Research and Evaluation 10, 7. Retrieved in June, 2006 from http://pareonline.net/pdf/ v10n7.pdf. Fairweather, P. G., Hanson, V.L., Detweiler, S. R., and Schwerdtfeger R. S. (2002). From assistive technology to a web accessibility service. In Proceedings of the 5th International ACM Conference on Assistive technologies (ASSETS’02) (Edinburgh, Scotland, UK, 2002) (4-8). New York: ACM Press. Fox, S. (2006). Are "Wired Seniors" Sitting Ducks? Pew Internet memo (April 2006). Retrieved in August 2006, from http://www.pewInternet.org/pdfs/ PIP_Wired_Senior_2006_Memo.pdf. Goodman, J., Syme, A., and Eisma, R. (2003). Older Adults' Use of Computers: A Survey. In Proceedings of British HCI Group Annual Conference (HCI’03) (Bath, UK, September 8-12, 2003). London, UK. Springer-Verlag. Hanson, V. L., and Richard, J. T. (2004). A web accessibility service: update and findings. In Proceedings of the SIGACCESS 6th International Conference on Computers and accessibility (ASSETS’04) (Atlanta, GA, USA) (169 – 176). New York, NY: ACM Press. Helander, M. G., Landauer, T. K., and Prabhu, P. V. (1997). Handbook of humancomputer interaction. Oxford, UK : Elsevier. Kubeck, J. E. (1999). Finding information on the World Wide Web: Exploring older adults' exploration. Educational Gerontology, 25, 2, 167-183. Kurniawan, S. H. and Zaphiris, P. (2005). Research-Derived web Design Guidelines for Older People. In Proceedings of SIGACCESS 7th International Conference on Computers and Accessibility 2005 (ASSETS'05) (Baltimore, MD, USA) (129-135). New York, NY: ACM Press. Kurniawan, S. H., King, A., Evans, D. G. and Blenkhorn, P. L. (2003). Design and user evaluation of a joystick-operated full-screen magnifier. In Proceedings of the SIGCHI conference on Human factors in computing systems (CHI’03) (Ft. Lauderdale, Florida, USA, Apr 5-10 , 2003) (25-32). New York, NY: ACM Press.

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Kurniawan, S. H., Evans, D. G. King, A., and Blenkhorn, P. (2006). Personalizing web Page Presentation for Older People Interacting with Computers, 16, 242-263 Lovett, S., Zeiss, A. M., and Heinemann, G. D. (2002). Assessment and development: Now and in the future. Team performance in health care: Assessment and development. New York, NY: Kluwer Academic, 385-400. Maglio, P. P., and Matlock, T. (1998). Metaphors we surf the web by. In Proceedings of Workshop on Personalised and Social Navigation in Information Space (138-147). Stockholm, Sweden. Mann, W. C. (2004). The aging population and its needs. IEEE Pervasive Computing, 3, 2, 12-14. McClellan, J. (2004). On the crest of a wave. Technology section, November 18, 2004. Retrieved in August, 2006 from http://technology.guardian.co.uk/online/story/0,3605,1353207,00.html. Meyer, B., Sit, R. A., Spaulding, V. A., Mead, S. E., and Walker, N. (1997). Age group differences in world wide web navigation. In Proceedings of the SIGCHI conference on Human factors in computing systems (CHI’ 97) (Atlanta, Georgia, March 22 - 27, 1997) (295-296). New York, NY: ACM Press. National Electronics and Computer Technology Center. (2005). Thailand ICT Indicator 2005. Retrieved in June, 2006 from http://www.nectec.or.th/pld/documents_pris/ ict_indicators2005_180705.pdf. Reaves, K. (2006). Top 10 Reasons Older Adults Should Be Online. http://www.family.org/focusoverfifty/articles/a0020568.cfm. Richards, S. (2006). Older People and the Internet. Retrieved in June, 2006 from http://www.seniorsnetwork.co.uk/computers/netbenefits.pdf Rousseau, G. G., and Bauer, K. W. (1996). Sensitivity analysis of a large-scale transportation simulation using design of experiments and factor analysis. In Proceedings of the 28th Conference on Winter Simulation (WSC’96) (Coronado, CA, USA, December 8-11, 1996) (1426-1432). New York, NY: ACM Press. Salthouse, T. A. (1996). The Processing-Speed Theory of Adult Age Differences in Cognition. Psychological Review, 103, 3, 403-428. Spink, A., Wolfram, D., Jansen, B. J., and Saracevic, T. (2001). Searching the web: The public and their queries. Journal of the American Society for Information Science, 53(2), 226-234. Tauscher, L., and Greenberg, S. (1997). How People Revisit Web Pages: Empirical Findings and Implications for the Design of History Systems. International Journal

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PsychNology Journal, 2006 Volume 4, Number 3, pp. 267-284

Inclusive design and human factors: designing mobile phones for older users
Matthew Pattison and Alex Stedmon

PDD, London, UK Human Factors Research Group, University of Nottingham, UK

ABSTRACT
This paper reviews the human factors requirements of mobile phones in order to facilitate inclusive design and provide older users with technological support that enhances their dayto-day lives. Particular emphasis is placed on whether human factors requirements are fully considered and meet the needs of older users. The scope of this review is necessarily wide including: human factors, gerontology, inclusive design, technology and design research methodologies. Initial consideration is given to understanding what it means to be an older user and the changes that occur with the aging process. Older user requirements are examined in relation to achieving inclusive design solutions and the way in which human factors methodology can be used to support inclusive design goals. From this standpoint, attention is given to the design of mobile phones, considering how human factors issues are reflected in product design and context of use beyond the phone handset to the wider interaction environment. This paper does not propose specific direction from primary research findings but argues for a ‘state of the union’ with regard to the current approaches designers and manufacturers adopt and the effects that design decisions have on potential end users. This paper argues that when effective and flexible human factors methodology and inclusive design ethos is integrated into the product development process global benefits to a wide user population can maximise inclusion as opposed to exclusion via technological advances.

Keywords: Human factors, inclusive design, older users, mobile phones, cell of exclusion Paper Received 28/07/2006; received in revised form 31/10/2006; accepted 12/12/2006

1. Introduction

With approximately 25 million mobile phones in use by one in three of the UK population, mobile phones have developed at a considerable pace over the past 20 years within the UK and throughout the world (The Stewart Report, 2000). With the increasing number of older users as a demographic group, this should mean that they
Corresponding Author Matthew Pattison, Human Factors Specialist PDD Group Ltd. 85-7 Richford Street London, W67HJ Tel:+442087351111 Email: mattpattison@pdd.co.uk

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present a large-scale user group of such technology. However, this is not the case as mobile phone design is skewed towards younger users. This may be due, in part, to techno-phobia which is an anxiety associated with using advanced technologies (Elder, Gardner, and Ruth, 1987; Hone, Graham, Maguire, Baber, and Johnson, 1998). Techno-phobia is correlated with age illustrating that older users are more reluctant to use new technology than younger users and could arise through poor user requirements capture where the design solutions do not meet the specific needs of older users. In a highly competitive marketplace, development of mobile phones is driven by consumer spending and problems can develop where the main consumer base becomes the main design focus because it is the main revenue platform. As a result, there is a danger that the development of mobile phones has not grown to support different users and that niche user groups have to ‘make do’ with what is generally available. This would seem to be the case for older users. However as the older population increases, so too does their power as a consumer group as they move out of being a niche user group and into being their own mainstream market sector (Lee and Kim, 2003). 2. Older users: a growing consumer group

Over the last 150 years the combination of reduced infant mortality and increased life expectancy has led to a restructuring of population demographics in the UK and across the developed world (Coleman, 2001). Population projections suggest that following the two post-war baby booms of the 20th Century, the older population will continue to expand during the first quarter of the 21st Century from 400 million to 1.3 billion by 2050 (Summers, 2001). As users grow older and their requirements change, designers should be sensitive to their changing user needs as well as designing for the users they might eventually become themselves (Coleman and Pullinger, 1993). Older users may have a substantial command of income, with children grown up and with mortgages paid off, they can control a significant portion of the country’s wealth, saving and spending power (Lee and Kim, 2003). However, many older users are poor and struggle financially and/or physically in an environment that can enforce disability out of impairment1. Disability through impairment can refer to those at a disadvantage
1

(http://www.ricability.org.uk/reports/report-design/guidelinesforproductdesign/contacts.htm#4)

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through a lack of resources and support. That users can be ‘disabled’ through poor design highlights the idea that users are often stifled by a restrictive, rather than derestrictive, environment that surrounds them (Fisk, 1993). With various needs, technology should be designed to support older users through independent living and interaction rather than being alienated because they cannot use a mobile phone, access the internet or understand the latest graphic user interfaces (Mikkonen, Vayrynen, Ikonen, and Heikkila, 2002). Since the early 1990s this has been a fundamental concept in design education philosophies applied by leading authorities in the UK and across Europe such as the Helen Hamlyn Research Centre at the Royal College of Art, The Design Council, The Danish Centre for Assistive Technology, as well as leading research groups such as COST 219 investigating accessibility for all users to services and terminals for next generation networks. 3. Older users: the performance continuum and aspects of aging

Older users by definition have lived longer than younger users and therefore represent one of the most heterogeneous groups in society (Bullock and Smith, 1987). Assuming that people generally start at a similar point, born with similar functions and abilities, by the time they become older users they will have gathered many different experiences, perceptions and mental models of the world, as well as possibly suffered the rigours of physical and mental demise in various forms. From a similar starting point older users will have travelled and deviated further than other user groups and therefore be further away from design homogeneity. A performance continuum exists as a function of age in terms of vision, hearing, motor function and cognition.

3.1. Vision Visual impairment takes many forms, from partial loss of vision through to complete blindness. Aging can be seen to affect older adults in many ways briefly highlighted below: • Decreasing Visual acuity (the ability of the eye to discriminate detail) diminishes

especially after 50 years of age (Haigh, 1993; Steenbekkers, Dirken, and Van Beijsterveldt, 1998). The average 60 year old requires three times more light than the average 20 year old to see the same level of detail (Haigh, 1993).

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Decreased contrast sensitivity (the ability to distinguish between light and dark)

diminishes from the age of 20 years to 80 years with the main decline beginning around 40 to 50 years. • Worsening light accommodation (the ability to focus on near and far objects)

decreases from the age of 8 to 50 years by roughly 50-55%, at which point the decline generally levels off. The decreased elasticity in the lens leads to a reduction in the accommodation and an average near point of 50cm for a 50 year old, compared to 12.5cm for a 30 year old (Haigh, 1993, Ishihara, Ishihara, Nagamachi, and Osaki, 2002). • Difficulties with glare (which arises from harsh light leading to discomfort and/or

disability). The scattering of light in the eye due to increasing lens opacity increases the effect of glare. With three times more light required (in relation to visual acuity), the increased likelihood of glare needs accounting for in design solutions for older users (Haigh, 1993). 3.2. Hearing As with vision, changes to or the gradual loss of hearing are most commonly associated with aging. The process is affected by many factors such as work exposure, diet and genetic influences, but by the age of 50 there is often sufficient loss of hearing to cause impairment (Takeda, Morioka, Miyashita, Okumura, Yoshida, and Matsumoto, 1992). Aging has also been shown to have an effect on the ability to interpret and respond to complex auditory information. The ability to discriminate frequency also deteriorates in a linear fashion between 25 to 55 years of age, after which a greater differential is required especially for the higher frequencies (Takeda et al., 1992). 3.3. Motor Function Age related changes in hand/motor function appear to occur as a decrease in strength, dexterity and range (Steenbekkers et al., 1998). There is a decrease in grip strength and endurance with age, with force exerted deteriorating from the mid to late twenties (40% decline in strength from 30 to 80 years old) and the average 65 year old user having only 75% maximal strength (Sato and Fukuba, 2000). 3.4. Cognitive aspects of aging In general, working memory appears not to decline in relation to storage capacity, but rather processing efficiency declines over time (Norris, Smith and Peebles, 2000).

