Table 2 Visualization intervention, evaluation, and results of observational studies to evaluate visualizations used in consumer health technologies to support older adults living in the community.
CitationVisualization(s)InterventionVisualization evaluation method Results
Ayoade et al.31Different visualizations for knee replacement surgery and fall participants. Visual feedback using guide and real-time feedback mannequins to show users how and where to place body sensors, exercises to be completed, and feedback about exercise performance including a weekly progress report. Consulted with falls experts prior to developing the visualizationIn either a laboratory or at home, participants reviewed an informational booklet and used a visualization tool while performing rehabilitation exercisesObservations
Semi-structured interviews
Short questionnaires
The visualization tool improved confidence in executing the exercise program.
The visualization tool encouraged slower, more controlled movements compared to the booklet use.
Participants appreciated the weekly chart feature as a tool that allowed them to assess their performance over time.
Bruun-Pedersen et al.32A virtual environment application describing landscapes that changed as participants used the exercise bicycle to give the impression that participants were cycling through the landscapes. Developed visualization based on previous literature regarding interactions with virtual environment-related technologies.Participants used the exercise bike and if they wanted to, focus on the screen that provided the Virtual Environment feature.Open-ended interviewsSeven participants preferred the virtual environment; three participants did not prefer it. Participants overall were enthusiastic about the Virtual Environment feature, that it enhanced the exercise routine, and motivated to exercise regularly or for a longer duration. It provided (1) a feeling of being outside, (2) a sense of accomplishment and (3) them with energy. Two participants with pain did not feel that the virtual environment made a positive difference. Five participants stated that improvements could be made (the environment did not match their interests or was redundant; novelty of the environment could be lost).
Gronvall and Verdezoto33Three different visualizations used to show weekly BP overviews (icon based, bar charts, and line charts). Four visualizations used to show daily BP (icon based, text based, speedometer, and slider).
Designs guided by Beaudin and colleagues (2006).*
Participants performed BP self-measurement for 1 week and interpreted BP visualizations (phase 2)Workshop feedback (phase 2)
Web-based survey of adults
(phase 3)
Visualizations helped enhance understanding of BP measurements. For the weekly view, the line chart was preferred. For the daily view, participants found icons simple although it lacked in precision; they used text representations for precise values. Mixed response towards the speedometer visualization; participants noted that precision might be an issue. Overall, participants were concerned with precision of measurements in the visualizations.
Le et al.34Two visualizations of passive sensor data regarding participants’ motion within their apartments: a streamgraph (variant of stacked bar graph) displayed longitudinal total sensor activity distributed by location within the home, thickness of each layer corresponds amount of sensor activity, and a radial plot, a clock-like display of a 24-hour period of sensor data. Researchers developed visualizations using participant interview data, cognitive perceptual visualization guidelines, the emotional design principles of Norman37 and Shah and Hoeffner’s model of information visualization processing.38Community-dwelling older adults used a passive sensor system in their apartments for six months (phase 1)Interviews with gerontology experts for heuristic-based feedback
(phase 2)
Overall, participants understood the spatial and temporal component of the visualizations. The radial plot was easier to understand than the streamgraph for comparing components in the visualization and understanding granular data.
Le et al.35Researchers developed three interactive visualizations – a bar graph diagram, a radial plot, and a light ball metaphor – that provided information about overall wellness and social, physical, cognitive, and spiritual health. Visualizations were guided by previous research and suggestions from gerontology researchers.Focus groups with older adults in which they interacted with the visualizationsInterview questions during focus groupsParticipants noted potential for visualizations to support assessments of their wellness and promote of shared decision making with healthcare provider. They wanted to identify interventions they could use to address trends in longitudinal data. Participants used visualizations first for a holistic perspective then looked at details. Participants thought there was too much information displayed in the visualization and were confused by data abstractions (e.g. radial plot, and light ball metaphor). Participants found it difficult to notice differences in sizes and brightness. They appreciated that separation of visualizations based on different components of wellness.
Uzor and Baillie36Researchers developed two animated visualizations of a mannequin: a guide mannequin that demonstrated movements for each exercise (passive feedback); a guide mannequin and a mannequin that showed users’ movements (real-time feedback). Researchers also developed games that incorporated participants’ movements. Developed visualizations after consulting with older adults and experts in falls and physiotherapy.In each study, participants completed exercises using an instructional booklet then repeated exercises while wearing body-worn sensors and using either the games or visualization toolCompared time taken to complete one exercise repetition using the booklet versus the visualization tool
Participants using the visualization tool on average took longer to complete each exercise repetition compared to those using the booklet (6.58 versus. 5.66 seconds). They found the guide mannequin useful in identifying problems while completing exercises. Participants agreed that seeing exercise visualizations improved their understanding about rehabilitation and felt that visualizations made it hard for them to ignore completing exercises perceived of as unexciting.
  • * Beaudin JS, Intille SS, Morris ME. To track or not to track: user reactions to concepts in longitudinal health monitoring. JMIR. 2006;8(4):e29.