A presentation at Research Huddle with Babylon Health by Rik Williams
User research with older populations a a f a a a a Rik Willi ms, UX Architect, Moor ields Eye Hospit l rikwilli ms.net/t lks/user-rese rch-older-popul tions/
ff How ageing a ects us, why it’s important and actionable tips for running inclusive user research with older people.
rikwilliams.net/articles/older-people-tips-guidelines/
Structure Wh t we’ll cover in this session… Who’s talking? Why it’s important? When do people become ‘old’? How does ageing affect people? Practical tips for user research with older populations a Discussion
Hi, I’m Rik
Content context …or where these insights re weighted Moderated research In-person research “Older people” sometimes living with age-related disease(s) I’ve excluded insights speci c to research people with dementia(s) a • • fi • • •
Why research with older people is important
“It’s easy for our teams to be tribal and for the customer to be [or to become] a stranger” Gerry McGovern
74% of UXPA members re between 26 nd 45 a a Source: Salary Survey, User Experience Professionals’ Association International, 2018
Don Norman, 86 Source: Salary Survey, User Experience Professionals’ Association International, 2018
“When you include the extremes of everybody, that’s to say di erently abled people of all sorts, then you produce things that are better for all of us.” ff a Miche l Wolff
When do people become ‘old’?
“At what age is a person ‘old’?” 🤔
“Ageing is a lifelong process, starting when we are born” Jeff Johnson
“Old is at least 10 years older than I am now!” a Ad ge, Anon.
Responders Age When they think ‘old age’ starts 40s 63 50s 68 60s 73 70s 75 Source: You’re old, I’m not: how Americans really feel about ageing. AARP, 2014
50+ a f a A good st rting point for de ining ‘older-hood’ for user rese rch purposes
70+ a a Where user rese rch with older people gets re lly interesting
fi Source: Quanti cation of biological ageing in young adults, PNAS, 2015
ff How does ageing a ect people?
Beliefs and Behaviours fi Beyond an older person’s perception of their age, there are two general things which can be more common in digital user research: fear and con dence.
A person in their mid/late 70s, recruited directly from a production digital service, in an interaction lab
Beliefs and Behaviours T kew ys Fear of making errors, appearing naïve or breaking something Concerns about privacy and data use Low con dence and task abandonment rate (x2 younger people) Longer sessions (time needed, re-checking, taking less e cient routes) ffi fi Modifying facilitation style (capabilities vs research objectives) a a • • • • •
Motor control fi As we age, our ability to manipulate things with our arms, hands, and ngers tends to decline. Then add in disease(s), or the impact of drugs.
A participant in their mid 70s with mild arthritis working a complex touch interface during contextual research.
Hearing ft Loss of hearing also accelerates as people enter their 50s (and is the second most common agerelated impairment a er arthritis).
A participant in their early 70s living with front0-temporal dementia AND with hearing loss.
Paired participants in their mid-50s / late-70s evaluating aspects of a content strategy elsewhere in the room.
Hearing T kew ys Plan for hearing impairments during aural screening and research Factor for and avoid noisy research environments (cafes, group-based research) a a • •
33% a a a a a a of people ged 60-65 will h ve problems with norm l ur l communic tion…
…rising to… 89% a …by ge 80
Vision Eyesight tends to get worse as people age, even without the impact of injury or disease. Expect to encounter issues with seeing ne detail, focussing on nearby objects and the impact of glare*. fi *very much not an exhaustive list!
A participant in their early 60s with corrected vision (glasses) encountering issues with glare, acuity and presbyopia.
Mean visual acuity as a function of age Owsley et al. 1983
Cognition Most cognitive abilities decline with age, starting as early as our 30s. However, people vary enormously as to which abilities, when the decline starts and a what rate.
A person in their late-70s in an interaction lab who experienced issues with mixed/mild age-related cognitive decline.
Practical tips for user research with older people
Structure Wh t we’ll cover in this section… Screening older people Scheduling with older people During research time a Closing the user research
fi These guidelines seek to balance aspects of best practice for any inclusive user research with areas more speci c and frequent in older people
ft This advice is more likely to apply more o en than with younger participants (but not always)
In-person only Remote only
Screening older people
Avoid cold calling fi If you’re recruiting from a database of participants then consider initiating contact for your study by message, rst.
Immediate credibility, legitimacy Older people can be especially sensitive about contact by strangers. Be meticulous in your content/design.
Immediate credibility, legitimacy Pr ctic l tips Ensure a clear, well formed/optimised, lede or subject line Truly personalise content to the participant Use o cial account(s) for contact Include logo, physical address, registrations (beyond corporate style guidelines) Provide clear opt-outs (action, process) If proposing days/times for screening proper — stick to them a ffi a • • • • • •
Be more lexible in your methods of contact f Remember that older people are more likely to live with a disability than the general population.
80% of dis bility is cquired AND t n ver ge ge of 53 a a a a a a a Business Disability Forum at a11yLDN monthly meet-up, 2018
Factor for digital literacy Evaluate participant digital literacy, but expect false perceptions about their suitability.
Comp red to extensive users of digit l, limited users re… 8x …more likely to be >65 ye rs a a a a Source: Digital Nation UK 2021, Good Things Foundation
Factor for digital literacy Pr ctic l tips Preempt any false perceptions of suitability based digital con dence Be clear that you’re looking for ‘normal people’ (unless you aren’t!) Assess digital literacy at second-stage screening (without being ‘techy’) fi fi Note any likely con dence issues and bridge to research time facilitation a a • • • •
Check and assess functional diversity ff ft Older people are not a homogenous group. They are o en living with age-related health conditions which may be pertinent to your research (or which may a ect your study design).