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Processing speed declines but recall stays within Miller’s 7 plus/minus 2 chunks (Miller, 1956). Long-term memory declines with age in relation to episodic memory, however, semantic memory is maintained and deficits are rare (Bowles, 1993). In relation to procedural memory, decline is elevated with the complexity of task and reaction time has been shown to decline with age. Therefore memory retention for prior known faces and places can appear to be good if supported by contextual knowledge but new complex tasks can be problematic for older people. Total knowledge increases with age and so a larger database is available for older rather than younger people although speed of retrieval slows down. Older people maintain the ability to learn, with evidence of neural plasticity, however, the process takes more time, especially with complex material (Kandel, Schwartz, and Jessell, 2000). This could help explain techno-phobia if there is little or no prior context for older users to use in learning how to use new technologies or new technologies are not developed which support the mental models of older users. Skills such as vocabulary and language use are maintained unimpaired until late in life whereas skills that depend on rapid processing, accurate logical thought and spatial ability are markedly affected as people become older (Haigh, 1993). Evidence supports the theory that older people cope poorly with divided attention tasks and whilst problem-solving increases in capacity until the ages of 40 - 50 years, after this period an experiential related decline occurs (Norris et al., 2000). In relation to the performance continuum and the effects of aging, decline occurs throughout adult life. Most areas of decline vary greatly between individuals due to the heterogeneous nature of aging itself and the multitude of factors (such as such as lifestyle, health, nutrition, individual differences, work and exercise) that can impact on everyone growing older. In relation to mobile phone design the performance continuum is linked to human interaction with complex systems. On one level a mobile phone is a single device used by an individual interacting with a keypad, screen and simple interface. On another level a complex set of combined cognitive and physical interactions are linked to changing contexts of use and environments in which these mobile devices are used. The management of these interactions underpin how successful and accessible these mobile technologies are. The challenge for designers is that there is no typical older user to design for. What is required is a clear philosophy (such as inclusive design) and an approach (such as human factors) in order to develop user-centred solutions that meet older user needs. If this is achieved then

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designers can target the design for a specific user group and provide an inclusive design solution. 4. Inclusive design: incorporating the needs of older users

Inclusive design aims to cater for as many users as possible and therefore incorporate diverse user requirements – it is more of a design philosophy than an end product. The underlying premise of this philosophy is that it should enable rather than exclude different users (Gyi, Porter, and Case, 2000). However, the aim is not necessarily to achieve a ‘universal’ solution but to be more pragmatic, supporting different users by forming generic design solutions that suit specific needs. A model of inclusive design is illustrated below in Figure 1 (adapted from Keates and Clarkson, 2004).
User Needs specify problem to be solved verify problem definition User Perception representation of the system verify user perception User Cognition structure the interaction verify user understanding User Motor Function quality of control and input verify user comfort Usability evaluation & validation validate usability & accessibility

Figure 1. Model of inclusive design (adapted from Keates and Clarkson, 2004)

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The model highlights the complexity of inclusive design from analysing user needs through to evaluating and validating the usability of design solutions. In order to achieve this, user needs have to be understood in terms of: • • • the representation of the design problem (taking user perception as a basis for

the design); the structure of the interaction between the user and design solution

(understanding that this will be different for different user requirements); the quality of control and input (as a basis of user comfort).

If these aspects are addressed then the design solution should be accessible to users and therefore inclusive in its nature. If inclusive design is implemented at the start of the overall design process, design options can be evaluated in an iterative manner. For older users this could mean that specific user requirements are identified. By incorporating human factors methods, involving users and designers, to help develop and sustain inclusion throughout the design process this should also support the uptake and usability of actual products and services. 5. Human Factors in Design research supporting inclusive design

Human factors offers a ‘user-centred’ approach which ensures fit between the design and the users needs and requirements. For decades, various task analysis techniques (eg. Kirwan and Ainsworth, 1993; Militello and Hutton, 1998) have allowed human factors experts to describe the interactions between users, technologies and their environments at a level of detail that can be used to inform the design solution. Recognition of this has recently been formalised by the publication of International Standard ISO 13407, Human-Centred Design Processes for Interactive Systems (Earthy, Sherwood Jones, and Bevan, 2001) which specifies four general principles of user-centred design: • • ensure active involvement of users and a clear understanding of user and task

requirements (including context of use and how users might work with future products); allocate functions between users and technology (recognising that today’s

technology, rather than de-skilling users, can actually extend their capabilities into new applications and skill domains); • ensure iteration of design solutions (by involving users in as many stages of the

design process and implementation cycle as is practical);

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ensure the design is the result of a multidisciplinary input (emphasising the

importance of user feedback, but also stressing the need for input from such disciplines as design, marketing, ergonomics, software engineering, technical authors, etc). Without such a standard there is a risk of specifying or designing solutions that fail to support the users’ understanding of the target application (Stone, 2001). Advances in applied methodologies have increased the level of exposure between designers and end users. Techniques such as video ethnography (Hughes, O'Brien, Rodden, Rouncefield and Blythin, 1997) and audio/video diaries (Palen and Salman, 2002) prove very powerful tools to a design team or client in developing solutions based on user understanding, requirements and ultimately real use. Beyond the ‘exploration and understanding’ phase, older users can act as powerful participants in the design process. These individuals can often provide an innovative contribution to design thinking and solution creation via articulation of real needs and real experiences which the design team can use to develop conceptual solutions (Woodhuysen, 1993). Implementing human factors methods and data can be difficult or can be seen to stifle individual designer creativity. Good design features can sometimes occur by chance, or design teams are not able to involve users until near the end of the project (Etchell and Yelding, 2004). Designers often have to follow a strict design specification from their clients and can find anthropometric data difficult to implement due to its format being non-design centric (Gyi, Porter, and Case, 2000). Furthermore, holistic end user analyses are required in usability testing to achieve designs that really meet the needs of target user groups and these are not always factored into the design process (Tuomainen and Haapanen, 2003). Human factors specialists involved in the design process must seek to supply knowledge to designers to maximise assistance and education whilst minimising information overload by disseminating knowledge based on shared mental models (Hitchcock, et al., 2001). One such model is defined as the ‘Cell of Exclusion’ (Mitchell and Chesters, 2004). The cell is based on a cube metaphor with each face of the cube highlighting design boundaries and barriers to use. Indeed, it has also been referred to as the ‘inclusive design cube’ because by taking account of these barriers a more inclusive framework can be established (Keates and Clarkson, 2004). The cell of exclusion reflects the design dilemma based on both the user’s and society’s expectations which could be altered through inclusive design initiatives.

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Figure 2. The ‘Cell of Exclusion’ (adapted from Mitchell and Chesters, 2004

The four sides of the cube, or walls of the cell, are defined as: (1) a non-inclusive design process (which ignores the needs of specific users), (2) ignorance about barriers (which ignores the user requirements), (3) ignorance about the penalties of exclusion (design blindness to the effects of alienating user groups), and (4) absence of disability expertise in the design process (limited or non-existent specialist knowledge). The ceiling of the cell refers to society’s low expectation of the older user and the floor of the cell refers to the low expectations of the users themselves (perpetuated through the society’s lack of consideration for their needs). The ceiling and floor of the cell help explain techno-phobia as society has expectations for niche users to adapt to mainstream technologies whilst users may have severe doubts about how easy it is to learn to use new technologies. Relating this to mobile phone design, non-inclusive design factors refer to the implicit performance specifications based on the ability to see the screen, use the keypad with dexterity and conduct tasks within specific time limits (Mitchell and Chesters, 2004). Based on this, it should be relatively simple to design out such barriers based on a better understanding of inclusive design principles rather than penalising users based on their sometimes limited abilities (Mitchell and Chesters, 2004).

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6. Mobile phones: ‘user-centred’ solutions for older users

Mobile phone designs have evolved with younger users in mind, but access to mobile phone technology can offer the older user the opportunity to maintain their quality of life (see note 1) . Furthermore, as mobile and wearable technologies evolve they also offer tools for monitoring health (Dishman, 2004) and maintain social inclusion and community connectivity via networks such as the ‘message center’ (Wiley, Sung, and Abowd, 2006) Such communication solutions designed specifically for adults can integrate carers, older and younger user and sustaining independent lifestyles. However, as technology advances and becomes increasingly complex, older users are exposed to products and services which they are unfamiliar with and which can actually further isolate them if they are not designed to support their needs. Older users have identified a number of problems with mobile phones such as displays that are too small; buttons and keypads that are too difficult to use; too many functions; battery life too short; poor sound quality; and a preference for speech input (see http: www.nttdocomo.com/pr/2004/001207.html). All these issues can be directly mapped to the performance continuum effects discussed earlier. These issues of functional improvement may apply to all users to some degree and serve to highlight the importance of inclusive design in meeting not only older user needs but also assisting other users. The screen display of a mobile phone to many older users (or any other visually impaired user) presents a barrier to use with many phone handsets. Mobile phones are used in all environments and varied levels of illumination must be accommodated by screen and display design. Older users may suffer a deteriorating capacity to use miniature screens as optical accommodation rates weaken. Poor vision can be supported by tactile feedback such as the raised ‘5’ key, use of contrasting textures, and clear and consistent key pad layout. Alongside this, audible feedback can be provided from an audible ‘beep’ through to fully functioning speaking phones, such as the ‘Owasys 22C’ which provides audible text, numbers and phone functions (see note 1). Phone use in public areas can be susceptible to background noise which interferes with auditory input. The inability to distinguish complex sounds can often make communication increasingly difficult for older users and hearing aids can also affect mobile phones usage, causing audible interference which can range from being annoying to masking communication. Hearing deficits can also be supported in mobile

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phones with the use of text, vibration warning and visual ringing, all providing nonaudible feedback. The text phone or videophone offers solutions for the hard of hearing but can be exclusive due to the high price of such products (see note 1). The trend for miniaturisation of mobile phones has impacted on keypad size which has diminished significantly, resulting in a smaller physical interface (with smaller key pads and spacing). For the older user, coupled with impeded dexterity, the interface can restrict them, making it difficult view the keys or move between them easily. These factors can be further compounded in older users by muscular tremors or joint rigidity which impact on motor control. Inclusive design principles have assisted users with regard to hand function in fixed phone technology, by user-centred developments such as the ‘Big Button’ telephone by British Telecom which bases its design solution on the ease of use of large keys which are easy to read and use. Complex cognitive processes are increasingly required with multi-functional phones which do more than just allow the user to make mobile phone calls. The combination of memory and dexterity issues can often exclude users in timed responses systems where limited dial time is allowed to make the call and/or where the phone interface is difficult to use. The decreased reaction times of older users may leave them unable to exploit this technology to the full, unless it is designed with them in mind. One major problem for the older user is the lack of standardisation in interfaces which is an essential component in designing transferable usability across mobile phones. Technological change has been rapid and the increased complexity of new phones with less intuitive interfaces may require previous experience of earlier generation products in order to understand current designs. However, older users may not possess the requisite specialised prior knowledge where as younger users can rely on the mental models they have built up from using previous generations of technology. This is apparent not only when considering the move to using mobile phones rather than land-lines, but also with the difficulties experienced in changing from one brand of mobile phone to another. Brand specific differentiation causes barriers to use as users find it difficult to learn new operating procedures from the ones they are familiar with. The general effects of the aging process are summarised in Table 1 below and provide a basis for evaluating how current phones meet the needs of older users.

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Factor

General effect on older users • more light required • ability to focus deteriorates • ability to deal with glare diminishes • loss of sensitivity to higher frequencies • general threshold deteriorates • complex sounds more difficult to process • general weakness (strength and grip) • dexterity often impaired • range of movement is more limited • processing time – with working memory • long term memory (episodic) • reaction time • learning time required • problem solving capacity

Potential design solution • improve illumination • provide user interface options • if a display is required, use antiglare coatings to display • do not use high frequency audio feedback • couple auditory feedback with visual or tactile feedback • keep auditory feedback as simple as possible • design casings that are easy to hold and keys so they are easy to press (oversized and/or easy press). • group keys by use and function. • keep menu structures intuitive and consistent • make user interfaces as simple as possible

Vision

Hearing

Hand function

Cognitive processes

Table 1. The effects of the aging and potential design solutions

7. Mobile phones: design solutions for older users

Whilst many mainstream phones do not cater for the older user, models are emerging that are designed with the older user in mind (even if not all of them are commercially available yet). The Design Business Association challenge winning ‘Ello’ phone minimised functions by providing a screen-free, large tactile button, ‘clam’ style handset that afforded clear visual contrast and graphics. As a concept phone it has not been produced commercially, but adopted simple to use memory functions, and programming with audio and visual feedback to provide a design solution based on inclusive design principles that produced a simple handset that affords ease of use. The ‘Mobi-Click’ phone, released in 2004 by Orange, affords ease of use (answering and hearing) with an integrated loud-speaker. As with the ‘Ello’ handset, this phone does not have a display and offers a very simple design with only three keys. However, although the interfaces is a simple and intuitive in design, it resembles a pendant alarm system for older users (such as the ‘Benefon Seraph’ which also has only three

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buttons), which places it at risk of falling into the specialist disabled equipment category rather than a standard phone with wider market appeal. By ignoring the ‘inclusive’ principle of non-specialist requirements, the design does not cater for younger users who require a display and texting facilities. Another similar design is the ‘SilverPhone’ which has been designed to be more usable by older users than conventional mobile phones. Along with the ‘Ello’ and ‘MobiClick’, this phone does not have a screen and uses a limited set of three buttons. It is bought pre-programmed in order to make it ready to use and easy to begin using than many conventional mobiles, store 3 most important numbers and uses one touch input for simpler interactions. It has an in-built loud-speaker and can be used by blind or partially sighted users also. However, this phone has the aesthetic of a remote control handset not a contemporary phone and might have been simplified too much in trying to make technology ‘simple to use’ rather than ‘easy to use’. One of the smaller phone producers in Japan, Kyocera, have targeted older users with considerable success by releasing the ‘Tu–Ka S’ phone. The handset is modelled on a standard handset very much like a wireless landline handset (and therefore fits with a common mental model of a standard phone which older users are more comfortable with). Like the other phones, it does not have a display and therefore has a long battery life. The keys are large with simple colour coding and good contrast. In emphasising the product slogan ‘no manual needed’, all aspects have a simple, intuitive, functional design that affords ease of use. Due to mapping onto a common mental model of a standard phone, this handset should be usable by a range of users with varying abilities and therefore could have wider appeal than just the older user market. Similar trends have seen to the move towards mapping contemporary technology with traditional interface design with the contemporary version of the old fashioned Roberts radio (RD50 DAB/FM radio) being a good example of new technology packaged within an older mental model underpinning the context of use. At the high end of the market NTT DoCoMo released the ‘Foma Raku-Raku’ phone aimed at users unfamiliar with mobile phone technology. This phone uses image-based instructions for task ‘walkthrough’ and a read aloud element for a wide variety of functions in order to make the learning process as easy as possible. As with the ‘Ello’ handset, it is a ‘clam’ style phone with good battery life however visually it is problematically styled in non-contrasting silver perhaps making it difficult to identify specific keys.

