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TB Notes Newsletter

(PDF - 1.4M)

No. 1, 2011

COMMUNICATIONS, EDUCATION, AND BEHAVIORAL STUDIES BRANCH UPDATES

Dr. Castro Provides Expert Commentary on IGRAs for Medscape

Medscape from the website WebMD is a source of medical news features, commentary, and reference content for more than 32 physician specialties and for nurses, pharmacists, and other health professionals.  CDC and Medscape are collaborating to produce a special series of CDC expert commentaries designed to deliver authoritative guidance directly to Medscape's physicians and other health care professionals. In the series, experts from CDC offer video commentaries on current topics important to all practicing clinicians, including H1N1 and seasonal influenza, infection control, travel medicine, and more.

DTBE’s Communication Team of the Communications, Education, and Behavioral Studies Branch developed the script, and on February 16, DTBE’s Director, Dr. Kenneth Castro, recorded a commentary titled What’s New in Blood Testing for TB Infection? at the CDC broadcast studios in Atlanta.  The commentary was posted on March 14, 2011, on Medscape’s site where it can be viewed after a short registration process. As an alternative, it can be viewed on the DTBE website where it is currently listed under “News and Announcements,” or on DTBE’s Testing and Diagnosis web page under “Related Links for Health Care Providers.”

Other examples of Medscape’s “CDC Expert Commentary Series” to date are available at http://www.medscape.com/partners/cdc/public/cdc-commentary.  The videos are displayed in chronological order on Medscape’s CDC Video Commentary page.

Reported by Ije Agulefo, MPH
Div of TB Elimination

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CDC TB Website Usability Study Results for 2010

Introduction
In 2010 the DBTE web team conducted three in-person usability studies on the TB website. The purpose of these studies was to observe participants as they completed tasks on the DTBE website. These data will be used to make website improvements to increase performance and user satisfaction. 

The three studies conducted in 2010 were in follow-up to the baseline studies conducted in 2007 and 2009. The focus of the 2010 studies was to observe participants in person, unlike the previous studies that had been conducted remotely.

Study Methods
The studies used Web Effective Keynote and TechSmith’s Morae usability software. This software enables the videotaping of participants and collects participants’ responses to web tasks. Using a laptop, 36 participants completed the studies. A facilitator and note taker were present for each study. The studies were conducted during conferences in March (the North American Region International Union Against TB and Lung Disease), June (National TB Conference), and August (TB Education and Training Network). Recruitment for the studies was primarily through e-mail. An e-mail was sent prior to the conferences to those who had registered to attend. For the first study in March, participants were also recruited at the DTBE materials display booth. The studies took, on average, 63 minutes to complete.

During the usability studies, participants:

  1. Completed a background questionnaire,
  2. Answered questions regarding their initial impressions of the website,
  3. Performed real-world tasks on the website,
  4. Answered questions about what they liked or disliked on the website, and
  5. Answered demographic questions about themselves.

In the studies, there were 10 task scenarios that each participant tried to complete. See appendix A for a list of the tasks.

This is an example of a task scenario:
You are a nurse who would like to give your patients information to help them adhere to TB treatment. Use the CDC DTBE website to find this information.

Study Participants
Thirty-six participants completed the study. The study participants included public health professionals (54%), health care providers (26%), researchers or scientists in the health or medical field (3%), and others (17%) (TB controllers, data analysts, international TB program staff, and vendors).

Participants were predominantly 40–59 years of age; 68% had achieved an advanced degree; 74% of study participants were female; and 74% of the participants worked in state, local, or federal government. (Figure 1) 

Figure 1: Where Participants Worked

Where particpants worked, see text verison below

Text version

Most participants considered their level of Internet experience intermediate (57%) and their computer experience intermediate (74%). Participants who had previously visited the DTBE website prior to the study visited several times a month. (Figure 2)

Figure 2: Participants’ Use of the TB Website

Particpants use of the TB website, see text version below

Text version

Forty-six percent of participants spent 21 or more hours per week, including office and personal use, on the Internet. Seventy-seven percent used the Internet at work, and most participants read online the information they found on the DTBE website. (Figure 3)

Figure 3: How Participants Use Information from the TB Website

How Particpants use information from the TB Website, see text version below

Text version

Overall, study participants represented medium- to high-end users of the DTBE website. 