Check and assess functional diversity Pr ctic l tips Screen for: • • • wider accessibility needs (think: diseases like arthritis, low vision, dementias) social needs (think: impact of caring responsibilities) digital adaptations (think: actual or needed) Ask participants to bring their: personal devices artefacts like ‘computer glasses’, magnifying glasses, hearing aids etc. a a • •
Scheduling with older people
Be lexible f Wherever possible, work in sympathy with the participants schedule, location and logistics
Be lexible Pr ctic l tips Travelling to real-world research: avoid peak times consider a research space near transport hubs o er taxi transfers and/or shepherding consider remote, or contextual, alternatives (where ideal is in-person research) a f a ff • • • •
Expect longer lead times Don’t assume that older people, including those who are retired, are time-rich. Similarly, that they are always online.
Over recruit ft It’s o en a good idea to recruit at least one extra participant for any study. This is even more true for older adults.
For l rger studies consider over recruiting by… 15% a a a a a a a … nd f lling b ck on remote moder ted rese rch nd/or rescheduling (depending)
Prevent predictable technology problems Consider scheduling time to set-up and/or familiarise the participant with the so ware* used to enable remote research so that the session itself is protected. ft *Lookback, Zoom etc
Landing the participant Older people can bene t from a more rigorous and/or hands-on approach* to structuring their journey into research-time than with younger people. fi *depends on the individual, but can similar to other more extreme audience groups.
Landing the participant Pr ctic l tips Send a clear, speci c summary of the research Go beyond essentials, like start/end time and date Include transport suggestions, printable maps, photos of the entrance Include speci c reminders about things to bring (like ‘computer glasses’) fi fi Follow-up across mediums as research time approaches a a • • • • •
During user research time
Expected the unexpected People are messy. It’s the basis for our profession, but can disrupt research time. Older people are more likely to have needs beyond younger participants.
Last-minute cancellations Older people can need to react to unforeseen circumstances. Have options in place continue to include them.
Very early arrivals Older people can arrive >20minutes before a session. Sometimes up-to 1-hour. Have resources in place to accommodate them.
Ad hoc shepherding ff Assume that at least 1 participant will be overwhelmed and lost inside the ‘last mile’ to the research space. Even if they’ve turned down o ers of support during screening.
Create a familiar environment Make a space which is representative and adaptable to the needs of the participants ff Try to limit novel, unfamiliar or fatiguing variables with might a ect data quality and ethics
Create a familiar environment Pr ctic l tips fi a • remove any distractions like: • • lighting (especially which cause glare) temperature (especially cold) con gure any technology to the participant (if needed) a •
Companions ff Allow people to bring companions, whether they ask (or simply bring them!) Have plans in place so that they don’t adversely a ect the session.
Set expectations early Remind the participant of the purpose of the study, its parameters. Reassure them why their insight is needed.
Warm-up and practise Spend time demonstrating any methods with an exercise so that the participant comprehends the study’s mechanics.
Research instructions ff Ensure that participants understand any instructions. Ask the participant to playback in their own words. Be prepared to repeat them (if necessary with di erent words) throughout the session.
Make it really real fl Older people can have trouble imagining “reallife” situations that don’t actually re ect their real lives. Ideally, make scenarios truly bespoke.
Think about Think-aloud Consider whether to use retrospective or concurrent verbal playback during a research method.
Stay on topic, stay on target Be mindful of a tendency to chat, reminisce, or stray from a topic during your session. Especially in participatory/group research
Allow extra time (but run to time) Older people may take longer to do things and can need extra facilitation (especially in group-based research) to stay focussed.
Visu l processing speed declines by… 50% a a a …between 70 nd 80 ye rs
Add n extr … 15-minutes a a a …for every 1-hour of rese rch time with older people
Avoid trying to cover too much Expect to cover fewer tasks, or interview questions, in a session than your might with younger people
Avoid trying to cover too much Pr ctic l tips Consider: • • chunked, shorter, sessions with built in breaks a single session, but with more limited objectives Look out for: participant fatigue (more likely, more quickly) loss of focus needing more time (than younger people) a a • • •
Positive predispositions ff Expect positive responses to prototypes, production or brand. A tenancy to praise rather than o end (vs. provide objective views).
Self-blaming Expect a general tendency to blame self when encountering issues (not the designer or developer).
Anxiety, fragile con idence f ft fi fi You’ll o en (but not always) see fragility in con dence in discussing or using technology. Speci cally anxiety about doing (or saying) something ‘wrong’, or breaking things.
User diaries ff Beware that factors like inexperience can a ect the data. Regularly check the data. Be ready to quickly with 121 support/discussion
Closing the research
Like any user research, close your study with any summative exercises, remaining administration or answers for participant questions. However, be prepared to go further for older people…
Provide immediate support You might have observed that the participant struggled with something related to their needs, the product, their system set-up or their abilities.
Provide follow-up support Your product, service or organisation may meet real health or social needs for your participant.
Discussion
🤔 Discussion ide s… • • • • • Did any of this chime with your research practice? What changes have you seen with remote research with older people since 2020? Is there anything you want to hear more about? Do you disagree with anything I’ve covered? How do you nd older people for your research? a fi …
A primer and practical tips about how ageing affects us, why it’s important and actionable tips for running inclusive user research with older people.
Originally made for a ‘research huddle’ for the product team at Babylon Health, a digital-first health service provider that combines an artificial intelligence-powered platform with virtual clinical operations for patients, in January 2022.
Subsequent talks with/for product people at:
— NHS England, — Department for Health and Social Care (DHSC).
The following resources were mentioned during the presentation or are useful additional information.
Slides and resources on rikwilliams.net
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