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Tu–Ka also present the TS41 ‘Bone Phone’ based on technology that transmits sound via the skull, thus increasing the efficiency of sound transmission. Previously this technology has only been used for fixed lines with older users in mind but is now proving popular to young businessmen who are working outside whilst they talk, illustrating how different design solutions can migrate across different user groups, broadening the market share and fulfilling many user requirements. These phones seek to address issues faced by the older user with varying degrees of success and emphasis on inclusive design. In so doing, many design solutions focus on the immediate physical design of the handset (incorporating different aspects of visual, auditory, dexterity and tactile based limitations). Focus on designing for context of use and wider environments or settings prove more of a challenge. Speed of processing skills, memory abilities and reaction time limitations can impact on the notion of the ‘cell of exclusion’ which designers need to be aware of. A consideration of users in context may reveal that older users find themselves using phone technologies in more complex changing environments and usage scenarios than their use of phones in static settings 10 years ago. It is important to consider mobile phone design as part of a holistic system and the Human Factors and Ergonomics Society (HFES) have developed standards to provide in-depth requirements to the design and usability of such systems (HFES, 2001). From the standards, the function of ‘dial-ahead’ designs (the ability to fast track through voice responses) and handling ‘time out’ (time periods allowed prior to stopping the function) are of interest. Older users vary in their ability to access such systems due to varying cognitive abilities, which along with younger user frustration at the time restrictions and lack of, or unclear, short cuts identify an area of design where the technology, engineering or the design itself has not afforded inclusive principles. In targeting an inclusive design it is essential to consider the system capability to speed up or slow down the response time and give control to individual users. An example of this could be the use of time prompts between each response tailored by the user via the keypad, with the aim being to empower the user in the use of such systems. Developing more inclusive mobile networks is something that the COST programme has been investigating for more than 30 years as part of an inter-Governmental framework for European cooperation. It has published guidelines for mobile phones ranging from the design of instruction books, physical characteristics, operation, display and keypad design, as well as audio output and the use of wireless interface technologies. Much of the guidance is generic and therefore provides an inclusive

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approach to designing for older users whilst also supporting younger users, but perhaps with a greater acknowledgement of older user limitations (based on an understanding of the performance continuum) would enable designers to develop solutions that are more sympathetic to older user requirements. 8. Conclusions

An aging society of consumers has a variety of specific user needs which need to be incorporated into the design of mobile phones. Inclusive design is a philosophy that can enable users and more specifically the older population to take a more active role in society through design solutions that support their needs. However, all too often, especially with rapidly developing technologies, this group is excluded making disabilities out of impairments. The advantages of inclusive design and user-centred approaches and standards, have been cited along with the requirements older users have, with a broad description of the performance continuum and changes that occur with ageing. The failure to include the needs of older users is due to a number of factors which construct a ‘cell of exclusion’ not only in the expectations of design but those of older users themselves and society also. The notion of the ‘cell of exclusion’ illustrates that there is more development required before the mobile phone is providing full access to older users. Trends for the miniaturisation of screen and keys have further excluded the older user and isolated an increasing market sector. Probably through financial motivation, phone companies are beginning to respond to the developing market of older users. However, whilst manufacturers and service providers may be addressing some issues in relation to handset design (micro-design) there are still many barriers that exist when considering wider systems use of the technology (macro-design). Older users may be willing to use mobile services as long as they truly facilitate independent living. 9. Acknowledgements

The authors would like to thank Colette Nicolle (Ergonomic and Safety Research Institute, Loughborough University), Dr Gregg Vanderheiden, Dr Gardner–Bonneau (Helen Hamlyn Research Centre, Royal College of Art), and Dr John Gill (Royal National Institute for the Blind) for their guidance and help.

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10. References

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Hitchcock, D. R., Lockyer, S., Cook, S., and Quigley, C. (2001). Third age usability and safety: an ergonomics contribution to design. International Journal of HumanComputer Studies, 55, 635-643. Hone, K. S., Graham, R., Maguire, M. C., Baber, C., and Johnson, G. I. (1998). Speech technology for automatic teller machines: an investigation of user attitude and performance. Ergonomics, 41. Hughes, J. A., O'Brien, J., Rodden, T., Rouncefield, M., and Blythin, S. B. (1997). Designing with ethnography: a presentation framework for design. In G. Van De Veer, A. Genderson and S. Coles (Eds) Proceedings of DIS ‘97 Designing Interactive Systems Conference (pp. 147-158). New York Association Computing Machinery Press. IEGMP (Independent expert group on mobile phones), (2000). Mobile phones and health. The Stewart Report. Retrieved Dicember 18, 2006, from

http://www.iegmp.org.uk/report/text.htm. Ishihara, K., Ishihara, S., Nagamachi, M., and Osaki, H. (2002). Difficulties for elderly people caused by age-related yellowing vision. In P. McCabe (Ed.) Contemporary Ergonomics 2002 (pp. 579-581). London: Taylor and Francis Ltd. Kandel, E. R., Schwartz, J. H., and Jessell, T. M. (2000). Principles of Neural Science. 4th Edition. New York: McGraw-Hill. Keates, S., and Clarkson, J. (2004). Countering design exclusion: An introduction to inclusive design. Springer: UK. Kirwan, B., and Ainsworth, L. K. (1993). A Guide to Task Analysis. London: Taylor and Francis. Lee, K. S., and Kim, B. (2003). A study on the usability of mobile phones for the elderly. In M. Kumashino (Ed). Aging and work (pp. 261-169). London: Taylor and Francis. Militello, L. G., and Hutton, R. J. B. (1998). Applied Cognitive Task Analysis (ACTA): a practitioner’s toolkit for understanding cognitive task demands. Ergonomics, 41(11),1618-1641. Miller, G. A. (1956). The magic number seven, plus or minus two: Some limits on our capacity for information processing. Psychological Review, 63, 81-97. Mikkonen, M., Vayrynen, S., Ikonen, V., and Heikkila, M. O. (2002). User and Concept Studies as Tools in Developing Mobile Communication Services for the Elderly. Personal and Ubiquitous Computing, 6(2), 113-124.

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Mitchell, J., and Chesters, R., (2004). Designing out the cell of exclusion. In P. McCabe (Ed), Contemporary Ergonomics 2004 (pp. 445-448). London: Taylor and Francis Ltd. Norris, B., Smith, S., and Peebles, L. (2000). Older Adultdata – The handbook of measurements and capabilities of the Older Adult – data for design safety. UK: Department of Trade and Industry. Palen, L., and Salman, M. (2002). Voice-mail diary studies for naturalistic data capture under mobile conditions. Computer Supported Cooperative Work Conference 2002 (CSWC 02). New Orleans, LA. Sato, H., Miura, A., Sakai, M., Sato, H., and Fukuba, Y. (2000). Muscle cross-sectional area an strength of upper arm in men and women. Japanese Journal of Ergonomics. 36(6), 335-341. Steenbekkers, L. P. A., Dirken, J. M., and Van Beijsterveldt, C. E. M. (1998). Designrelevant functional capacities of the elderly, assessed in the Delft

Gerontechnology project. In P. Seppala, T. Luopajarvi, C.H. Nygard and M. Mattila. (Eds). From Experience to Innovation - IEA '97. Proceedings of the 13th Triennial Congress of the International Ergonomics Association (612-614), Tampere, Finland, June 29-July 4, 1997. Stone, R. J. (2001). Virtual Reality. Virtual and Synthetic Environments: Technologies and Applications. In W. Karkowski (Ed.), International Encyclopaedia of Ergonomics and Human Factors. London: Taylor and Francis. Summers, A. (2001). Living Longer – The context for new design. London: The Design Council. Takeda, S., Morioka, I., Miyashita, K., Okumura, A., Yoshida, Y., and Matsumoto, K. (1992). Age variation in the upper limit of hearing. European Journal of Applied Physiology and Occupational Physiology, 65(5), 403-408. Tuomainen, K., and Haapanen, S. (2003). Needs of the active elderly for mobile phones. In C. Stephanidis (Ed). Universal access in HCI: Inclusive design in the information society (pp. 494-498). Mahwah, New York: Lawrence Erlbaum Associates. Wiley, J., Sung, J, Abowd, G (2006). The message center: Enhancing elder communication. Conference on Human factors in Computing Systems, CHI 2006, ACM, Montreal Quebec. Woodhuysen, J. (1993). A call for trans-generational design. Applied Ergonomics, 24(1), 44-46.

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PsychNology Journal Volume 4, Number 3, pp. 285 -308

Cognition, technology and games for the elderly: An introduction to ELDERGAMES Project
Luciano Gamberini♠♣, Mariano Alcaniz!, Giacinto Barresi ♠, Malena Fabregat , ♦ Francisco Ibanez , Lisa Prontu ♠

HTLab, Department of General Psychology University of Padova (Italy) ♦ AIJU, Alicante (Spain) ! Universitat Politecnica de Valencia (Spain)

ABSTRACT
Eldergames is a EU-funded project to develop games using advanced visualisation and interaction interfaces to improve the cognitive, functional and social skills of older users. The project merges two major areas to which technology for elderly people is applied: health and social engagement. Its platform will allow users to improve their cognitive skills and individual well-being by playing on a mixed-reality platform; in addition, it will offer the unusual experience of communicating with people located in other countries without the need to share the same language. After introducing the field of gerontology and the project, this paper describes the main cognitive abilities that change with aging (perception, attention, memory, and other more specific processes such as decision-making), and that have to be taken into account while designing a technology for elderly people. Some guidelines that are specifically meant to ensure usability of these products are listed in the conclusions.

