RESNA 27th International Annual Confence
Use of Cell Phones by Elders with Impairments: A Survey Design
Through survey format this study explored cell phone design in relationship to the needs of the elder population. Six-hundred and sixty-five participants with disabilities (age range 40-96 years, M =71 + 8, Males 210, Females 448, 596 over age 60, and 69 age 40-59) were surveyed through face-to-face interviews and phone interviews. The survey addressed satisfaction, importance, frequency of use, methods for learning, barriers to use, views on features, and views on benefits gained from cell phone use. The results showed: elders valued their cell phone, although a large proportion (37%) used the cell phone for emergencies only; with the most frequent suggestions being to increase button size and decrease the complexity of the cell phone.
Cellular phones, equipment design, frail elderly
Cell phones, as currently designed, may be difficult for elders to use due to limitations in vision and fine motor coordination. This study explored elder perspectives on cell phone design and features. Presently thirty-five million Americans (12% of the population) are over the age 65 (1). By 2030 the over-65 population will double to 70 million, representing 20% of the U.S. population (2). As this population advances in age, the likelihood of experiencing a disability increases (3). In 1995, 47% of the 65-to-79 year age group and 72% of the 80+ year age group had at least one disability (3).
The leading cause of disability in the U.S. is arthritis (4) and over half (58%) of the elder population in the U.S. have arthritis (5). Elders with arthritis may have difficulty holding and manipulating a cellular phone. When given a choice between a larger and smaller television remote control device elders with visual and/or fine motor impairments preferred and made fewer mistakes with the larger device (6). Many elders have vision impairments. The elder population represents 12% of the U.S. population, yet 30 percent of all visually impaired individuals are elders (7). By 2050 there will be a 265% increase in persons over age 65 who have difficulty seeing letters in ordinary newsprint (8). Vision and fine motor coordination impairments could have an impact on using a cell phone, and the degree of impact could vary with the design of the phone.
While considerable research has been reported on the effects of cell phones in relation to cell-phone microwave emissions, and cell phone distractions while driving, there have been no published studies on the design of cell phones and in particular on the use of cell phones by elders with disabilities. Product design for people with disabilities has resulted in many new products that are more easily used by all people; this principle is called universal design. Yet cell phone designers have focused on a younger, more mobile population, creating smaller devices with increasing numbers of features (9, 10).
The objective of this study was to conduct an in-depth analysis of cell phone use by elders. Through survey format this study explored cell phone design in relation to the needs of the elder population.
Subjects . Six-hundred and sixty-five study participants with one or more limitations in activities of daily living were surveyed. Participants ranged in age from 40 to 96 years, with a mean of 71. Five-hundred and ninety-six participants were between the ages of 60-96 years. Sixty-seven percent of these participants were female, and 90 percent were white. Forty-four percent had completed college. Eleven percent of the sample had incomes under $10,000 per year. To compare younger and older adults with disabilities, a sample of 69 study participants with disabilities between the ages of 40-59 years were included. The 40-59 year old group resembled the elder cell phone user group relative to gender, and education level.
Procedure . Survey methodology was employed, in-home and phone interviews ranged from .5 to 1.5 hours to complete. Seventy face-to-face interviews, 166 phone or in-home interviews, and 429 mail surveys were completed. The mailed surveys included elders from across the United States, while the phone and face-to-face interviews were conducted with study participants in Northern Florida, Southern California and Western New York. The survey addressed the areas of: 1) satisfaction, 2) importance, 3) methods for learning, 4) frequency of use, 5) barriers to using the cell phone more often, 6) views on cell phone features, and 7) views on benefits gained from cell phone use.
When asked ‘what the primary purpose was for using a cell phone,' all respondents ranked ‘emergencies' highly (86% of elder group and 83% of 40-59 year old group). The largest difference in purpose of cell phone-use between the two groups was that over half of the 40-59 year age group used the cell phone for ‘business' (54%) versus 16% of the elder group.
Only 30% of the elder group used their cell phones daily compared with 51% of the 40-59 year age group. Both the elder group (26%) and the 40-59 year age group (29%) used their phones weekly. However a large number of elders (37%) did not use the cell phone daily or weekly but rather just for ‘emergencies only'.
Cell phones were rated ‘highly important' across all respondent groups. Seventy-seven percent of the 40-59 year age group and 60% of the elder group who ‘regularly' used their cell phone rated the cell phone as ‘very important.' Forty-six percent of the elders (who had access to a cell phone but only used it in emergencies) found the cell phone ‘very important' in their lives. Moreover, only 5% of the respondents reported the cell phone as ‘not important' or ‘not at all important'.
The majority of respondents (89%) reported being ‘very satisfied' to ‘somewhat satisfied' with their cell phone. Specifically a higher proportion (47%) of the elder group who ‘regularly' used the cell phone reported being ‘very satisfied' compared to 41% of the younger group. Moreover only 11% of the respondents were found to be ‘not satisfied' or ‘not at all satisfied' with the cell phone.
