Amanda Adams currently works as a Research Fellow with the Aged Care Research & Industry Innovation Australia (ARIIA) project. Her role in the ARIIA Project is to support and build the aged workforce knowledge and practical skills through the identification, synthesis and translation of research evidence. Amanda has experience creating tailored online content for diverse audiences including patient, carers, consumers and workforce of both the health and aged care sectors. As a principle digital lead, her skills also extend to designing, developing, and evaluating technologies as well as managing digital projects. Practical capabilities include UI/UX interface design, information architecture, content design, data anlytics and user experience research. Amanda's previous position was with the End-of-Life Directions for Aged Care (ELDAC) Technology project. In this role, she managed the design, development and evaluation of the Home Care App, an innovative resource to support end of life care provided by staff within residential and home care settings. Amanda also has experience in managing and creating content for websites, platforms, and apps including information resources for national palliative care projects [CareSearch, Dying2Learn MOOC, palliAGEDnurse, palliAGEDgp, ELDAC website].

As an Early Career researcher in the Research Centre for Palliative Care, Death and Dying (RePADD), Amanda has recently completed her PhD within the College of Nursing and Health Sciences at Flinders University. Her research investigated how evaluations of usability and accessibility can improve universal health interface designs. She also explored and how digital health literacy can influence how people interact with palliative care information.
Her research interests include:

• Interdisciplinary usability evaluation practice,
• Universal and inclusive interface designs for health information and services,
• Applying usability evaluation methodologies to improve user experience of health information for everyone,
• AI integration,
• Digtial translation of evidence,
• Accessibility, and
• Impacts of the digital divide, social determinants of health and levels of digital competency on interaction behaviours between users experiencing digital exclusion and health information.

PhD Thesis Title and Abstract:

Thesis title: Progressing from discretionary to obligatory evaluation practice to improve use and access of health information interfaces for all – Understanding the pragmatic complexities facing non-specialised development teams
Supervisors: Professor Jennifer Tieman and Dr Lauren Miller-Lewis

Summary:
Access and use of digital health interventions have become a critical factor in the transition to patient-centred models of care. Characteristics shaping an individual’s online interactions are also those influencing barriers to using and understanding health information. Evaluations of usability and accessibility are considered crucial developer activities. Considered intrinsically burdensome, complex, and costly, evaluations have become discretionary to the process. Consequently, assumptions of universal Internet access and technical competency levels drive interface design leading to increased digital, social and health exclusion. My significant original contribution to knowledge within this thesis was improving scholarship and awareness of real-world evaluation practice during health information resource development. Contextualised to palliative care, the studies reflect those evaluations could improve interface design to ensure that carers and patients understand information to assist decision-making when facing a non-curable life-limiting condition.

Primary study question: Does comprehensive and structured evaluation of usability and accessibility when undertaken during development identify interface areas that could improve user experience?

What is known already: Consumers are driving the need to personalise their health management. Online health information lies crucially on the intersection between consumers need for information, abilities to understand information and potential improvements in health outcomes. Socio-cultural characteristics interplay across all factors influencing digital equity, competency, and technological acceptance. These characteristics affect literacy and health literacy levels, directly impacting on abilities to make informed health decisions. Improving digital readiness levels can increase confidence and the ability to assess information trustworthiness. Usability and accessibility evaluations are critical to user-centred design (UCD) but are not readily employed nor reported within health resource development. Team structures, usability experience, funding levels, participants and process management are all likely factors influencing the likelihood of evaluations being undertaken. Delegation of responsibility for evaluations is unresolved between development teams and commissioning funders.

Main findings: Evaluation outcomes are not readily reported within peer-reviewed literature and cannot be used as an evidentiary source supporting novice developers’ evaluation practice. Developer uncertainty and their unawareness of the implications of usability errors on interface accessibility across reiterations limit their ability to design usable experiences for all end-users. Inherent barriers to evaluations include previous usability and development experience and capacity to access participants. Attempts to diversify usability samples to include individuals from hard-to-reach groups facing barriers to online health information is problematic and may require in-person strategies rather than reliance on electronic messaging. Experiential digital capabilities appear to be reflective within measures of digital health literacy (DHL) in those choosing to interact remotely with usability evaluation methods, whereas socio-cultural/economic factors influence DHL in reluctant individuals engaging online. DHL stratification produced performance and behaviour variations, complicating participant selection. Responsibility for ensuring evaluations are employed needs to be considered by commissioning funders to ensure resource interfaces provide meaningful experiences for all users.

Conclusion: Through identifying deficiencies and barriers within the development of health information resources, strategies can improve the normalisation of evaluation practice within processes by clearly articulating the roles, expectations and responsibilities of participants, developers, evaluators, and commissioning funders. Structured evaluation practice improved interface designs for end-users of palliative care resources to create a meaningful information experience.