Keywords: successful aging; cognitive aging; gerontechnology; playing Paper Received 16/11/2006; received in revised form 10/12/2006; accepted 19/12/2006

1. Introduction Life is characterized by transformations; every aspect of the human being changes along the whole lifespan during both development and aging, and it is impossible to define exactly the end of the former and the start of the latter. While people aged over 60 can be conventionally considered older adults, yet a more
Corresponding author: Luciano Gamberini HTLab- Dept. of GeneralPsychology University of Padova Via Venezia,8 –35131 Padova (Italy) Tel.+39 049 8276605 Fax. +39 049 8276600 e-mail:luciano.gamberini@unipd.it

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complex definition must take into account three levels (Fisk, Rogers, Charness, Czaja and Sharit, 2004): biological, psychological and social. It is easy to think that getting older involves decrease of performance and weakening of memory; however, people believe that the large number gain knowledge and wisdom and accumulate heterogeneity of experiences (Hummert, Garstka, Shaner, Strahm, 1994, in Park, 2000). On the basis of the distinction between a fluid (e.g. problem-solving, distribution of attention on multiple tasks) and crystallized (e.g. cultural knowledge, linguistic competence) intelligence (Horn and Cattell, 1967, in Mata, 2006), Baltes et al. (1999, in Mata, 2006) classify the first set of abilities as the mechanics of cognition (basic information processing) and the second kind as the pragmatics of cognition (acquired cultural knowledge). Dixon has grouped the advances related to cognitive aging, as “gains qua gains” (some abilities continue to grow, like wisdom; Heckhausen, Dizon and Baltes, 1989, in Dixon, 2000), “gains as losses of a lesser magnitude” (e.g. redefining the goals of life can help to cope with the impossibility of maintaining some usual high standards; Brandstädter and Wentura, 1995, in Dixon, 2000) and “gains as a function of losses” (for example, the brain is able to develop compensatory ways to perform a cognitive task; Buckner, Corbetta, Schat, Raichele and Pettersen, 1996, in Dixon, 2000). This last point links to the notion of plasticity of the neural system, which decreases with age, but is nonetheless able to compensate for the losses due to aging processes (Singer, Linderberger and Baltes, 2001), for instance, by reorganizing the aspects of a problem; Park, Polk, Mikels, Taylor and Marshuetz, 2001). The possibility of “successful aging” is strictly related to this ability to reshape thoughts and goals in order to cope with the difficulties derived from the elderly condition, such as the consequences of retirement. The present line of thought is to improve the quality of life for these people, not only to extend the duration of their life. In particular, gerontechnology (Burdick and Kwon, 2004) is the expanding field of technology applications to improve the elderly life conditions, considered as a special category of users, whose particular abilities and needs, at cognitive, social and health levels, have to be taken into account during the design process. The goal of this paper is to present a European-funded project in this application area, attempting to use playing as an opportunity to solicit the cognitive activity and to facilitate successful aging in several spheres, including sociability. First we will introduce the ways in which technology can be used to improve elderly people’s social life and health; then, from a user-centered design perspective, we will provide a synthesis of the main cognitive changes accompanying aging, for they have to be taken into account when designing

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technologies for this category of users; finally, we will illustrate the specific purpose of the “Eldergames” project and its starting assumption, according to which, playing represents an advantageous way, from several points of view, to engage users cognitively and socially. 2. Elderly and Technology From a demographic point of view, the percentage of the older population has increased in the past decades and at present, it constitutes between 6 and 15% of the worldwide population (Kinsella and Velkoff, 2001, in Burdick and Kwon, 2004) and is expected to exceed one billion in 20 years (United Nations, 2001). According to Kinsella and Velkoff (2001, in Burdick and Kwon, 2004), the percentage of older people using computers is also continuously increasing. Stereotypes and myths should be revised according to the latest statistics: 40% of the U.S. population over 65 uses computers (U.S. Department of Commerce, 2002), 35% has access to the Internet ( U.S. Department of Commerce, 2002) and 60 to 90% owns new electronic devices like microwave ovens, videocassette recorders, cordless phones and answering machines (Adler, 1996, in Burdick and Kwon, 2004). Technology helps elderly keep in touch with families and friends, ensures more safety at home, assisting and facilitating them in health care (Czaja, 1996, in Mikkonen Vayrynen, Ikonen, Heikkala, 2002), bringing new stimuli into their lives and providing more access to information (Lehto, Tekniikkaa, 1998, in Mikkonen et al., 2002). Other studies confirm the role of technology in increasing social interaction and pride (Kautzamann, 1990), self-esteem (Lustbader, 1997), life satisfaction (Sherer, 1996), and perceived autonomy (McConatha, McConatha and Dermigny, 1994). Regarding health support, communication technologies and wireless systems enable health consultations, physiological data collection, safety and environmental control in order to avoid disease, maintain physical and cognitive function, and maintain engagement during life (Burdick and Kwon, 2004). With respect to the first objective, avoiding disease, the HomeCare and Telerehabilitation Technology (HCTR) Center at The Catholic University of America started a project using plain older telephone service (POTS) for health care communication and interaction between remote health care experts and elderly patients at home. Results reported are generally positive (Buckley, Tran and Prandoni, 2001, in Burdick and Kwon, 2004): high levels of tolerance and acceptance by patients,

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positive impact on the quality of care given, consistence of the support also from a psychosocial point of view. Tele-health technologies can also be employed to diagnose and monitor chronic illnesses, such as heart failure (Fulmer et al., 1999, in Burdick and Kwon, 2004), respiratory diseases (Kinsella, 2000, in Burdick and Kwon, 2004) and diabetes (Gomez et al., 2002, in Burdick and Kwon, 2004). Data collected through common (blood pressure, temperature, heart rate sensors) and specialized (electrocardiograms, heart and lung sounds, blood oxygen levels…) systems is transmitted to monitoring stations or directly to caregivers. An example of the second objective, maintaining cognitive and physical functions, is provided by a “consumer toolkit” of home automation and monitoring developed by HCTR center with the objective to collect environmental information during daily life activities. In this system there are sensors that continuously collect data about an individual’s location and activities; this information is then used to monitor changes in everyday behaviors, which are probably related to changes in health status. Finally, the third objective, lifelong engagement, is illustrated by technologies that facilitate communication, for they are especially appreciated in case of people who suffer from physical and cognitive disabilities, isolation, frustration and depression (McColl and Skinner, 1995, in Burdick and Kwon, 2004). They give older people the possibility to share their experiences in social networks, perhaps with others who have the same diseases or disabilities who can provide suggestions and emotional support, but could not possibly move from their home or live alone (Charness, Schaie, 2003). For instance, the University of Oulu and Nokia Mobile Phones (Mikkonen, Vayrynen, Ikonen, Heikkala, 2002) are engaged in the implementation of products, services and complete systems for disabled and elderly communication. The major goal is the development of the “Home Assistant,” a multimedia communication terminal to keep in touch with families, friends and care assistants. Assistive technology has been defined as “any item, piece of equipment or product system, whether acquired commercially off the shelf, modified, or customized, that is used to increase, maintain, or improve functional capabilities of individuals with disabilities” (Public Law 105-394, 1998). The principal application of assistive technologies concerns daily activities, social relationships, communication, participation needs and self efficacy. Their positive effect has been demonstrated both for the users and for their social world, i.e. the relationships with family and other caregivers (Gitlin et al., 2002, in Burdick and Kwon, 2004), those persons directly involved in daily caring for elderly with chronic illnesses or disabilities. In general, they are members of the family who help with housework,

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transportation, dressing, bathing, medications…, and are sometimes organized into support groups, in order to get advice, face stress and other possible negative consequences in their private, social and health life (Schulz, O’Brien, Bookwala, Fleissner, 1995, in Burdick and Kwon, 2004). Computer-mediated communication can facilitate this group-interaction, especially when time for regular face-to-face meeting is lacking. Fisk et al. (2004), who conducted several focus groups with elderly people, found that more than 50% of problems reported by participants in using technological tools related to usability, and could be solved by improving the design (25%) or by providing training (28%). Input and output devices are particularly delicate, because they involve an interaction with the sensory or perceptual system of the user, which undergoes several changes with age that can hamper usability. Fisk et al.(2004) consider “usability” as the possibility to have access to a product, and define “utility” as the capability to provide the functionality the product possesses. They also identify five characteristics related to usability, which are particularly important when speaking about older adults: • Learnability: how difficult it is to learn to use a device, to understand and to integrate functioning instruction. Time needed to complete a task correctly and results obtained in a certain amount of time are possible measures of learnability. • Efficiency: the extent to which technological applications satisfy users’ needs, avoiding loss of time, frustration and dissatisfaction. It can be measured by an experienced user’s performance on a specific task; • Memorability: elderly users’ memorability of a device’s functioning is very important in order to avoid frustration and loss of time. A simple measure of this characteristic can be obtained by considering the time needed to perform a previously experienced task; • Errors: how easily a product can induce errors for elderly users and how easily it recovers from them. • Satisfaction: users’ attitude and adoption of technological applications could be influenced by the pleasure derived from their usage.

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3. Eldergames Project ElderGames is a EU-funded project within the information society technology area (IST), to develop games using advanced visualization and interaction interfaces with a high preventive, therapeutic value that will allow elderly people to enjoy new opportunities for leisure and entertainment situations, while improving their cognitive, functional and social skills. The Consortium is composed of universities, industries, elderly leisure/care centers and technology centers/associations from Spain, Norway, United Kingdom, Finland, Austria and Italy. The project relies on the assumption that playing a game may have several benefits for elderly people, and that technologies may increase these benefits by providing specific integrated solutions to other aspects of elderly people’s everyday lives. ElderGames will try to address the problem of older users’ exclusion from opportunities and exclusion from advances deriving from technology (SEU, 2005), by designing the tool around their needs and by testing the platform in care/leisure centers. The assumption according to which gaming may benefit users’ cognitive and general well-being is supported by several research findings, both of general users and of elderly users. For instance, according to Rauterberg (2004), entertainment technology has positive effects on human behaviour in areas including: general development (thanks to use of logic, memory, problem-solving and critical thinking skills, visualization and discovery); collaborative and pro-social behaviour; healthcare and therapies (phobia, hyperactivity…). Participation in entertainment activities could be very helpful for the maintenance of cognitive skills. For example, Goldstein, Cajko, Oosterbroek, Michielsen, Van Houten and Salverda (1997) compared results obtained from two groups of older adults aged 69 to 90; the experimental group played Super Tetris five hours a week for five weeks, the other group did not. Authors measured reaction time (Sternberg Test), cognitive/perceptual adaptability (Stroop Color Word Test), and emotional well-being (self-report questionnaire), before and after this play period. Data analysis showed that the videogame-playing group had faster reaction times and felt a more positive sense of well-being compared to the non-playing one. Whitcomb (1990) reviewed a number of videogames that were enjoyable for the elderly, and considered

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unsuitable those games that had small objects on the screen, required rapid reactions, or had inappropriate sound effects, generating a certain level of frustration and absence of interest. Whitcomb showed benefits of gaming practice for elderly people revealed by the studies he reviewed, in several domains: stimulation of social interaction and participation; enhancement of perceptual-motor skills (eye-hand coordination, dexterity, and fine motor abilities); improvement of performance speed (basic movements and reaction time); transfer of the skills acquired in the games to other aspects of everyday routine (like automobile driving). Although these studies do not directly focus on improvements in cognitive skills, they report on several effects on information processing, reading, comprehension, memory, self-image. As mentioned above, the Eldergames platform will not only allow users to play a game individually; it will integrate this facility with other solutions made available by information and communication technology. First, a low cost mixed-reality technology will be used, namely a technology where the real environment is enriched with artificial information generated by the computer. Khoo et al. (2006) developed ‘Age Invaders’, an interactive game, to allow the elderly people to play together in a physical space with grandchildren, while parents could participate through the Web. Second, Eldergames will implement an unusual communication environment for users, connecting people of different European nationalities; in order to do this, Eldergames will have to use a communication interface that helps overcome comprehension and communication problems, in order to foster cross-cultural interaction. Third, ElderGameshas been conceived as a tool for early diagnosis. In order to do this, the first steps are to identify the following: • • • areas of intervention and cognitive variables that ElderGames should address. instruments and indexes, already tested and validated, to measure cognitive skills and quality of life; appropriate communication systems that will easily integrate into the ElderGames platform and that would satisfy the communication and interaction needs of culturally and linguistically different kind of users; • visualisation and interaction technologies appropriate for use by older people or for implementation in recreation and specialized centres.

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The level of acceptance and usability of the system will be tested with direct users (older adults) and experts. Taking into account the specific abilities of the elderly user is a necessary pre-condition for usability when designing the system and especially when designing the interface. For these reasons, we will summarize some of the main cognitive changes accompanying aging, and conclude with design guidelines that take them into account. 4. Aging and Cognition Theories of psychological aging emphasize three aspects of this process: the speed of information processing shows an aging-related decline that negatively affects cognitive abilities (Salthouse, 1996, in Park, 2000); lack of resources and the reduced capacity of working memory (Craik and Byrd, 1982 in Park, 2000); poor capacity of inhibiting irrelevant information (Zacks and Hasher, 1997, in Park, 2000). 4.1 Perception 4.1.1 Vision The anatomical changes in the ocular apparatus affect adaptation to darkness, visual acuity, glare, contrast sensitivity, peripheral vision, motion perception and color perception. Omori, Watanabe, Takai, Takada, Miyao (2002), for instance, found that bigger font sizes in mobile phones can increase elderly users’ speed and accuracy in reading the display. Schieber (2003) analyzed these changes and proposed 9 design criteria within a human-factor perspective in order to compensate for age-related deficits in the visual system: increasing the illumination of environment or task context; increasing the levels of luminance contrast; minimizing the need to use a device excessively close to the eyes; adapting the font size; minimizing glare; minimizing the use of peripheral vision; adopting marking strategies to enhance motion perception; using great color contrast; optimizing the legibility of spatial forms using computer capabilities.

