Seniors’ Info-Inclusion Through Interactive Television: Results of a

Field Trial

Telmo Silva

1,2

, Hilma Caravau

1,2

, Jorge Ferraz de Abreu

1,2

and Liliana Reis

1,2

Department of Communication and Arts, University of Aveiro,

Campus Universitário de Santiago 3810-193, Aveiro, Portugal

CIC.DIGITAL/Digimedia, University of Aveiro, Aveiro, Portugal

Keywords: Seniors, Interactive Television, +TV4E, Field Test.

Abstract: Television platforms are becoming more relevant due to multiple factors, namely the interactive features that

can be provided. Interactivity can effectively support citizens’ problems and needs and open a range of

opportunities in several society’s sectors. One of these opportunities is related to seniors’ level of information.

In this framework, to improve Portuguese seniors’ info-inclusion in subjects such as social and public services,

the +TV4E project aims to develop an Interactive Television (iTV) platform to broadcast personalized content

regarding these topics. This paper presents the process and the results of the +TV4E prototype evaluation

considering usability and functionality. The platform was made available to a sample of seniors that used it

for five weeks in their homes. After this period, the research team applied an evaluation scale and a

questionnaire survey to collect data. Despite the high level of usability depicted in results, it was also possible

to identify a set of features that should be improved in the final iTV platform.

1 INTRODUCTION AND

MOTIVATION

Today's societies are increasingly embedded in the

available technology solutions and products, with

significant consequences for the consumer

behaviours and life styles (Van Woensel et al., 2015).

With the spread of technologies in the last decades,

comes the growing to assure that products and

services are easy to use, especially to newbie users or

to people with lower levels of digital literacy.

Furthermore, all the technological solutions

developed should be designed and developed

according to the needs and expectations of their target

audience, thus improving their efficiency and

efficacy (Silva, Caravau and Campelo, 2017). This is

even more important when the products aim to

achieve a particular segment of the population with

specific requirements, as in the case of older people.

The significant increase in the number of older

citizens' all around the globe, a trend that will persist

according to projections (United Nations, 2017),

creates a wide range of opportunities in the field of

technological solutions for the elderly. The high

volume of technological innovations related to

seniors’ needs that have appeared shows that this is a

dynamic area. To counter difficulties experienced by

seniors in maintaining their information levels,

technologies may help by spreading information

throughout means which elderly are already familiar

with. Also, it is important to guarantee that the

experience is efficient and pleasant for the individual,

which will help to ensure the acceptance of the

solution.

A supportive environment can help older people

to continue doing their daily activities and start doing

new things, thus enhancing their quality of life. The

promotion of older adults’ well-being, autonomy,

independence and quality of life through technology

has already encouraged the creation of dozens of

innovative solutions for seniors. Technologies have a

long tradition in helping seniors with physical

impairments but they are also currently recognized as

an important support for the promotion of social life

(Harrington and Harrington, 2000). In 2012 with the

“European Year of Active Ageing and Solidarity

Between Generations 2012” a Portuguese action plan

was created to develop several projects that support

individuals aged over 50 in the national context. As

an example, the SEDUCE project (Ferreira, Veloso

and Mealha, 2013), aimed to assess the impact of the

134

Silva, T., Caravau, H., Ferraz de Abreu, J. and Reis, L.

Seniors’ Info-Inclusion Through Interactive Television: Results of a Field Trial.

DOI: 10.5220/0006730201340141

In Proceedings of the 4th Inter national Conference on Information and Communication Technologies for Ageing Well and e-Health (ICT4AWE 2018), pages 134-141

ISBN: 978-989-758-299-8

use of ICT in older adults’ emotional variables. This

type of products should address a real need in a simple

and trustable way. To achieve a high level of

acceptance users’ opinion should be considered

during development. Obviously, if seniors were

already familiar with the solution, the adaptation

process would be easier.

In Portugal, television (TV) is one of the most

used media platforms with high importance in

seniors’ way of living (Silva, Caravau and Campelo,

2017). The numbers reveal that, in average, people

with 65 years or more watch TV for 5 hours and 8

minutes per day (Marktest Group, 2011). The high

consumption of TV contents is recognized, both for

people living in their homes, which constitutes the

second most time consuming activity for seniors, and

for institutionalized people, which it is the

predominant activity (Martins, 2010).

