Mobile health (mHealth) applications hold immense potential for elderly self-care, yet adoption remains low due to visually cluttered user interfaces that fail to accommodate age-related declines in selective attention. To address this gap, this study validates a minimalist design framework grounded in Nilli Lavie’s Perceptual Load Theory (PLT).This study developed a medication reminder prototype incorporating five minimalist UI principles: partially flat design, high-contrast restricted colors, consistent typography, maximized negative space, and restricted features with camera-based character recognition.A moderated mixed-methods usability study with older participants (N=8, aged ?60) evaluated seven tasks across five standard metrics. Quantitative results demonstrated excellent usability: a Laplace-adjusted task completion rate of 96.55% (90% CI = [91.78%, 100%]), a normalized geometric task execution time of 15.96 seconds (95% CI = [15.66s, 16.25s]), an overall post-task Single Ease Question (SEQ) score of 5.86, and an overall mHealth Application Usability Questionnaire (MAUQ) score of 5.91.Qualitative interviews confirmed that the simplified visual environment significantly reduced cognitive strain and enhanced legibility. These findings validate the minimalist-PLT framework as a highly usable, accessible design guideline for elderly-centric mHealth interfaces.
Adams, E. J., Nguyen, A. T., & Cowan, N. (2018). Theories of working memory: Differences in definition, degree of modularity, role of attention, and purpose. Language, Speech, and Hearing Services in Schools, 49(3), 340-355. https://doi.org/10.1044/2018_LSHSS-17-0114
Anderson, M., & Perrin, A. (2017). Tech Adoption Climbs Among Older Adults. Pew Research Center. https://www.pewresearch.org/internet/2017/05/17/technology-use-among-seniors/
Awan, M., Ali, S., Ali, M., Abrar, M. F., Ullah, H., & Khan, D. (2021). Usability Barriers for Elderly Users in Smartphone App Usage: An Analytical Hierarchical Process-Based Prioritization. Scientific Programming, 2021, Article ID 2780257. https://doi.org/10.1155/2021/2780257
Benoni, H., & Tsal, Y. (2012). Controlling for dilution while manipulating load: Perceptual and sensory limitations are just two aspects of task difficulty. Psychonomic Bulletin and Review, 19(4), 631-638. https://doi.org/10.3758/s13423-012-0244-8
Cajita, M. I., Hodgson, N. A., Lam, K. W., Yoo, S., & Han, H. R. (2018). Facilitators of and Barriers to mHealth Adoption in Older Adults with Heart Failure. CIN: Computers, Informatics, Nursing, 36(8), 376-382. https://doi.org/10.1097/CIN.0000000000000442
De Fockert, J. W., Rees, G., Frith, C. D., & Lavie, N. (2001). The role of working memory in visual selective attention. Science, 291(5509), 1803-1806. https://doi.org/10.1126/science.1056496
Eltiti, S., Wallace, D., & Fox, E. (2005). Selective target processing: Perceptual load or distractor salience? Perception & Psychophysics, 67(5), 876-885. https://doi.org/10.3758/BF03193566
Forster, S., & Lavie, N. (2008). Failures to Ignore Entirely Irrelevant Distractors: The Role of Load. Journal of Experimental Psychology: Applied, 14(1), 73-83. https://doi.org/10.1037/1076-898X.14.1.73
Gomez-Hernandez, M., Ferre, X., Moral, C., & Villalba-Mora, E. (2023). Design Guidelines of Mobile Apps for Older Adults: Systematic Review and Thematic Analysis. JMIR MHealth and UHealth, 11, e43186. https://doi.org/10.2196/43186
Hickmann, E., Richter, P., & Schlieter, H. (2022). All together now - patient engagement, patient empowerment, and associated terms in personal healthcare. BMC Health Services Research, 22(1), 1116. https://doi.org/10.1186/s12913-022-08501-5
Hilmy, I. (2022, September 26). Smartphone usage nears 100%. The Star. https://www.thestar.com.my/news/nation/2022/09/26/smartphone-usage-nears-100
Holzinger, A., Searle, G., & Nischelwitzer, A. (2007). On Some Aspects of Improving Mobile Applications for the Elderly. In C. Stephanidis (Ed.), Universal access in human computer interaction: Coping with diversity (Vol. 4554, pp. 923-932). Springer. https://doi.org/10.1007/978-3-540-73279-2_103
Isakovi?, M., Sedlar, U., Volk, M., & Bešter, J. (2016). Usability pitfalls of diabetes mHealth apps for the elderly. Journal of Diabetes Research, 2016, Article ID 1604609. https://doi.org/10.1155/2016/1604609
Jusoh, S. (2017). A survey on trend, opportunities and challenges of mHealth apps. International Journal of Interactive Mobile Technologies, 11(6), 73-85. https://doi.org/10.3991/ijim.v11i6.7265
Lavie, N. (1995). Perceptual Load as a Necessary Condition for Selective Attention. Journal of Experimental Psychology: Human Perception and Performance, 21(3), 451-468. https://doi.org/10.1037/0096-1523.21.3.451
Lavie, N. (2010). Attention, Distraction, and Cognitive Control Under Load. Current Directions in Psychological Science, 19(3), 143-148. https://doi.org/10.1177/0963721410370295
Lavie, N., & De Fockert, J. (2005). The role of working memory in attentional capture. Psychonomic Bulletin and Review, 12(4), 669-674. https://doi.org/10.3758/BF03196756
Lavie, N., & Tsal, Y. (1994). Perceptual load as a major determinant of selective attention. Perception & Psychophysics, 56(2), 183-197. https://doi.org/10.3758/BF03206947
Lavie, N., Hirst, A., De Fockert, J. W., & Viding, E. (2004). Load theory of selective attention and cognitive control. Journal of Experimental Psychology: General, 133(3), 339-354. https://doi.org/10.1037/0096-3445.133.3.339
Lee, J. Y., Wong, C. P., & Lee, S. W. H. (2020). m-Health views and perception among Malaysian: findings from a survey among individuals living in Selangor. MHealth, 6, 6. https://doi.org/10.21037/mhealth.2019.09.16
Lee, M., Kang, D., Yoon, J., Shim, S., Kim, I. R., Oh, D., Shin, S. Y., Hesse, B. W., & Cho, J. (2020). The difference in knowledge and attitudes of using mobile health applications between actual user and non-user among adults aged 50 and older. PLoS ONE, 15(10), e0241350. https://doi.org/10.1371/journal.pone.0241350
Lewis, J. R., & Sauro, J. (2006). When 100% Really Isn't 100%: Improving the Accuracy of Small-Sample Estimates of Completion Rates. Journal of Usability Studies, 1(3), 136-150.