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Pinto, De Medici, Zlotnicki, Bianchi, Van Sant and Napoli (1997, p. 343) analyzed the role of environmental design in case of reduced visual acuity in elderly people and proposed recommendations to improve users’ comfort and safety (Table 1). These recommendations define the values of a list of perceptual properties of areas (e.g. glare index of the walls, opacity of windows and doors, direct and indirect lightning) to reduce the risks caused by poor design of floor, wall, doors and windows, furniture and equipment, direct lighting, indirect lighting. 4.1.2 Hearing The anatomical changes in the ear affect absolute sensitivity, frequency and intensity discrimination, sound localization and speech recognition. For instance, Kiss and Ennis (2001) observed that computer-generated speech, which does not match the rhythm properties of natural verbal production, can be problematic for elderly drivers. Schieber (2003) proposed 9 design criteria, as he did for vision: increasing stimulus intensity, controlling background noise, avoiding the need to detect/identify high-frequency stimuli, avoiding long-term exposure to high levels of noise, avoiding signal locations with low frequency sound sources, using redundant and semantically well-structured speech materials, adapting the rate of words per minute, asking for feedback from users to calibrate the devices, using the Web to provide verbal communication channels for assistance.

4.1.3 Touch and Movement Aging determines problems (arthritis, tremors, particularly for Parkinson’s disease) affecting the manipulation of objects and the perception of sensorial feedback in terms of pressure, vibration, spatial acuity, perception of roughness, length and orientation (for a brief review, see Scialfa et al., 2004). In particular, older adults have a higher threshold of detecting vibrations (Goble, Collins and Cholewiak, 1996, in Scialfa 2004), which has to be taken into account when devising vibrating alerts. In this vein, Liu et al. (2002) realized a system producing a mechanical noise to reduce the

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vibrotactile detection thresholds in older adults, patients with stroke, and patients with diabetic neuropathy. 4.2 Attention 4.2.1 Attention and Resources Attention is a multidimensional construct (Parasuraman and Davies, 1984) that categorizes a variety of processes distributing elaboration resources on several dimensions. Attentive processes are necessary to perform complex tasks like planning or problem-solving; aging reduces flexibility in selecting the correct solution, so that the intrusion of incorrect solutions becomes more frequent (Bisiacchi, Sgaramella and Farinello, 1998). 4.2.2 Selective and Focused Attention Selective attention is the process of selecting certain information to elaborate on it, filtering out the irrelevant information. Rogers (2000); suggests that this ability loss (e.g. lack in inhibitory processes, Zacks and Hasher, 1997, in Park, 2000; augmented probability to be distracted, McDowd and Shaw, 2000, in Burdick and Kwon, 2004) is task-specific and related to previous experience with the objects used as target and distractors in the task (Clancy and Hoyer, 1994, in Rogers, 2000). Therefore, agerelated differences in selective attention can be reduced by increasing familiarity with the items manipulated and with cues that change the attentional need from selective to focused, which does not seem to show age-related deficits (Rogers, 2000). For instance, Staplin and Fisk (1991) observed that cues about incoming hazards at intersections improved the safety behavior practiced by older users of driving simulators. 4.2.3 Divided Attention and Attentional Switch Divided attention is the distribution of processing resources among multiple simultaneous tasks or rapidly switching from one task to another (Rogers, 2000). Age-related deficits increase with the increase of the stimulus complexity (McDowd and Craik, 1988) and decrease with the increase of the amount of practice in the task (for a brief review: Rogers, 2000). Strayer and Drews (2004) for instance, found that a longer experience in driving and taking fewer risks reduced the predicted

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augment in reaction time of older compared to young users talking to the telephone while driving in a simulator. 4.2.4 Automatic and Voluntary Processing Automatic processes are not affected by aging, while voluntary processes, which require a certain amount of attentional resources and awareness, decrease with aging (like fluid intelligence, see above); practice can reduce this decrease through a process of automatization (Rogers, 2000), even though its effectiveness depends on the kind of task: for instance, visual search needs attentional resources even after a long practice (Fisk and Rogers, 1991, in Rogers, 2000). As to the kind of training, Jamieson and Rogers (2000) showed the absence of age-related differences in the acquisition of the ability to perform transactions on a simulated automatic teller machine if the practice schedule was random instead of being organized by blocked sets of trials. 4.2.5 Sustained Attention and Vigilance Sustained attention means maintaining focus on the same task under continuous stimulation. Vigilance means keeping the focus on waiting for a rare event. Giambra (1993, in Rogers, 2000) observed contradictory results in his review of past studies; when age-related deficits are reported, they are attributed to functions related to task (discrimination and duration of single stimulation, requirement of working memory effort), which are not strictly ‘attentive’. Anstey, Wood, Lord and Walker et al. (2005) insert sustained attention among the age-related factors affecting driving performance, linking them to mental workload like other resource-dependent functions. 4.3 Learning and Memory Like other cognitive constructs, the memory is a heterogeneous category of processes, each one specifically affected by aging (Craik, 2000). Learning is also affected by interacting factors like affective processes, motivation, strategic approach and metacognition (the knowledge of an individual about her own cognitive abilities): for instance, older people’s lack of confidence in their abilities can create obstacles to the efforts to approach new technologies (Marquié, Jourdan-Boddaert, Huet, 2002) .

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4.3.1 Implicit versus Explicit Processes One of the first characterizations could be implicit (procedural and performancerelated) processes versus explicit (declarative and conscious) processes: the first ones seem unaffected by aging (Light and La Voie, 1993), in opposition to second ones. This situation induces an imbalance in cognitive control in older people, which ends up being mainly governed by the unimpaired processes, producing, for example, false memories (Schacter, Koutstaal, and Norman, 1997). Specific training programs for technological tools have been studied by Mead and Fisk (1998, in Burdick and Kwon, 2004) who contrast two kinds of training for older adults, namely ‘Concept’ versus ‘Action’ and found that Action trainees repeat errors less frequently than Concept trainees on menu navigation tasks. 4.3.2 Working Memory Working memory is conceptualized as a temporary and limited workspace for the manipulation of present and active fragments of information available to the awareness to accomplish a task (Baddeley and Hitch, 1974, in Craik, 2000); it includes the following processes: central executive, phonological loop, visuo-spatial sketchpad, and episodic buffer (Baddeley, 2000). Craik et al. (1990, in Craik, 2000) observed a great deterioration of working memory capabilities in older adults according to task complexity. Reducing the number of options and the speed of item presentation in an interface menu may positively affect the demand for cognitive resources and information manipulation (Reynolds, Czaja and Sharit, 2002). 4.3.3 Semantic Memory Semantic long-term memory stores general knowledge (meaning of words, concepts, recognizing a location), regardless of when and where it has been acquired (Baddeley, 1986). In this sense, it contrasts with the episodic one, which consists of the recollection of events localized in space and time, even originally experienced ones. Semantic memory is substantially preserved during the normal aging process (Light, 1992) and it is a strong help to build elderly-centered technologies, as was observed above in case of perceptual problems. Neale and Carroll (1997) proposed the use of metaphors to create a semantic-relevant context to guide the use of an interface by elderly people.

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4.3.4 Prospective Memory Prospective memory is the “remembering to remember” (the memory of a task to be accomplished in the future); studies revealed significant age-related increases in error rate (Cockburn and Smith, 1991, in Burdick and Kwon, 2004), more for timebased tasks (acting after a certain time span) than for event-based tasks (acting after a certain event). The use of cues facilitates this recollection, but depends on the nature of the task (Einstein and McDaniel, 1990, in Mayhorn, Rogers and Fisk, 2004). 4.4 Everyday Cognitive Tasks 4.4.1 Navigating in Environments Sheperd and Metzler (1971) defined “spatial ability” as the function of manipulating images or patterns. Processes related to space (even visuo-spatial attention and working memory) or to its mental representations decline during the normal aging process (Salthouse, 1992). Environmental cognitive psychology is a field central to aging applied research aimed at improving elderly people’s quality of life by redesigning their everyday life space or integrating it with tools and general cues supporting losses in memory or attention (Sundstrom, Bell, Bubsy, Asmus 1996). Mayhorn et al. (2004) highlighted the spatial connotation of web-navigation tasks and suggested the implementation of Web site maps as an external support to the deteriorated spatial abilities of the user (Mead et al. 2002, in Burdick and Kwon, 2004). 4.4.2 Reading and Understanding Instructions Some learning activities start from reading texs; reading ability is relatively preserved in non-visually impaired older people; problems may emerge with texts that do not semantically refer to the readers’ knowledge, as happens with instructions of home medical devices. Hancock, Fisk and Rogers (2001) found that understanding improved by reducing the number of inferences needed. The perspective of cognitive load theory (Van Gerven, Paas, Merriënboer, Schmidt, 2000) suggests “to optimize schema acquisition by stimulating an efficient use of working memory” (p. 16); some proposals in this direction include: presenting goalfree problems (without a specific solution) to stimulate the exploration of the domain,

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distributing information over different modalities, avoiding split attention, presenting problems along with solutions and leaving out redundant information. 4.4.3 Risky Decision-making Decision-making is fundamental to position in a world full of options. In several cases, the prediction of the consequences of a certain choice includes a high degree of uncertainty (Dawes, 1998). Older people seem to have a tendency to search and consider less relevant information when in the process of making a decision, and to perform more slowly in making the choices (Sanfey and Hastie, 2000). The research in this field needs ecological data to situate the decisional act in its context and to monitor the biases occurring in elderly people. A decisive help to analyze the decisional behavior of older people in potentially dangerous settings comes from the use of instrumented vehicles and simulators. Instrumented vehicles permit collecting quantitative data (strategy, vehicle usage, upkeep, drive lengths, route choices, and decision-making) in the field. Along with driving simulators, they can provide complementary information about driving behavior, accidents and their dynamics (Rizzo, Jermeland, Severson, 2002). 5. Design Implications Currently, user interface design is oriented to graphic conceptualizations like WIMP (Window, Icon, Menu, Pointing device). Dickinson, Eisma, Gregor (2003, in Van de Watering, 2005):) highlighted several solutions to elderly-related problems with WIMP interfaces,: reduction of operations offered at once to avoid excessive interface complexity caused by excessive number of functions; minimizing the trees of options to avoid the presence of layered menus, causing a lack in working memory about the existence of “invisible” options; realizing specific keyboard commands instead of mouse “drag and drop”, complicated for elderly people at motor level; giving immediate feedback about any selection on screen to simplify the understanding of the correctness of the operations;

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-

maintaining the consistency of the appearance of the interface to minimize the confusion of the user seeing changes when looking at several screens using the same interface.

Chadwick-Dias et al. (2003) observed the frequent tendency of elderly users to click on items that are not links (headings, bullets, icons and plain text, too); they also present difficulties with horizontal scrolling and tabbed navigation. Davies, Haines, Norris and Wilson (1998) cited Easterby and Hakiel (1981) to show how even easily recognizable symbols can lead to poor understanding of their meaning in older adults when compared to younger people, probably for specific lacks in working memory, elaboration speed and basic elaboration to extract of the meaning of new information (computer skill learning could be a new experience for some older adults, with some needing practice periods longer than for young people, even if equally successful at the end; Siek et al., 2006). Apted et al. (2006), to maximize learnability and memorability of new elements of the interface of a tabletop-sharing system for digital photographs, arrived at the following modified version of the Nielsen guidelines: relying on familiar aspects of the activity (i.e. manipulating photographs), reducing the amount of learning efforts; o o o minimising the number of interface elements; maximising the interface consistency; using all-new items for new tasks (to avoid confusion with already learnt actions). According to these criteria, Apted et al. (ibidem) proposed the SharePic multi-user, multi-touch, gestural collaborative tool to help social interactions and digital object interaction “around a table” (the touch-screen tabletop interface). These objects are manipulated through commands operated by a hand-shaped cursor, whose actions are very learnable and natural (like the “rosize” operation: rotation and resizing of the photo using its corners), thanks also to the touch-screen interface. Two new interactive objects were proposed, and both of them were easily mastered by the elderly users: the Frame (to cut photos and create photocards) and the Black Hole (to delete and hide other objects). More generally, and given changes in the cognitive abilities of elderly people, mentioned at paragraph 4, designers are recommended to respect the following guidelines:

o

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"

the signal strength of messages should be increased, especially for warning signals, and, the sources of noise for the system should be reduced. In order to make the product more usable, redundant channels should be provided, using several sensory modalities. It important to allow older people to read printed text easily, by exploiting the contrast between text and background.