TV has the potential to reach a large population

segment and considering this there are several

projects developed with the aim of broadcasting

specific information to the elderly citizens through

TV, thus helping them to age at their homes.

There are some projects in the scope of iTV

aiming to promote physical and psychological well-

being for the seniors. Med-Reminder (Stojmenova et

al., 2013) is a health project designed to inform

people when they should take their medication and

make emergency calls to health professionals. The

VitalMind project developed an iTV application that

provides cognitive training for seniors aiming to slow

the psychological and cognitive ageing. Finally,

iNeighbourTV (Abreu, Almeida and Silva, 2013)

allows its users to organize information about medical

exams and alerts caregivers of potential emergencies,

and it also includes a social component where it is

possible to make calls and send text messages.

2 DESIGNING AND TESTING

TECHNOLOGIES FOR

ELDERLY PEOPLE

Most seniors want to live at home as long as possible,

which sometimes is not possible due to health,

physical and social limitations that naturally appear in

advanced ages (Schneider and Irigaray, 2008). These

limitations make seniors depend on their caregiver's

network. Despite that, those limitations can

sometimes be overcome with a little help from

technological solutions. According to Rosenberg

(2013) and colleagues one of the most important

principles when designing innovations for seniors, is

the co-creation process. This means that potential

end-users are engaged since the initial stages of the

product development. This participatory design

process also helps to assure high levels of usability

benefiting the user experience (UX), which in turn

increases the probability of acceptance and success of

the technical services and devices (Madan and

Dubey, 2012).

The usability concept emerged in 1980’s and has

often been associated with the ability of a product to

be easily used (Martins et al., 2013). Throughout time

many definitions have surged for the usability

concept. Each model includes sub-attributes that

should be accomplished to guarantee the usability of

the software. In 1998 the International Organization

for Standardization (ISO) created a model consisting

of three basic sub attributes, namely effectiveness,

efficiency, and satisfaction (ISO 9241-11). In 2001

ISO 9126 defines the following sub attributes of

usability: understandability, learnability, operability,

attractiveness and usability compliance (Madan and

Dubey, 2012).

As referred in the literature review carried out by

Martins and colleagues (2013), improving the

usability presents several benefits, such as: increasing

effectiveness and efficiency; increasing productivity;

reducing the number of user errors; decreasing the

training needs; improving the level of acceptance;

supporting users with less technology literacy skills

and supporting users with disabilities. Usability’s

evaluation consists of interactive cycles of design,

prototyping, and validation (Dix et al., 2005). Taking

this and the co-creation aspect into account,

developing a product or service with inputs from

potential end users may represent an advantage to

overcome the usability challenges. Usability should

be assessed through an evaluation process, with one

or more available methods, for example, inspection,

empirical testing or questionnaire (Madan and Dubey,

2012; Martins et al., 2013).

The methodology applied to data collection

should consider the specificities of the target

population, and the research team should be flexible

to understand if the applied technique is the most

adequate both to the population and to the data under

evaluation. Despite there are no clear and established

standard rules about how to test technologies targeted

to elderly, there are some authors who have shared

their experiences and provided recommendations for

further testing (Demirbilek and Demirkan, 2004;

Swallow et al., 2016).

The USERfit tool is a methodology oriented to the

development of usability and accessibility

specifications, created for the Assistive Technology

Seniors’ Info-Inclusion Through Interactive Television: Results of a Field Trial

135

field that supports the Design for All (Abascal et al.,

2002). USERfit is composed by seven protocols that

allow the design team to collect, evaluate and develop

information to construct a product specification.

Developing tests with the elderly allows to better

understand the potential of a specific technology and

can help to define what challenges must be overcome

for success. Tests can be implemented under a set of

controlled conditions in laboratory or in the natural

environment. With the inputs collected through

product tests in a “real life” background, it is possible

to create a “problem list” with valuable information

for developers and designers that helps them shape

the solution according to the precise requirements of

the ageing population (Rauterberg, 2017). Initiatives

that test technologies in a real context with people

along a specific period of time, during which the

person uses the system autonomously with no

supervision have several benefits in comparison to

laboratory tests, like a better understanding of the

users’ reactions in their familiar environment (space,

objects, dynamics, routines, etc). This type of

experiences allows the researchers to collect a lot of

detailed data and find social facts that may not be

immediately obvious or that the participants may be

unaware of (Rauterberg, 2017). However, field trials

also have some drawbacks, like requiring a high

degree of effort and engagement from the users,

which sometimes can be difficult to encourage. The

equipment also has to be installed at participants’

home, causing some practical implications. It is also

known that having adequate support when problems

occur is crucial for the field trials’ success

(Rauterberg, 2017).