• Manage digital projects including design and evaluation across the design cycle using an user-centred design approach.
• Intermediary role in development process to negotiate, collaborate and translate designs, data and feedback to ensure a user centred approach to design is maintained and products are delivered on time.
• Undertake various co-design approached to conceptualise and design interfaces of digital technologies including mobile apps, websites, and platforms.
• Apply user-based usability evaluation methodologies to generate feedback to inform improvements in the interface during both pre- and post-release periods of development.
• Develop and maintain meaningful relationships with stakeholders, advocacy groups and community organisations to encourage involvement of representatives in co-design and evaluation activities across the lifecycle of digital products.
• Undertake inspection-based usability evaluation methods to assess interfaces for ease of use, identify issues or errors and conformance of interfaces to accessibility guidelines.
• Apply analytical software to explore levels of interaction and adoption of digital interfaces and products at an individual (user), service provider and sector level of engagement
• Managing relationships between all groups and organisations across the project delivery schedule including University legal and contracts department, project teams, expert advisory and working groups, consumer and stakeholder representative organisations, aged care service providers and IT service providers.
• to ensure continuous clear and efficient communication across the project period to ensure overall milestones are met.
• Preparation of publications, reports, and formal documentation to support grant applications, dissemination of study findings, formal reporting to commissioning funders and human ethics applications.

Invited Conference and Seminar Presentations

• Adams A. Complimentary, not contradictory … Exploring usability feedback from Learning Designers and Healthcare Professionals to improve user experiences of digital health information. Presented at the Australian and New Zealand Association of Health Professional Educators, 4 July 2024, Adelaide, Australia.
• Adams A. Beyond counting downloads: Understanding Home Care Workers' engagement with digital palliative care information. Presented at the Oceanic Palliative Care Conference, 14 September 2023, Sydney, Australia.
• Adams A. A quality-driven approach to palliative care app design and development: Why Quality Processes Matter. Presented at the Research Centre for Palliative Care, Death and Dying, 20 June 2023, Flinders University, Adelaide, South Australia.
• Adams A, Vandersman P,Tieman J. ELDAC Home Care App – How co-design processes and a user-centred approach can shape resources for the home care workforce. Presented at the Aged & Community Care providers Association (ACCPA) National Conference, 12th October 2022, Adelaide, South Australia.
• Adams A. The ELDAC Digital Dashboard - Tracking End of Life Care Processes and Indicators for Reporting and Clinical Decision Making. Presented at the Aged and Community Services Australian Symposium, 24^th November 2021, West Lakes, South Australia.
• Adams A. Applying usability and accessibility evaluations to shape user-centred health interfaces – Identifying barriers to practice and exploring influence of end-user characteristics on evaluation outcomes. Presented at the Research Centre for Palliative Care, Death and Dying, 16th February 2021, Flinders University, Adelaide South Australia.
• Adams A. None, one or some - is the usability testing method all we need when developing and evaluating health information interfaces? Presented at the Australasian Institute of Digital Health Summit. 25th November 2020, Adelaide, South Australia.
• Adams A. Developers and Usability Testing – The Holy Grail or a Herring in Disguise? Presented at the Research Centre for Palliative Care, Death and Dying, 28th March 2020, Flinders University, Adelaide South Australia.
• Adams A. Can usability testing be all we need when developing and evaluating health information resources under pressure? Presented at the Flinders University Digital Health Research Centre. 15th September 2020, Tonsley Precinct, Adelaide, South Australia.

Invited Research Blogs

• Adams A. The importance of co-design and usability evaluation in shaping the design of the App for the home care workforce. End of Life Directions for Aged Care (ELDAC) Project. Published December 13, 2022.
• Adams A. How ELDAC’s Home Care App for care workers can help. Blog. End of Life Directions for Aged Care (ELDAC) Project. Published October 19, 2022.
• Adams A. Valuing diversity when designing online information technology. Blog. CarerHelp Project. Published August 10, 2022.
• Adams A. Balancing audience diversity and health information resource design. Blog. CareSearch Palliative Perspectives. Published August 13, 2020.
• Adams A. Usability evaluation and online palliative care information resources. CareSearch Palliative Perspectives. Published July 16, 2019.
• Adams A. Have you ever wondered why it is difficult to find a useful and relevant palliative care app when you need one? CareSearch Palliative Perspectives. Published March 15, 2016.

Conference Abstracts and Posters

• Tieman J, Vandersman P, Adams A. How co-design processes and a user-centred approach shaped ELDAC’s mobile app for the home care workforce. Aged & Community Care providers Association (ACCPA) National Conference, 12th October 2022, Adelaide, South Australia.
• Tait P, Adams A, Tieman J. Evaluation of the palliAGEDgp Smartphone Application: A National Survey [Poster Presentation]. 2017 Australian Palliative Care Conference (APCC17) 6-8 September 2017, Adelaide South Australia.
• Tait P, Adams A, Button E, Tieman J. An evaluation of doctor’s experiences with palliAGEDgp smartphone app. 14th National Rural Health Conference, 26-29 April 2017. Cairns Queensland.
• Tait P, Adams A, Tieman J. palliAGED: Developing an innovative tool supporting evidence-based palliative care. PHC Research Conference, 8-9 June 2016. Canberra National Convention Centre, Australian Capital Territory.
• Tait P, Adams A, Tieman J. [Poster] Information resources for healthcare professionals in primary care: Improving access through information technology. National Medicines Symposium, 19–20 May 2016. Canberra Convention and Exhibition Centre, Australian Capital Territory.
• Tait P, Adams A, Tieman J. Smart phone apps and GPs: A portable solution for community care. 13th Australian Palliative Care Conference, 1 - 4 September 2015. Melbourne Convention and Exhibition Centre, Melbourne, Victoria.