"

designers should decrease the number of steps and controls needed to complete a task, being aware that mistakes in any part of the serially organized sequence could affect the overall goals’ achievement. In particular, the likelihood of committing errors during a long sequence of operations is higher for older people than young users.

older adults are less experienced with ICTs and could lack some basic knowledge required to effectively interact with them. Thus, the information required to correctly perform a task should be immediately visible in the interface, avoiding older people to rely on intuition or to memorize long sequences of operations.

designers should also consider users’ goals and expectations of how a system actually works and how it matches with their objectives. In particular, older adults’ expectations could be strictly anchored to mental models developed in their past experiences with other tools. Yet, interfaces have to provide consistency as much as possible,, in order to have a correct balance between expectations and functioning. Information should also be organized according to past knowledge. Of particular importance is the use of icons and other symbolic representations. They can convey information in a simple and direct way; designers select those icons that can be actually recognized and understood by users, without any ambiguity or misunderstanding.

Consistency: aging involves a decrease in working memory capabilities. Older users tend to rely on external cues and on environmental support to find out information and correct responses from memory; so it is important to give more evidence to the link between stimuli and learned responses, especially for those users that have some difficulties in quickly learning. Designers have to organize the information framework in order to avoid complex visual displays and, instead, use visual cues that reduce the

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search space, because of the likelihood to forget command names and to waste a long time searching for basic information. • Compatibility refers to the extent to which options offered in the interface and display are compatible with the user’s options. For example, it is important that a task labeled in a menu corresponds to labels users would select themselves, capitalizing on users’ past experiences and knowledge. • Finally, design processes have to focus on documentation, available helps, error messages and manuals in order to help users, especially the older ones, to recognize and correct possible breakdowns. Older people are particularly likely to make errors in some steps of the task, thus application should provide information about kind of errors, consequences and recovering strategies. Older people could also prefer formal training and manuals to learn system functioning and they often rely much more on help systems and error messages. Thus it is important not only to make them accessible in an application but also to use the most compatible and consistent ones.

6. References

Adler, R.P. (1996). Older adults and computers: Report of a national survey. Technical Report for SeniorNet. Anstey, K. J., Wood, J., Lord, S., and Walker, J.G. (2005). Cognitive, sensory and physical factors enabling driving safety in older adults. Clinical Psychology Review, 25, 45-65. Apted, T., Kay, J., and Quigley, A. (2006). Tabletop Sharing of Digital Photographs for the Elderly. In Proceedings of CHI2006, the Conference in Human Factors in Computing Systems, April 24 - 27, 2006, Montréal, Québec, Canada, 781 - 790 . Baddeley, A.D. (1986). Working Memory. Oxford: Clarendon Press. Baddeley, A.D. (2000) Working Memory. APA Encyclopaedia. Baddeley, A.D., and Hitch, G.J. (1974). Working memory. In Bower, G.H. (ed.), Recent Advances in Learning and Motivation, 8, New York: Academic Press. Baltes, P. B., Staudinger, U. M., and Lindenberger, U. (1999). Life-span developmental psychology. Annual Review of Psychology, 50, 471-507.

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PsychNology Journal, 2007 Volume 4, Number 3, 311 – 335

“Augmented itineraries”: Mobile services differentiating what museum has to offer
Maria Cristina Brugnoli , Federico Morabito , Giancarlo Bo , Elena Murelli

Telecom Italia, Rome (Italy) Giunti Labs, Sestri Levante (Genova, Italy) Università Cattolica del Sacro Cuore Piacenza, Italy

ABSTRACT
Museums are the mechanism through which we research, interpret and present our insights into the natural and cultural worlds. They represent our belief systems concerning cultural inter-relationships, our relationship with the environment and of our place in the Universe. They are windows on the "dream-time" of humanity. Wireless technology is becoming a part of the museum experience. In an effort to bring art and science to life for a new generation of technically sophisticated patrons, an increasing number of museums are experimenting with advanced mobile technologies to make museum going more interactive, more educational — and more fun. An ideal electronic guide to a museum is one that you take at the entrance, put in your pocket and forget you have. It should fully support a free, natural visit providing the most appropriate information at the right time and place. The only activity required of visitors is to enjoy the exhibition: the interaction is with the (augmented) museum, no longer with the guide; the guide analyses the context and composes presentations adapted to the current situation. In this paper we present the results of an experimentation conducted in the Florence’s Uffizi Gallery with groups of user using the MOBILearn systems a novel application based on innovative mobile-learning services specifically designed to improve the Museum “experience”. The main objective of this paper is to describe the results of qualitative research into the behavior of users during the trial. In particular the paper will present the participants’ overall experience, responses and needs; the participants’ responses to, and perceptions of, specific system capabilities (including responses relevant to the particular device they used in the trial), pointing to comments and suggestions that may serve to improve the system; and will finally identify “key findings” and provide general observations on how the MOBILearn system can change users’ experience of a museum.

Keywords: mobile learning, interactive services for museums, user experience, augmented itineraries. Paper Received 10/11/2006; received in revised form 18/12/2006; accepted 19/12/2006.

Corresponding Author: Maria Cristina Brugnoli Telecom Italia Viale Parco de' Medici, 37, Rome-Italy Phone: +39.06.368.70402 fax: +39.06.368.72910 e-mail: mariacristinabrugnoli@gmail.com

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1. Introduction

Museums are the mechanism through which we research, interpret and present our insights into the natural and cultural worlds. They represent our belief systems concerning cultural inter-relationships, our relationship with the environment and of our place in the Universe. They are windows on the "dream-time" of humanity. Wireless technology is becoming a part of the museum experience. In an effort to bring art and science to life for a new generation of technically sophisticated patrons, an increasing number of museums are experimenting with advanced mobile technologies to make museum going more interactive, more educational — and more fun. An ideal electronic guide to a museum is one that you take at the entrance, put in your pocket and forget you have. It should fully support a free, natural visit providing the most appropriate information at the right time and place. The only activity required of visitors is to enjoy the exhibition: the interaction is with the (augmented) museum, no longer with the guide; the guide analyses the context and composes presentations adapted to the current situation. Of primary importance in an augmented museum is the interpretation of both visitors’ behaviour (e.g., stops, long stay, coming back) and the context where the action takes place. The places of use (a museum, the open air), the device (a PDA, a phone) or the available infrastructure (networks, GPS, infrared) are as important as social aspects (e.g., being alone or not, who the others are, if this brings pressure) and personal traits (e.g., attitudes, preferences, interests). In this paper we present the results of an experimentation conducted in the Florence’s Uffizi Gallery with groups of user using the MOBILearn systems a novel application based on innovative mobile-learning services specifically designed to improve the Museum “experience”.

2. The MOBILearn Project

The MOBIlearn project, co-funded by the European Commission, the National Science Foundation and AU Department of Education, Science and Training in July 2002, is strategically positioned to provide relevant research outcomes in the field of innovative use of mobile environments to meet the needs of learners, working by themselves and with others (www.mobilearn.org). The MOBIlearn project directly targets priority areas for the knowledge society, and addresses the need for Europe to stay dominant in the crucial area of mobile applications. The MOBIlearn project

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exploited a partnership that is truly international, capable and influential, including wellknown Universities with a large user-base (Open University, University of Birmingham), and calling on expertise from two US World-level academic institutions (Stanford University and OKI/Massachusetts Institute of Technology), mobile operators from four countries (Telefónica, Cosmote, Deutsche Telekom, Telecom Italia), European-leading commercial organisations (Space Hellas, GIUNTI Ricerca, Emblaze Systems, University for Industry), World-class mobile devices manufacturers (Hewlett-Packard, Nokia), and Australian on line learning content providers (www.education.au). The objective of the project is to improve the knowledge level of individuals through cost and time optimization of learning processes. This maximises the opportunities of three representative groups (Taylor, Murelli, Brugnoli, Frohberg, Clow, McAndrew, 2005): Workers, to meet their job requirements and to update their knowledge continually; Citizens as members of a culture, to improve their learning experience while visiting a cultural city and its museums; Citizens as family members, to have simple medical information for everyday needs. 3. The integrated MOBILearn System

From a technical point of view the development of MOBILearn System was aimed to the creation of a virtual network for the diffusion of knowledge and learning via a mobile environment where, through common themes, it is possible to demonstrate the convergence and merging of learning supported by new technology, knowledge management, and new forms of mobile communication. This also creates a virtual point of mobile access to content that could be used at a European and International level. A subsidiary goal is to develop deeper understandings of the social processes and interactions that arise when connectivity reaches a critical point, so that we are alert to the possible emergence of "ambient intelligence" equivalents of the widespread takeup by users of SMS. To this end, from the technical point of view the main objectives are to design, develop and operate the MOBILearn system, as a reference mobile learning architecture, to be accessed by the consortium partners and users in trials. In order to obtain a final system that is actually able to provide effective and efficient mobile learning services, it is necessary to design, develop and implement the single modules within a more general and “high-level” framework. Instead of designing a

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“vertical” architecture, probably able to support only few specific mobile applications, it has been preferred to make the effort of developing an open abstract framework for mobile applications, within which single “concrete” services can be implemented. This choice was motivated by the need of guaranteeing the interoperability amongst different applications and the possibility of using existing modules and services to develop new mobile applications. The process that has been followed for MOBILearn is to develop an Open Mobile Access Abstract Framework (OMAF) based on layers of infrastructure and application profiles, instead of targeting a single vertical architectural implementation. Since its purpose is only to focus on the interfaces between layers, in order to ensure a good level of interoperability, the OMAF does not need to be implementable in detail. Notwithstanding, an “instantiation” of the OMAF model has to be implemented into a demonstrator and tested in real users’ trials. As it is perceived today, the OMAF model should bring to data extensions (such as mobile/location aware learning objects, with geographical references included in their metadata structure) and new services definition which could sit on top of the infrastructure and learning services, under definition within IMS-ALF and OKI initiatives. The MOBILearn system results from the integration of several subsystems, each one providing mobile learners with a specific set of functionalities and features. Since not all components are relevant to this paper a set of them have been chosen to be described in the following paragraphs: the MOBIlearn Learning Content Management Subsystem, MOBIlearn Adaptive Human Interface Subsystem, the Context Awareness Subsystem. 3.1 The Learning Content Management Subsystem On the basis of the requirements and specifications of MOBILearn, an existing learning content management system (LCMS), which was already a distributed architecture interfacing with one or more repositories of learning objects, has been adapted to the specific needs and requirements of mobile learners. The LCMS was developed natively in xml, with data models and storage formats fully compliant with main e-Learning specifications, including IEEE LOM and Content Packaging. 3.1.1 Description The subsystem produced by WP7 is essentially a complete Learning Content Management System (LCMS) that can be used to create, manage, index, publish and deliver on desktop and/or mobile devices instructional or knowledge based content in

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the form of Learning Objects (LO). The system allows for a scale of delivery superior to a simple Learning Management System due to its ability to create, store and reuse a vast range of Learning Objects. The proposed subsystem combines the function of administration and management with content creation and customization. The subsystem offers a comprehensive knowledge resource from which instructional content can be assembled and delivered to multiple mobile users. The subsystem provides: • instructional designers with the ability to create new contents aimed at addressing specific training needs or the assembly of new learning objects from existing instructional content • • • • content editors with the facility to edit and approve new course content prior to publication tutors with the means to determine the administrative parameters in accordance with instructional requirements, user profiles and course registration system administrators with a means of continuously updating course resources in accordance with training needs learners with a mobile access to contents through a user-friendly interface and an intuitive interaction approach The mobile learning content management subsystem can be specifically customized to provide information that is directly relevant to instructional needs. Equally, the administrative features can be tailored to provide a wide range of parameters designed to direct users to specific courses, track their progress, monitor their performance and interface with development plans and assessment procedures. Every feature of the LCMS is designed to provide just in time mobile learning that is relevant and manageable. The subsystem has been designed and developed to accommodate the needs of different types of users: • • A system administrator who manages the overall process and assigns roles A portal administrator who personalizes the layout, monitors the use and manages the enrolment (subscription and management) of users (and groups of users) to contents • • A publishing process administrator who manages the status of contents published on the repository Authors who are enabled to produce learning objects, to edit them and to publish them on a repository

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Mobile learners who can access complex contents and learning objects available to them, as well as services (chat, forum, etc.) of the portal.