Lim, L. M., Mcstea, M., Chung, W. W., Azmi, N. N., Abdul, S. A., Alwi, S., Kamarulzaman, A., & Kamaruzzaman, S. B. (2017). Prevalence, risk factors and health outcomes associated with polypharmacy among urban community-dwelling older adults in multi-ethnic Malaysia. PLoS ONE, 12(3), e0173466. https://doi.org/10.1371/journal.pone.0173466
Lin, T. T. C., Bautista, J. R., & Core, R. (2020). Seniors and mobiles: A qualitative inquiry of mHealth adoption among Singapore seniors. Informatics for Health and Social Care, 45(4), 360-373. https://doi.org/10.1080/17538157.2020.1755974
Madden, D. J. (2007). Aging and Visual Attention. Current Directions in Psychological Science, 16(2), 70-74. https://doi.org/10.1111/j.1467-8721.2007.00478.x
Maylor, E. A., & Lavie, N. (1998). The influence of perceptual load on age differences in selective attention. Psychology and Aging, 13(4), 563-573. https://doi.org/10.1037/0882-7974.13.4.563
Moran, K. (2015). The characteristics of minimalism in web design. Nielsen Norman Group. https://www.nngroup.com/articles/characteristics-minimalism/
Murphy, G., Groeger, J. A., & Greene, C. M. (2016). Twenty years of load theory-Where are we now, and where should we go next? Psychonomic Bulletin and Review, 23(5), 1316-1340. https://doi.org/10.3758/s13423-015-0982-5
Sauro, J., & Lewis, J. R. (2016). Quantifying the User Experience: Practical Statistics for User Research (2nd ed.). Morgan Kaufmann Publishers Inc.
Vaportzis, E., Clausen, M. G., & Gow, A. J. (2017). Older adults perceptions of technology and barriers to interacting with tablet computers: A focus group study. Frontiers in Psychology, 8, 1687. https://doi.org/10.3389/fpsyg.2017.01687
Vo, V., Auroy, L., & Sarradon-Eck, A. (2019). Patients' perceptions of mhealth apps: Meta-ethnographic review of qualitative studies. JMIR mHealth and uHealth, 7(7), e13817. https://doi.org/10.2196/13817
Wike, R., Silver, L., Fetterolf, J., Huang, C., Austin, S., Clancy, L., & Gubbala, S. (2022, December 6). 3. Internet, smartphone and social media use. Pew Research Center. https://www.pewresearch.org/global/2022/12/06/internet-smartphone-and-social-media-use-in-advanced-economies-2022/
Wildenbos, G. A., Jaspers, M. W. M., Schijven, M. P., & Dusseljee-Peute, L. W. (2019). Mobile health for older adult patients: Using an aging barriers framework to classify usability problems. International Journal of Medical Informatics, 124, 68-77. https://doi.org/10.1016/j.ijmedinf.2019.01.006
World Health Organization. (2011). mHealth: New horizons for health through mobile technologies (Global Observatory for eHealth). World Health Organization.
Yazdani-Darki, M., Rahemi, Z., Adib-Hajbaghery, M., & Izadi, F. (2020). Older adults' barriers to use technology in daily life: A qualitative study. Nursing and Midwifery Studies, 9(4), 229-236. https://doi.org/10.4103/nms.nms_91_19
Zhou, L., Bao, J., Setiawan, I. M. A., Saptono, A., & Parmanto, B. (2019). The mhealth app usability questionnaire (MAUQ): Development and validation study. JMIR MHealth and UHealth, 7(4), e11500. https://doi.org/10.2196/11500
Norizan, W. H. W., & Tun, O. S. (2026). A Mixed-Methods Usability Validation of an Elderly-Centric Medication Reminder App. International Journal of Academic Research in Business and Social Sciences, 16(8), 939–953.
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