In spite of the pros and cons, the test phase is very

important, and should never be neglected, not only to

measure the usability aspects of the system's user

interface, but also to identify other specific problems

(Madan and Dubey, 2012).

Taking in consideration the course of TV

technologies for seniors and the importance of testing

these types of solutions, the +TV4E project and the

field tests carried out in its scope are presented in the

next section.

3 +TV4E PLATFORM

It is common for Portuguese citizens of all ages to

face difficulties when it comes to accessing and

understanding information concerning social and

public services (Silva, Caravau and Campelo, 2017).

This is especially problematic when referring to the

elderly, a situation that causes high levels of

informational dependency on their formal and

informal caregivers (Silva et al., 2016).

Taking into consideration the seniors’

informational needs related to social and public

services, the +TV4E platform is currently under

development and consists in an iTV platform, running

in android set-top box (STB), with the purpose of

promoting the info-inclusion and improve the quality

of life of Portuguese seniors through the transmission

of video spots, presented on TV, with informative

content about these services. The information

presented in the videos is aggregated into seven

macro-areas of interest, previously studied, titled

Assistance Services of General Interest for Elderly

(ASGIE) (Silva, Caravau and Campelo, 2017). These

seven areas are: (1) health care and welfare services;

(2) social services; (3) financial services; (4) culture,

informal education and entertainment; (5) security

services; (6) local authority services and (7) transport

services.

For each ASGIE, there are informative online

sources defined, in which the system checks regularly

if there is new informational content that could feed

the platform. In its majority, the sources feeding the

platform’s informative contents belong to highly

credible and reliable sources, specifically

governmental web sources. To achieve this, an

algorithm selects content from different web sources

and builds audio-visual pieces on its own.

After the video spots’ creation, which includes an

audio track narrating the news content, the system

injects it into the linear television presentation flow.

At this moment, the regular TV broadcast is locally

paused and later resumed after the presentation of the

informative video.

When the informative content is sent to a STB it

triggers a notification on the screen allowing two

options, visualize or ignore the video (Figure 1).

The notification remains present on screen during

three minutes and a half, however after the initial 30

seconds it is minimized to reduce the intrusive

appearance.

Figure 1: New informative content notification.

ICT4AWE 2018 - 4th International Conference on Information and Communication Technologies for Ageing Well and e-Health

136

It should also be observed that when the STB is

turned on, a splash screen is shown with contextual

elements: a greeting based on the time of the day;

information regarding the weather (temperature and

an icon that visually represents the weather); the time

and date; the current season.

All the video spots available in the +TV4E

platform have the same structure, typically composed

by an introduction animation, the informative content

itself and a closing animation.

Additionally, there is a video library that gives the

user access to the videos generated in the last five

days, categorized as seen and unseen.

All the elements and functionalities available in

the high-fidelity prototype were defined through a

participatory design process with seniors. The design

and development of a technical solution should

consider that it is important that the product improves

user's life in an easy and intuitive manner. In this

context the aim of this study is to evaluate the

usability, usefulness and aspects to improve in the

+TV4E platform.

In addition to this introduction, this article is

organized in the following parts: section 3 which

illustrates the methodological steps followed for data

collection; section 4, where the obtained results are

presented in detail and discussed and, finally, section

5 presents the main conclusions and future steps for

the +TV4E project.

4 METHODOLOGY

To collect information for the improvement of the

+TV4E platform field tests were carried out in the real

context with a reduced sample of seniors. The results

from these tests will help to identify the aspects that

should be adjusted in the platform. This test occurred

after a set of previously developed steps, summarised

in Figure .

In the first phase, the research team aimed to

analyse and define several key aspects: the areas in

which Portuguese elderly feel lack of information; the

most appropriate web sources to feed the information

areas, and the functionalities of the platform (Silva,

Caravau and Campelo, 2017). The compilation of this

information allowed the creation of a first prototype.