3.1.2 Functionalities The Learning Content Management Subsystem is composed by several modules, each one capable of providing specific functionalities to the users previously mentioned. Production and Packaging of Information Objects: is a client/server module that allows the creation of Learning Objects according to widely accepted standards and specifications (IMS/SCORM, LOM, AICC, etc.). Can be used also for indexing rough resources (images, videos, audio files, text, etc.), through the use of metadata. A light version can be accessed by end users (learners) to produce, package and store their own objects Information Objects Storage: Local and/or remote repository used by the packaging module to store and retrieve indexed resources. It is based on an XML-native database. Can be used also for recording information about the users (profiling) Semantic Priorities Tagging: software module that enables content designers/owners to create structured (multi-media) learning objects to tag the different components with semantic priorities. This allows to automatically re-structuring the learning object according to the user profile, the pedagogic objectives, the features of the devices adopted in MOBILearn and used by the mobile learner. This solution will preserve existing collections of learning objects, but it could imply a review and adaptation of IEEE LTSC standards for mobile learning; Content Delivery: a web-based module that actually delivers the Learning Objects. It is a complete Learning Objects Management System (LOMS), which allows for the customisation of the default layout for each user. Provides additional services like: chat, forum, e-mail, etc. Both the use of Learning Objects and the users’ performances are traced. Content Multi-Rendering: is devoted to the rendering of delivered contents. It allows for a flexible and effective delivery on different mobile output devices: notebooks, tablet PCs, PDAs, mobile phones, etc. It automatically re-engineer (e.g. re-sizing, resampling…) learning objects composed by a single media according to the different devices features and learner’s context.

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3.2 The Mobile Media Delivery Subsystem

3.2.1. Description Emblaze developed and commercialises a platform suitable to enable the delivery of media content to mobile users. This platform uses advanced compression technology, real-time streaming technology and advanced bandwidth adaptation techniques to enable the delivery. The Mobile Multimedia Delivery Platform (MMDP) incorporates the following elements: Encoding capability for creating media content; Streaming server capability to deliver the media content; Software players allowing access by handheld devices via cellular technology Emblaze Mobile Multimedia Delivery Platform is designed in a way that allows the delivery of Media by a variety of applications. Each MMDP component is supplied with an API layer that allows flawless integration to any application within service solutions that will require delivering media by a mobile application.

3.3 The Adaptive Human Interface Subsystem An adaptive user interface can be defined as “a software artifact that improves its ability to interact with a user by constructing a user model based on partial experience with that user” (Langley, 1999, 358) . This kind of focus has not been possible in The Adaptive Human Interfaces development team, because the overall development focus in the project has been in optimising content (and user interface) for different devices and scenarios. It can also be noted that adaptive user interface development requires a lot of research on user models and finally lot of data about user’s behaviour and its changes. The task of the Adaptive Human Interfaces development team has been to identify and document the basic components of the adaptive human interfaces subsystems and to define the interfaces with the other subsystems. Additionally, the user interface (UI) prototypes have been designed to evaluate personal navigation services by the users in different contexts of user and in different devices. The overall research and implementation challenge has been: How to adapt the user interface to different terminals, scenarios (Museum, MBA, Health), user needs, task models and evolving user skills.

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3.3.1 Description The first user interface versions were created in Flash and HTML and they were optimised for PDA. These prototypes where then evaluated and a storyboard with function calls were illustrated. This was done to visualise UI both for technical and nontechnical people. Next prototype versions were created for Jetspeed environment utilising XML-structure files, XSL-stylesheets, Javascript and Velocity templates in portlets. Architectorally speaking, the Adaptive Human Interfaces Subsystem consists of Personalisation, Customisation and services which are in connection to Portal and Context Awareness Services.

The functionalities: To provide a consistent look and feel To provide support for navigation and for memorisation To provide enable an enjoyable user experience To support different devices (optimised for a Compaq iPAQ, Tablet PC and Nokia 6600) and optimise usability for them To enable different functionality, navigation logic and menu structure in 3+1 scenarios (MBA, MBA game, Museum, Health) To enable menu structure changes on the fly based on context awareness information. This requires multiple XML parsing phases (like DOM-tree is parsed with XSL files) To provide information on the screen about the changing context to the user ( like informing about new users in chat or informing about a space or room facilities) Additionally, some functionalities are common with CA Context Awareness subsystem. 3.4 The Context Awareness Subsystem

3.4.1 Description The University of Birmingham, partner of the MOBILearn project, has developed a context awareness module (CAM) designed to facilitate context dependent content delivery for learners using mobile devices such as phones, PDAs, and tablet PCs. The CAM is intended to provide learners with a way to access appropriate content on their

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mobile devices without having to pay too much attention to searching and querying the set of all available content. The CAM incorporates the following elements: • • An object-oriented software architecture that allows the creation of customised listener objects that respond to the learner’s current context of use A set of exclusion and ranking algorithms that provide a rating for each item of content currently available, matching the current context with meta-data on the learning content • An inspectable and modifiable display of the current inferred context that allows the learner to view and change assumptions made by the module The CAM and its underlying architecture are designed to support flexible re-use by non-expert users by providing a generic, re-usable architecture with the means to define customised listener objects using a structured textual description. The CAM itself is designed to sit below a delivery module, providing recommendations for content delivery. The CAM also addresses the need to provide learners with recommendations about resources (e.g. local data stores and personal files) and services (e.g. communication links to other learners and more remote data stores). 3.4.2 Functionalities Context Awareness Architecture The context awareness architecture is a software architecture implemented in Java. This architecture provides a framework for the creation of customised context awareness functionality through the provision of context feature listener objects that respond to the learner’s current context. These features use elements in the current context to determine which content is most appropriate for the learner at the current time. This process is driven by a set of exclusion and ranking algorithms. Exclusion and Ranking Algorithms The CAM uses a process of exclusion and ranking to determine appropriate content. Exclusion is typically driven by technical constraints, e.g. the display capabilities of the learner’s device, whilst ranking is more typically driven by learner goals and preferences. The system can be set-up to provide default exclusion and ranking capabilities, but these processes can be inspected and modified by both content providers and the learner themselves.

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Context Awareness Interface Whilst the CAM itself does not provide a graphical user interface, it is designed to interact with an interface module that can display the current inferred context and the assumptions made in inferring that context. This display also allows the learner to change the values of the context features, thus changing the inferred context and altering the content recommendations. In this way learners are given a way to inspect and control the context awareness module.

4. Running the Trial

4.1 Trial: execution and context In parallel with the final refinement of the technical prototype the next step was to organize the User Trials. Three trials were carried out on December 6, 2004 in Florence’s Uffizi Gallery. During these trials, “real” users tested the MOBILearn system. The trials took place in two galleries (Fig.1): -The “Leonardo Gallery”, containing 11 canvases including “The Adoration of the Kings” and “Annunciation”, by Leonardo Da Vinci; -The “Botticelli Gallery”, containing 19 canvases including “Allegory of Spring” and “The Birth of Venus” by Sandro Botticelli. Altogether, 28 participants took part in the trials. Each trial lasted about an hour. For logistical and security reasons, the trial was carried out on a day when the Museum was closed to the public. This clearly changed the participants’ experience: the museum would normally be full of tourists. Each trial consisted of the following phases: MOBILearn project presentation and introduction to the trial. Before the trial began, participants received a brief presentation about the MOBILearn system, the project’s objectives and the trial. The presentation lasted about 15 minutes. It took place in the first room, the Leonardo Gallery. Device distribution and an introduction to system capabilities In the next phase, the devices that would be used by participants to access MOBILearn services were distributed. Each participant received one of the following devices: mobile phone, PDA, notebook or pocket PC. Technical support staff then showed participants how to use their devices to access the MOBILearn system. The support team gave special attention to those participants using PDAs or notebooks. (This team was composed of project partners. The team provided technical support throughout the trial.)

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Execution: Once the devices were distributed, and the necessary information provided, participants began their tour of the two galleries. 4.2 Specific characteristics of the Uffizi Some of our findings of our study are valid for any form of mobile learning in a museum or art gallery setting. However, it is important to bear in mind certain specific characteristics of the Uffizi and of the two galleries used for the trial. The Uffizi provides very little information for visitors (just the name of the painting, the date and artist’s name); The Uffizi is a spacious environment that does not always appear to have a rational layout. Most galleries are larger than 100 m2; The Uffizi displays a very large number of artworks in each gallery, this is especially true for the Botticelli Gallery; The gallery displays a huge number of works which, although well-known to the general public, are complex and hard to interpret.

4.3 User recruitment On December 6th 2004, the MOBIlearn users trial took place at the Uffizi Gallery in Florence. Università Cattolica del Sacro Cuore undertook a long and thorough process of selection in order to gather as many students (both foreign and Italian) as needed for this trial. At the end, six schools with a total of 80 students took up the challenge and accepted to test the MOBIlearn system. Unfortunately, two working days before this test the Uffizi Gallery administration informed us that due to security problems only 10 ‘external’ people (basically those who do not have any inside ties with the Gallery) were allowed to enter the museum. Therefore, from 80 students it became necessary to select only 10 people and the choice fell on the Middlebury College. The Uffizi Administration chose two groups of people from the Association “Amici degli Uffizi” and from the School of Restoration in Florence, which joined the afternoon session of the trial. The test then involved three groups of people for a total of 28th users, with an interval of 1 hour and a half between one and the other: the Middlebury College, all foreign students coming from various parts of U.S.A., the ‘Amici degli Uffizi’, who played the part of art experts, and students from a Restoration School in Florence. The group of users participating to the trial was composed by: female (33%) and male (67%) of which 33% between 18 and 25, 11% between 26 and 30, 45 % were aged between 31 and 60 years, and 11% over 60. Most of the participants (54%) had a high

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familiarity with new technologies since the rest of the group was composed by participants with low familiarity with technology (46%). Grouping the participant by age (two groups: the first “young” composed by participants with age lower than 31; “adult” the second over 31) the familiarity with technology was higher in the “young” group: here most of the participants (70%) reported a high familiarity with new technologies, in the adult group 40% of the participant reported an high familiarity.

4.4 Research methodology The qualitative research conducted for this study took the form of participant observation. This methodology is borrowed from anthropological research. In it, researchers observe subjects in a natural setting. In this trial, researchers observed the interaction and relationships between trial participants, the MOBILearn system, the devices used and the museum environment. The advantages of participant observation are immediately clear when we compare this option with other methodologies. Surveys and interviews use eye-witness accounts, opinions and impressions. These responses tend to be filtered by memory or by the perspective of the interviewee. However, anthropological research gathers information on the same subjects using direct observation. This avoids the noise produced when obtaining the same opinions through an interview. Another important advantage is that interviews and questionnaires typically gather information from individuals isolated from their social environment. Participant observation allows researchers to consider (and collect data on) individuals as actors and integrated components in their social environments. From this point of view, anthropological methodologies allow researchers to study and respond to individuals not as “atoms” but rather as “molecules” (Coleman, 1990).

4.4.1 The Participant observation The results reported in the following paragraphs were gathered using “participant observation” (Murelli, Brugnoli, 2004). In this methodology, borrowed from

anthropology, the role of the researcher is that of “investigator”, observing participants in a real-life situation, and taking note of what happens in this situation and how it happens. The observer is not necessarily engaged in the activity being observed, but he or she is visibly present and is collecting data with the knowledge of those being observed. In the Uffizi Museum trial it was impossible for observers to be anonymous and/or hidden because of logistical constraints; at the same time, it was necessary to provide participants with technical support: some researchers took on the role of

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technical support staff in the event that participants needed assistance in using the system. Given these constraints participant observation was the only option available. The research was carried out in two different modes: Non structured observation, in which researchers observed participants in a completely “open” manner without the use of timetables or checklists. This form of observation allowed researchers to gather information flexibly, and to extract the richest possible data from the field.

Fig. 1. “Researcher taking notes during the trial”

Structured observation, in which researchers took a note of participant behaviour using an “observation card”. This tool was composed of a checklist containing pre-defined items. The observation card helped researchers to reduce the volume and complexity of the data they were collecting. The card also assisted the structuring and organization of the results of observation. The observation card that was used during the Uffizi Museum trial is available in the appendix. Alongside questionnaires were used to collect specific information from the users: although they are not the focus of this paper a brief summary of the outcomes of this quantitative study are summarised here in 5.2 and detailed in (Taylor and Bogdan, 1984). 5. Running the trial

5.1 The experience Most participants seemed satisfied with the trial. The vast majority immediately became involved, becoming so “absorbed” by the system that they seemed to “forget”

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about the world around them. The initial reaction of participants was one of curiosity and strong interest in the project. When they first entered the galleries (after taking a quick look around them and listening to a brief introduction from program coordinators) they took to the devices with enthusiasm. Participants were of various ages. Age seemed to play an important role in determining their experience during the trial. Young participants: Participants in this group appeared to be the most satisfied, using the system extensively, and adopting a playful, interactive approach. The general feeling of these participants was that the trial provided an opportunity for dynamic learning. They frequently returned to works they had already seen, exploring first the rooms and then the system. They were interested in “harnessing…making the most of “ the content offered by the system. “I really like it, I want to find out about everything!” Adult participants: Older participants were more critical of the system, especially where they had relevant experience and/or considered themselves “art experts”. Criticisms were not motivated by a lack of satisfaction with the MOBILearn system but rather by the presumed “sacredness” of a museum like the Uffizi, which participants saw as a “special place”. These perceptions became weaker as the trial went on, and a positive appreciation of, and interest in, the system began to emerge. The “art experts” were also highly critical of the information provided by the system, even when they were completely satisfied with the way it worked. The way that they used the information was, however, different from that of other participants. For example, all participants listened to audio files giving information about the artworks. However, the art experts (unlike most other participants) did not use this information to learn about the works but as a starting point for discussion, a way of kicking off a debate on artistic issues. Not all participants were equally familiar with new technologies. Two groups emerged: High level of familiarity with technology: Once introduced to the system, and having understood its structure and capabilities, this group of participants interacted with the system confidently. Most had little need of technical support. These participants explored the system extensively before asking for technical support. Technical support was used not so much to resolve problems, as to find out more about the system’s capabilities.