The four primary complaints of the elder group who ‘regularly' used the cell phone were: 1) screen size ‘Too Small' (22%), 2) button size ‘Too Small' (45%), 3) size of the phone ‘Too Small' (12%), and 4) ‘Poor Quality' sound (15%) This data is presented in Table 1. A higher percentage of complaints were made by the elder group who did not have access to a cell phone, with two of the features with 1) 33% reporting the screen size ‘Too Small' and 2) 26% finding the overall size of the phone ‘Too Small.'
The foremost three barriers to using a cell phone for the 60 year and over age group who ‘regularly' used the cell phone were 1) ‘Lack of Need', 2) ‘Lack of Knowledge of Devices' and 3) ‘Too complicated or confusing'. Ninety-five percent of the 40-59 year age group and 69% of the elder group who ‘regularly' used the cell phone were ‘self-taught' in learning how to utilize the cell phone.
Have
Access to a Cell Phone |
Do
Not Have Access to a Cell Phone |
||
|---|---|---|---|
Screen |
|
Screen |
|
OK |
123 (61.8%) |
Other |
62 (36.1%) |
Too Small |
44 (22.1%) |
Too Small |
56 (32.6%) |
Poor Contrast |
23 (11.6%) |
OK |
48 (27.9%) |
Other |
16 (8.0%) |
Poor Contrast |
15 (8.7%) |
|
|
|
|
Buttons |
|
Buttons |
|
OK |
97 (48.0%) |
Too Small |
70 (38.5%) |
Too Small |
90 (44.6%) |
Other |
59 (32.4%) |
Other |
15 (7.4%) |
OK |
46 (25.3%) |
Poor Contrast |
4 (2.0%) |
Poor Contrast |
4 (2.2%) |
Too Many Buttons |
|
Too Many Buttons |
3 (1.7%) |
|
|
|
|
Size of the Phone |
|
Size of the Phone |
|
OK |
136 (68.7%) |
OK |
63 (38.7%) |
Too Small |
24 (12.1%) |
Other |
55 (33.7%) |
Too Large |
20 (10.1%) |
Too Small |
43 (26.4%) |
Other |
11 (5.6%) |
Too Large |
3 (1.8%) |
Too Heavy |
9 (4.6%) |
Too Heavy |
|
|
|
|
|
Clarity of the Connection/Sound |
|
Clarity of the Connection/Sound |
|
OK |
140 (69.0%) |
Other |
77 (53.9%) |
Poor Quality |
31 (15.3%) |
OK |
42 (29.4%) |
Varies |
15 (7.4%) |
Poor Quality |
13 (9.1%) |
Other |
12 (5.9%) |
Varies |
6 (4.2%) |
Volume too low |
6 (2.9%) |
Volume too low |
5 (3.5%) |
Elders place ‘high value' on their cell phone. This ‘high value' placed on cell phones may be attributable to the way elders view the ‘purpose' of their cell phone. The ‘purpose' of ‘contacting family' and ‘contacting friends' as a reason for having a cell phone was found to be secondary to having the cell phone for ‘emergencies.' This focus on ‘emergency use only' in the elder group was also reflected in the ‘frequency of use' found with elders. With the largest percentage of elders not reporting ‘daily' or ‘weekly' use but rather reporting primarily using their cell phone for ‘emergencies only.'
Elders reported being generally satisfied with the cell phone design, which was reflected in the majority of elders being ‘satisfied' with the overall ‘size of phone', ‘screen size', and ‘clarity of connection.' However less than half of the elder respondents where ‘satisfied' with ‘button size.' Forty-five percent of elders reported buttons as ‘too small,' supporting earlier findings by Mann (1994) with the size of buttons on TV remote controls.
The elder group expressed concern in regard to the complexity of their cell phone. When elders were asked to give suggestions on improving the cell phone, specific complaints such as, ‘I would like the book of instructions written in simple English rather than computerized', ‘Less option in program, no need for game, music, and all other things other than to call', and ‘make it simple, no extra features just call-out and receive' were documented. The desire for a less complicated cell phone may also be attributable to the current trend to increase the number of features. The burden of learning how to use these features as well as just using the cell phone for basic communication is placed on the elder as over 70% of elders report being ‘self-taught.'
We found that elders place high value on their cell phone and a majority view safety as the purpose of their cell phone. While overall satisfaction was high with the cell phone design, some suggestions were made for improvement in increasing screen size, increasing overall size, and improving quality of voice. The largest number of complaints related to button size being too small and in the complexity of the cell phone.
This is a publication of the Rehabilitation Engineering Research Center on Technology for Successful Aging, funded by the National Institute on Disability and Rehabilitation Research of the Department of Education under grant number H133E010106.
William C. Mann,
OTR, Ph.D.,
Department of Occupational Therapy,
University
of Florida,
PO Box 100164
Gainesville, FL 32610-0164,
Office:
(352) 273-6817,
EMAIL: wmann@hp.ufl.edu