1. Evaluating a Mobile Application Against Dating Violence in African American Adolescents Vipavee Thongpriwan, Ph.D., R.N., Nursing Yi Hu, Ph.D., Behnam Azimi PhD student, Electrical Engineering Jean Bell-Calvin, MS, RN, PHCNS-BC, Nursing Aaron Buseh, PhD, MPH, MSN, Nursing University of Wisconsin-Milwaukee

2. Presenter Disclosures (1)The following personal financial relationships with commercial interests relevant to this presentation existed during the past 12 months:

3. Background Limitation of mobile apps designed for and used by adolescents aimed at preventing DV A tailored app to assist adolescents increase their awareness and recognition of violence is essential We have developed a mobile app called Better Me The Better Me app has the potential to be used as a tool to prevent dating violence

4. The Better Me app is developed based on – Cognitive Behavioral Interventions [1] – The Conflict in Adolescent Dating Relationship Inventory (CADRI) [2] has five main tabs – My Relationship – Chart – Calendar – Get Help – Setting

5. Purpose of the Study To examine the usability of the app in African-American adolescents – Content – Features and functionality – Usability – Intentions to use in the future

6. Methods A descriptive, cross-sectional research design Participants – A convenience sampling method was used to recruit 19 African American adolescents (10 girls, and 9 boys), ages 13-17 years old

7. Recruitment Informed consent of the parent/guardian and adolescents was required Four recruitment strategies – Referral – School and community events – Flyer – Media Nursing center website Facebook

8. Instruments A demographic questionnaire A semi-structured interview guide A 5-point Likert System Usability Scale (SUS) [3] – 10 statements – Scores range from 0 to 100 – “I thought the app was easy to use.” – “I would imagine that most people would learn to use this app very quickly.” – “I felt very confident using the app.”

9. Data Collection Location: A private room at the Community Nursing Center in the study area Duration: 45-60 minute Participation Activities: – Try out the app – Complete the SUS and a demographic questionnaire – Participate in an interview

10. Data Collection A think aloud protocol – Use an App Testing Script Entering Information in the My Relationship Using the Calendar Viewing the Charts Using the Getting Help Working with the Setting An individual audiotaped interview

11. Data Analysis Data from the demographic were analyzed descriptively. A score for the SUS questionnaires was calculated using the SUS guideline [4] The audio-taped interviews were analyzed using the content analysis method [5]

12. Results Content – Clear and understandable – Some words might be difficult to understand “I don't know what anxious means.” “ I don't know what manic is.” “I know the words but I sometimes get them mixed up like manic, and elated, and euphoric.” This one “Threatened to tear down something I value” I don’t know what it means.

13. Results Features and Functionality “It's self-explanatory. You just play around with it...” “When I put in information into the My Feelings, or My Partner’s Behavior, or Events it goes into the chart and calendar.” My Relationship - the most desirability Chart - the least desirability Get-Help and Reminder – the most confusing feature

14. Results Usability – A SUS score above a 68 is considered above average – In our study, the SUS score was a 78 (a percentile rank of 83%) indicating an excellent usability testing [3]

15. Results Intentions to Use in the Future – “if I’m in a relationship, and I’m in a bad situation that I really need help. I will use it.” – “If this is not the most used app, people don't know though ” – “I don’t think people will be afraid to use it. It doesn’t ask you like your name…”

16. Results Suggested Improvements – User interface Make it more customize Remove the math symbols – Change words that are unclear – Charts and Get Help Make it readable and easy to understand – Add a guideline for breaking up – instructions

17. Future Plans Use multiple approaches – Ask for feedback from experts Revise the app based on the findings Include local domestic violence agencies into the app Examine the practicality of using the app in participants’ real life conditions Explore the feasibility of using the app as a tool of change in knowledge and attitude toward dating violence

18. Key Lessons Learned It is essential to validate whether there is a real need for an app early in the design and development process Informed consent process should be clear and effective as much as possible Recruiting male adolescents to participate in the study is challenging Ways to handle “no show”

19. References 1.Stuart, G.W., Principles and Practice of Psychiatric Nursing 2012, Elsevier, Mosby: St. Louis, MO. p. 816. 2.14.Wolfe, D.A., et al., Development and validation of the Conflict in Adolescent Dating Relationships Inventory. Psychological assessment, 2001. 13(2): p. 277-93. 3.Sauro, J. Measuring Usability with the System Usability Scale (SUS) 2011; Available from: http://www.measuringusability.com/sus.php. http://www.measuringusability.com/sus.php 4.Bangor, A., P.T. Kortum, and J.T. Miller, An empirical evaluation of the System Usability Scale. International Journal of Human- Computer Interaction, 2008. 24(6): p. 574-594. 5.Sandelowski, M., Whatever happened to qualitative description? Research in Nursing & Health, 2000. 23(4): p. 334- 40.

20. UW-Milwaukee www.nursing.uwm.edu College of Nursing