In the second phase, the developed prototype was

evaluated by a group of seniors, through a focus

group methodology, focusing on the audio-visual

elements and functionalities (Silva, Caravau and

Campelo, 2017). This phase allowed the

identification of major problems in the seniors’ point

of view, which after were corrected by the

developers. At the end of this process, the research

team created the high-fidelity prototype which had

almost all the predefined functionalities

implemented, with the audio-visual elements adjusted

according to the elderly’s suggestions. To complete

the platform’s evolution and evaluation process,

towards the fully functional iTV platform, a field test

with a sample of seniors was performed in their

natural environment. To further improve the

platform, this field test aimed to give people the

possibility to use the platform freely and without time

constraints, since it is only possible to detect specific

problems that may arise during a continuous use.

Figure 2: Timeline of developed phases.

The field trial carried out in this work consisted of

three stages: (1) a first moment, where research team

elements went to the participants’ home to explain the

project’s goal and install the platform; (2) follow-up

phone questionnaire survey; (3) final data gathering

and collection of the installed material.

Participants who joined the study received, in this

initial face-to-face moment, an information guide of

the iTV application. Study objectives and aspects

related to data collection were orally explained. All

participants were given the opportunity to request

further information on the study and were informed

about the possibility to withdraw at any time without

any personal injury and without further justification.

After this, each person was asked to sign and date an

informed consent, furthermore a sociodemographic

data questionnaire was applied. The installed STBs

offer seven channels, as is practiced in Portuguese

Digital Terrestrial Television (DTT). During the time

of this field trial, the high-fidelity prototype tested in

the participants’ home, only generated videos in five

of the seven ASGIE: health care and welfare services;

financial services; culture, informal education and

Seniors’ Info-Inclusion Through Interactive Television: Results of a Field Trial

137

entertainment; security services; and local authority

services. Social and transport services did not have

available web sources to produce news.

In this initial moment, participants had the

opportunity to explore the platform alongside one

researcher that, after a first utilization without any

help, answered all questions about the system asked

by the participant. In the second phase, a follow-up

phone questionnaire was conducted aiming to

preserve a frequent contact with the participants as

well as to record incidents or events that may occur.

Sometimes this is an often-neglected aspect and not

referred in final projects prototypes’ evaluation.

Moreover, this phone call intended to promote the

trust relationship between researcher and participant

maintaining the individual's engagement with the

project. A questionnaire survey (Quivy and

Campenhoudt, 1995) and the Post-Study System

Usability Questionnaire (PSSUQ) were applied on

stage three, five weeks after the field tests begun. The

PSSUQ, a tool to evaluate the usability of the high-

fidelity prototype, allows the gathering of results

concerning usability and perception of utility and thus

it was selected.

The PSSUQ is an instrument that assess the user

satisfaction with system usability (Lewis, 2002). It

consists of 19 items rated on a 7-point scale ([1] –

strongly agree; [7] - strongly disagree) in which the

lowest scores indicate better usability. The PSSUQ

consists of an overall satisfaction scale and three

subscales: system usefulness - SysUse (items 1–8);

information quality - InfoQual (items 9–15); and

interface quality - IntQual (items 16–18) (Lewis,

2002). The final score in these three subscales is

achieved through the mean of the corresponding

items for each one. The final score of overall

satisfaction scale is the mean of item 1 to 19 (Lewis,

2002). The PSSUQ was validated to the European

Portuguese version, with positive results of

psychometric evaluation (Rosa et al., 2015). Among

the several methods used to evaluate usability,

PSSUQ was selected due to the success achieved by

other authors to evaluate iTV systems for seniors (

Ribeiro et al., 2015).

After PSSUQ, a questionnaire was applied. This

questionnaire was essential to collect qualitative data

concerning the usefulness, aspects that users found

that should be improved and their satisfaction levels.

This questionnaire was constructed by the research

team, with open-ended questions, which were written

down by the researcher based on the participant’s

answers.

The sample of this study was selected by

convenience (Carmo and Ferreira, 2008). For the

selection of the sample, inclusion criteria considered

were age over 60 years; watches TV regularly; lives

in Aveiro area and neighbouring cities and provides

informed consent. Participants needed to have a TV

with High-Definition Multimedia Interface input to

connect the STB provided, as well as an internet

connection.

