# Quality of an Assistive Technology Web Application for Primary Care Physicians Serving Older Adults: Concurrent Mixed Methods Study

## TL;DR

A web app called MGAT was developed to help primary care physicians in Puerto Rico better understand and recommend assistive technologies for older adults with functional disabilities.

## Contribution

MGAT is a new web application designed to improve PCPs' knowledge and use of assistive technologies for older Latino adults in Puerto Rico.

## Key findings

- MGAT received high quality ratings, particularly in information and functionality.
- PCPs found MGAT useful and reported increased awareness of patient needs and AT knowledge.
- Suggestions for improvement included adding customization and interactive features.

## Abstract

Older Latinos living in Puerto Rico experience significantly higher rates of functional disabilities (FDs; 1093/87,300, 27.8%) compared to older adults in the continental United States (755,685/57,913,200, 13.3%). While assistive technologies (ATs) can improve daily function and support aging in place, primary care physicians (PCPs), who are essential in addressing FDs resulting from chronic diseases, often lack knowledge about AT devices and services. The Mi Guía de Asistencia Tecnológica (MGAT; My Assistive Technology Guide) web application was empirically developed to address this gap by providing comprehensive information and videos about AT devices for older adults with functional difficulties in daily living activities.

This study aimed to assess the quality of MGAT among PCPs and describe their experiences using the app to increase access to AT for older Latinos.

A total of 10 PCPs participated in this usability project, receiving MGAT training before a 30-day implementation period. A concurrent mixed methods design was used, combining quantitative data from the User Version of the Mobile User Application Rating Scale (uMARS) and qualitative insights from semistructured individual interviews. The analysis included descriptive statistics and a directed content analysis.

The MGAT received high overall objective quality ratings on uMARS (mean 4.06, SD 1.05). Among subdomains, information scored highest (mean 4.60, SD 0.51), followed by functionality (mean 4.20, SD 0.63), aesthetics (mean 4.00, SD 0.82), and engagement, which scored lowest (mean 3.34, SD 1.51). Subjective quality ratings were also favorable, with a mean score of 3.93 (SD 1.19), with recommending the app to others scoring the highest (mean 4.70, SD 0.48) and willingness to pay for the app the lowest (mean 3.11, SD 1.90). Perceived impact received the highest score across all domains (mean 4.82, SD 0.39), with behavior change scoring the highest (mean 5.82, SD 0) and awareness scoring the lowest (mean 4.60, SD 0.52). Qualitative findings revealed that PCPs found MGAT entertaining and interesting, but wanted more customization and interactive features to boost engagement. They appreciated its ease of use and navigation, but noted the need for a stable internet connection. While the design was visually appealing, improvements to the color scheme and element sizes were suggested. Participants valued the high-quality information relevant to older adults but desired more specialized content for medical professionals. They were likely to recommend MGAT, though cost opinions varied. Most importantly, MGAT increased awareness of patient needs, expanded AT knowledge, and positively influenced intentions to recommend AT, ultimately facilitating patient access to AT.

The high-quality and usefulness ratings suggest MGAT could be an effective tool for PCPs in managing older adults’ FDs. Future research should evaluate the effectiveness of MGAT in managing FDs among older adults.