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Fig. 2. “Art expert listening audio file during the trial”

Low level of familiarity with technology: People in this group were not familiar with the technological devices they received. They turned to fellow participants for help, often guided by a member of the support team. These participants saw the group environment as a place to learn about the system, and to share their discoveries with others. Despite having little familiarity with new technologies, not a single user abandoned the trial or expressed any dissatisfaction with the service. The system generated interest and curiosity in participants, who proved very willing to take on board new information. 5.2 MOBILearn system functions Below we describe participants’ responses to the most important elements of the system, their needs with respect to these elements and their suggestions for improving the system. Accessing the system: Some participants found it took too long to register. The length and complexity of the registration process created high expectations. Such expectations were fostered by the vast quantity of information the participants were required to provide “in exchange” for system services. Many participants expected a greater – or at least comparable – quantity of information from the system. In some cases, this set off psychological mechanism whereby users wanted something in return for what they were giving. “The more information I provide to the system, the more I expect in return.” Due to such expectations, a number of participants were left feeling disappointed and

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dissatisfied. Other participants were completely unwilling to provide the system with information. They felt that the purpose of the system was to provide, not request, information. Some people were frustrated with this dynamic, asking each other “are you getting any information?”

Fig. 3. “Technical support during the trial”

Some participants were worried that, if the service was made commercially available, data provided for log-in purposes might be used for commercial gain. Many suggested that the authentication and log-in procedures should be faster and simpler. These findings confirm the results of a number of studies which clearly show that a log-in process that takes more than a few minutes (or indeed any requirement to provide information before accessing a web-based service) leads many users to abandon the service (Nielsen, 2000). - Navigating: Some participants felt that the navigation functions were neither simple nor intuitive. When they used the system for the first time most participants had difficulties in exiting applications or moving from one application to another. On subsequent occasions, participants were able to use the system more quickly and experienced no such problems. Taking this factor into account, we can thus define the accessibility and usability of the system as quite good. The learnability of the system, defined as the ease with which users can recognize and use various functions after using the system once, can be defined as good.

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- Conducting searches: Participants perceived the search function as very useful. Some participants, however, found the experience of carrying out a search unsatisfactory, frequently complaining that the search criteria were not flexible enough: “I put in Da Vinci and I didn’t get any results!”. Participants also indicated that they needed to carry out more advanced searches than the system allowed.

Fig. 4. “Search function picture captured during the trial”

For example, in addition to carrying out a search by typing in the title of a given work, participants also wanted to use other search criteria, such as period, artist’s name, the name of the room in which specific works are located, the theme of the picture, painting techniques, etc. In certain cases, the search tools were seen as unresponsive, with some participants even asking for technical support to allow them to understand what sort of information needed to be inserted as search criteria. - Chat : At first, participants failed to identify the chat function. In many cases the technical staff had to suggest that participants use the function, and then explain how it worked. Most people were surprised and impressed by the function and immediately understood how it worked and wanted to use it. All participants enjoyed using chat for the first time and were satisfied by the service. There was little or no need to deploy chat as a communications tool due to the limitations of the trial environment, an empty museum with a group of no more than 8 participants. Despite this, people had fun using the facility and appreciated chat as facilitating enjoyable exchanges. In many instances, participants were enthusiastic about the idea of being able to use chat if they were visiting the

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gallery in a large group. Participants thought that the ability to share information and to chat would be practical and thus popular. Many, especially younger participants, were keen on the idea of using the service to save, download and print conversations. They would thus have a textual photograph to remind them of their visit to the museum.- Feedback: In certain cases, the system failed to provide feedback allowing participants to understand what was happening inside the system. Some people felt confused by the system: “what happened?!” The participants also commented that it was unclear, and difficult to check, whether or not the system was connected. - Audio files: The audio files were widely appreciated and frequently used by all participants, especially those with PDAs. In many cases, it was this facility that played the most important role in evoking a sense of presence and of participation. It was particularly important for participants using PDAs, which were sometimes under-used due to accessibility and usability problems (see below).

5.3 Experiences with devices Participants received a variety of devices (either a mobile phone, a PDA, a pocket PC or a notebook) and so had different experiences during the trial. Moreover, the interface of each device was slightly different, meaning that accessibility and usability changed between devices. The pocket PC and notebook interfaces featured better usability than the mobile phone and PDA interfaces. Therefore, participants using these devices had not only inferior accessibility regarding their device, but also in terms of the MOBILearn system as a whole. People allocated PDAs or notebooks typically sought technical support only to confirm that they were using their instrument or the system correctly. Those with a general familiarity with new technologies who were using the more accessible interfaces typically needed little training or support from technical staff. Below, we describe participant responses to the three different types of device and identify user needs. - Mobile phones: Mobile phones were the least popular and least used devices. Most participants had to repeatedly ask for assistance from technical staff. Participants found it difficult to navigate the system and to understand its capabilities. This meant that the vast majority of participants tended to interact very little either with the MOBILearn system or with the museum exhibits themselves.

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- PDAs: These devices were quite popular. PDAs were much more than a “compromise between an audio-guide and a mobile phone”. They were perceived as providing attractive multimedia information. The only criticism participants had was that navigating the system proved difficult. Many people asked technical staff for help with navigation. It is worth highlighting that people using the PDA responded enthusiastically to the MOBILearn system. They thought that MOBILearn services offered a “little something extra”. The device, however, was generally considered not particularly useful. - Pocket PCs and notebooks: These were the most popular devices. Participants given pocket PCs and notebooks used them more than users with PDAs and phones used their devices. Participants explored the functions of these devices extensively. People using pocket PCs and notebooks spent longer on their tour and had a more intensive experience than those using other devices. Young people and especially young women, were particularly enthusiastic. They saw the devices as an extension of their personal diary or calendar, a place to write, note down appointments, play games and exchange messages.

Fig. 5. “Young girl using notebook during the trial”

This tendency to associate the best interfaces with an object as personal as a diary, meant that notebooks and tablet PCs were well appreciated by participants. People liked using the system and were quick in learning how to use the functions provided.

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Participants using pocket PCs and notebooks were the most sociable, sharing their device with others and exchanging information and opinions. People with these devices worked well together thanks to the devices’ ease of use, larger screen and accessible interface. 5.4 Quantitative results in brief Alongside the qualitative studies about 600 visitors were briefly interviewed in Florence Museums and at the Duchy of castles in Parma and Piacenza (Italy) to establish their real requirements, needs and expectations. The visitors interviewed are part of a relatively young public (31% between 18 and 25 years old - 23% between 25 and 30); they visit museums and castles 2 or 3 times a year in their spare times or during holidays; almost of all of them have a mobile phone and 55% of those have a Nokia; few people (15%) have a palmtop. The results of this first part of the questionnaire are satisfying: the tourists find the services proposed that are accessible before entering the museum very interesting and useful. In particular, they are interested in booking the tickets in advance, in receiving information about the museum opening times and any related changes and in viewing the shortest route to reach the destination. The services proposed are appreciated by tourists because they see the possibility to find their way around an unknown town and they would like to avoid any type of inconvenience (changes in the timetables) especially during their holidays or a week-end. In the second part of the questionnaire dedicated to the specific requirements faced during the visit inside the museums, the results analysis highlighted the following issues. The services: “Viewing museum plan”, “Planning the visit according to personal interest and requirements” and “Reaching the area of interest as quickly as possible” made a good impression on tourists. Opinions were positive about “viewing a catalogue of works by a particular artist and understanding the artist’s techniques. Few people want or have time to make notes or comments during their visit except for those that visit museums for work or for study purposes. Opinions were positive on the use of an audio guide (32% of the persons interviewed gave a mark of 4 and 32% gave 5) as it is considered a good alternative to the traditional guide especially for those that usually make the visit alone. Finally, from a general point of view, it is possible to say that the tourists interviewed expressed positive opinions and interests on the use of mobile technologies and their applications.

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6. Conclusion and key findings

Observing trial participants, it became clear that most were keen to interact with the MOBILearn system and were satisfied using the system. Indeed, participants in all three trials responded positively. Clearly the system can be improved, but considering that the trial took place in a real-life setting and that the system is a prototype, we can consider the results most encouraging. Most participants found the system was a plus compared to usual museum facilities. In a number of cases, in fact, the system was perceived as the actual museum facility, making the ability to benefit from the real physical environment (by looking at paintings, etc.) a secondary consideration. This response was common to various groups of participants, especially young people who, from the very beginning, approached the system positively and were keen to interact with it. 6.1 MOBILearn: differentiating what the museum has to offer

While participants were using the MOBILearn system, they interacted less with the museum environment. However, it is worth noting that, in most cases, the MOBILearn system was responsible for reintroducing interaction with the museum environment, putting the focus back on the artworks. Often, the system directed participants towards certain artworks, perhaps suggesting works that participants had not noticed, or which had not caused them to pause when they did notice them. In some cases, participants chose independently to focus on the artworks, often because they were irritated with the system or tired of using it. This happened most frequently in the case of participants given PDAs or mobile phones. The system modified participants’ interaction with the museum, creating or changing their expectations and needs. For example, they sometimes approached a work only to discover that it was not featured on the MOBILearn system, and it was not possible to find out any additional information about it. The participants’ reaction in such cases was always deep disappointment. When this happened, participants immediately withdrew from the canvas, even if was an important work. This illustration reported in the paragraphs below (realised by observing and tracking user’s paths during the MOBIlearn trial and the paths realised by a control group visiting the museum without using the MOBILearn system) confirms that the participants perceived the real service on offer as the possibility of exploring the museum with MOBILearn rather than the museum itself.

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6.1.1 “Augmented” itineraries Normally, visits to the museum tend to follow a “rational” itinerary. Visitors’ itineraries often depend on the location of well known works, or on the physical organization of the museum. Figure 6 shows a typical itinerary: the different lines (blue, green and red coloured), indicate different itineraries usually covered by the visitors. The pictures in the figure indicate the different canvases; the structure and the shape of the room is based on the “Botticelli Gallery”.

Fig. 6. “Rational itinerary”

Normally, visits to the museum tend to follow a “rational” itinerary. Visitors’ itineraries often depend on the location of well known works, or on the physical organization of the museum. Figure 6 shows a typical itinerary. When using the MOBILearn system, itineraries and the experience of visiting the museum changed dramatically. Participants ceased to follow simple, linear itineraries and began take more complex routes through the museum. The route selected was no longer so strongly influenced by the museum’s physical structure (and by the location of specific works). Instead, participants allowed themselves to be guided through an “augmented” itinerary suggested by MOBILearn (see figure 7). In this way, the museum transformed itself into a complex environment that could be controlled and monitored indirectly.

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Fig. 7. “Augmented itinerary”

This is a significant finding for those involved in managing museum activities and organization (Griffin, 1987) since it allows staff to improve the management of visitor traffic. Using a system like MobiLearn, museum personnel could, for instance, reduce excessive flows of people into a particular gallery or limit the number of visitors accumulating in front of a particular painting. The support offered by a system like MOBILearn makes it possible to offer a rich and flexible service to museum visitors. The MOBILearn system also allows museum staff to monitor and manage routes taken by visitors. The system can thus be compared to the service provided by the Minneapolis Institute of Art which offers its visitors the option of using the Internet to access a vast amount of information that helps visitors “to plan a deep, organized visit”. 7. Acknowledgements

This work was performed as part of the Mobilearn Project, funded by the European Union as part of the Framework V research program. The authors wish to express their gratitude to the members of the Mobilearn Consortium (www.mobilearn.org) for their valuable contributions.

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8. References

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