The sample was composed of four homes

contexts, in which each house was composed of two

individuals (n=8), with four females (50%) and four

males (50%) with an averaging age of 71. The two

elements of each dwelling where a couple, thus the

marital status of all were “married”. Around 25% of

the sample completed the higher education and the

remaining the medium literacy levels. On average,

each individual watches 3 hours and 45 minutes of

TV per day and all have pay TV services. Concerning

the use of the operator’s STB four participants said

they do not use any of the box’s available features,

and the remaining referred: view the upcoming

schedule (n=3); rewatch past TV broadcasts (n=2)

and schedule recordings (n=1). The most frequently

watched programs categories were: news (n=8),

entertainment (n=6), documentary programs (n=3),

sports (n=3) and soap opera/TV series (n=3). All

participants said they did not need help from others

while watching TV.

5 RESULTS AND DISCUSSION

During the questionnaire survey, the research team

identified one house, with two participants that over

time showed disinterest in using the platform.

Concerning this disengagement situation, it was

determined that these participants should not be

considered in the results since it was not possible to

collect the desired data. Also, one participant (a

member of a couple) did not answer both the PSSUQ

and the questionnaire survey because since he had

access to a pay TV service with more interesting (in

the participants opinion) channels, he declared that he

did not use the platform. In this section, it will be

presented and discussed the results of the data

collected through the follow-up questionnaire survey

applied and the PSSUQ (n=5), after five weeks of

participants' use.

5.1 Questionnaire Survey

The final questionnaire applied was composed by 16

questions. All the participants (n=5) said that the

platform could be useful, both for themselves and for

others, to stay updated and engaged with their

surrounding context. These opinions corroborate with

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138

what some authors have been saying about the

seniors’ need to be aware of what is happening in the

surrounding environment, allowing them to age well

and to be socially included (Everingham et al., 2009;

Silva, Caravau and Campelo, 2017). All the elements

of the sample also agreed that the splash screen

(Figure 1) is an important feature. Besides allowing

time orientation, in a simple and visual way, this

feature also provides updated daily information of

seniors’ interest. The decline in cognitive functions

can indicate the emerging of cognitive impairments,

but the normal cognitive ageing may also entail some

cognitive slow down (Spar and La Rue, 2005).

Concerning this, the splash screen seems to be an

important informative screen.

Regarding the ASGIE categories in which the

platform offers information, one participant referred

that the available ASGIE are enough while, the other

four participants mentioned that they would like to

see contents on other subjects, namely about sports

(n=2) and decoration activities (n=1). These inputs

allowed a better understanding of the relevance that

leisure activities represent in seniors’ daily living but

allowed also to infer that seniors understood the

existence of content specific areas. Although, this

type of information is outside the scope of social and

public services, which are the key information areas

of the project.

Regarding the notification that appears when a

new video is available (Figure 1 and Figure 2), the

following features were analysed with the sample:

perceptibility of the icon size; text readability (font

type and size); perceptibility of which button should

be pressed to start watching the video, considering the

visual hint. Most of the sample considered that all the

elements are perceptible and easy to understand. Only

one person mentioned that the notification’s icon

should be bigger. The voice-over (female gender),

font type and size (Tiresias Screenfont at 55 pts) of

the text presented during the informative videos (Reis

et al., 2017) were perceived with no difficulty by the

five participants. The background images and the low

volume background music present in the video spots

were not considered problematic elements for the

content understanding. These results are expected

since those elements were firstly designed based on

literature guidelines and then discussed and validated

with a group of seniors in a participatory design

process (Reis et al., 2017;). Despite these positive

answers, the voice-over was considered monotonous

by one of the participants. The five participants

classified the time interval between videos as

“acceptable”. The entire sample also considered the

video library (Figure 1) a useful extra feature, with

two participants (40%) using this tool to watch

“unseen videos”, while the other three (60%) to

visualize “seen” and “unseen” video spots. These

results reveal that the easy and fast access to available

content is highly appreciated by +TV4E platform’s

potential end users. Only one participant, denoted

problems in using the remote control, saying that

sometimes it did not reply instantly to the click (e.g.

“Sometimes I tried to change the channel and it would

not work”). After some tests carried out by the

developers, it was noticed that this problem was

related to the internet connection available in the

participant’s house.

When the participants were asked “Have you ever

felt disoriented and/or confused with the operation

system, losing the control over what happened on the

TV?” they replied with two “no” and three “yes”.

Two of the participants who answered positively said

that sometimes the video stops without any reason

and they do not know how to react (“The video and

the image stop several times and I do not know what

to do”). The other person referred that in the

beginning of the field test, had some difficulties in

realizing how the STB remote control works, but by

end of the field test, it became an easy and intuitive

task. All the participants expressed that if the platform

is available without financial costs they will use it.

Furthermore, all the participants had the opportunity

to add observations that are not included in the

questionnaire. Only one person referred that the

minimization process of the notification, which

informs about the availability of new content, is very

fast (defined as 30 seconds after the notification

appears).

5.2 PSSUQ

Results from the PSSUQ showed that the participants

were satisfied with the usability of the +TV4E

platform (see

Table 1).

Table 1: Results of PSSUQ subscores (n=5).

Mean SD

Overall satisfaction

2,24 0,49

System usefulness (SysUse) 2,04 0,59

Information quality

(InfoQual)

2,48 0,37

Interface quality (IntQual)

2,20 0,80

Analysing the results by subscale, the lowest average

was for “System usefulness” and the highest for

“Information quality”. When analysing each question

of PSSUQ, the lowest score was question number 15

“The organization of information on the system

screens was clear” (mean=1,6; SD=0,55) and with the

highest observed is question number 10 “Whenever I

made a mistake using the system, I could recover

easily and quickly” (mean=3,6; SD=1,52). It was

clear that the highest average obtained in question

Seniors’ Info-Inclusion Through Interactive Television: Results of a Field Trial

139

number 10 reflects that improvements in the system

should be addressed. For example, the system may

generate and send automatic messages when the

video stops playing due to internet connection

problems, something that was not happening at the

time. This will help the user to clearly understand the

error that is occurring. If the results are analysed

disaggregated by participants, the person with the

lowest scores on all the subscales classified: “Overall

satisfaction” (mean=1,64); “System usefulness”

(mean=1,45); “Information quality” (mean=1,95);

“Interface quality” (mean=1,33). The participant with

the highest results in almost all subscales achieved:

“Overall satisfaction” (mean=2,83); “System

usefulness” (mean=2,79); “Information quality”

(mean=2,64); “Interface quality” (mean=3,33).

6 CONCLUSIONS AND FUTURE

WORK

The main goal of the field tests was to collect inputs

from a group of seniors in their real use context,

concerning the functionalities available in the +TV4E

high-fidelity prototype.

This study allowed the research team to assess the

usability and the functions that should be improved in

the platform, through the administration of PSSUQ

and a questionnaire survey. Despite the reduced size

of the sample, a recognized limitation of the study, it

was possible to collect several valuable data

concerning system usage. It is mandatory for the

research process that more field tests are carried out

with improved versions of the +TV4E. Although, the

achieved results reveal interesting inputs for the

upgrading of +TV4E high-fidelity prototype.

Regardless of the high usability’s levels obtained

in PSSUQ, some components should be improved.

Error messages should appear whenever the system

crashes. Also, the best way to provide messages that

help the user to recover easily and quickly from

unexpected situations should be analysed. Most of the

issues that arose during the field tests were related to

internet connection problems. To assess this issue, a

more reliable internet connection and with more

bandwidth should be used. The complaint of the

voice-over being monotonous tone will encourage the

developers to further improve the Text-To-Speech

solution. The developed software must have

mechanisms that increase the reliability of the

platform functionalities, thus minimizing potential

errors (e.g. misclassifying videos in the video

library).

After improving the high-fidelity prototype,

according to the gathered inputs, the team plans to do

new field tests with potential end users. The team also

plans to analyse some aspects that only one or two

participants considered important, such as to improve

the duration of the notification message and

functionalities available in the remote control.

ACKNOWLEDGEMENTS

The research leading to this work has received

funding from Project 3599 – Promover a Produção

Científica e Desenvolvimento Tecnológico e a

Constituição de Redes Temáticas (3599-PPCDT) and

European Commission Funding FEDER (through

FCT: Fundação para a Ciência e Tecnologia I.P.

under grant agreement no. PTDC/IVC-

COM/3206/2014).

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