Participant Performance
Overall, 90% of participants were successful at completing the 10 task scenarios. Only 10% were unsuccessful in using the TB website to complete the scenarios.

Figure 4: Overall Success Rate

Overall Sucess Rate - 10% total unsuccessful, 90% total successful

Many of the tasks had a 100% success rate. See Figure 5 below for the success rates of each task.

Figure 5: Participants’ Success in Completing Task Scenarios

Participants success in completing task scenarios, see text version below

Text version

Out of the 10 tasks that participants were asked to accomplish, three tasks were more challenging to complete compared to the rest. Those tasks are listed below.

  1. Adhere to TB Treatment: You are a nurse who would like to give your patients information to help them adhere to TB treatment.
  2. TB Transmission & Travel: Next month you will travel to South Africa. You know that South Africa has a high rate of tuberculosis (TB). You would like to find information on travel to help reduce the risk of TB transmission.
  3. Skin Test Publication: At a recent conference you picked up a DTBE document entitled “What you need to know about the TB skin test.” You currently have one copy and would like to print copies of the document to give to patients.

 

Findings and Recommendations

Task 1 identified an issue with how publications and products are categorized. Participants stated that they would search by audience first versus topic or format.  Recommend adding audience-specific publication groupings on the Publications and Products web page.

Participants had trouble deciding where to click on the DTBE home page in order to complete task 2. Currently, TB travel information is located within two topics on the DTBE home page, specific populations and infection control. This was not apparent to participants in the study. Once participants had selected the topic, specific populations, they stated that they found it strange to find it there. Recommend adding descriptive text to the infection control topic indicating that travel information is contained within this topic. Review the placement of this information and consider conducting a card sort if a better placement is not obvious.

Task 3 further emphasized the issue with how publications and products are categorized on the DTBE website. Participants had difficulties selecting the correct format category when they reached this web page. Recommend adding audience-specific publication and product groupings, along with definitions for each format type. This way, a user of the website will know what they will find in each publication format category. Also, consider adding a link to patient materials or patient education on the DTBE home page.

Conclusion
These studies indicate that overall, the DTBE website has high usability among two of the primary audiences, health care providers and public health professionals. However, there is room for improvement and the DTBE web team remains focused on identifying usability issues, providing solutions, and increasing user performance of the website. 

In 2011, the DTBE web team will be implementing some of the recommended changes. The team will also conduct further testing to ensure the success of these changes. In 2011 usability studies will be conducted with additional user groups, including members of the general public.

We would like to thank all of you who took the time to complete this study, and welcome any comments and feedback you would like to share with the DTBE web team (e-mail: hsttbwebteam@cdc.gov).

—Submitted by Sharon Mc Aleer, MISM, CUA
Div of TB Elimination

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Appendix A – Task scenarios for CDC TB website usability study

  1. Find TB Events: Your employer has asked you to attend two TB events in 2010. Use the CDC DTBE website to find a Calendar of Events. When you find the answer, click on the green answer button, and select the two events that you plan to attend.
  2. Introduction to Program Evaluation Materials:
    A. Use the CDC DTBE website to find the section specifically for TB programs. Indicate when you have found it.
    B. You would like to download some introductory information on program evaluation. When you find this information, click the green answer button and select the document title.
  3. What are your thoughts on the “Resources for TB Programs” section of the website? Do you think more resources should be added?
  4. Adhere to TB Treatment: You are a nurse who would like to give your patients information to help them adhere to TB treatment. Use the CDC DTBE website to find this information. When you find the answer, click on the green answer button and select the correct page title where you found this information.
  5. Skin Test Publication: At a recent conference you picked up a DTBE document entitled “What you need to know about the TB skin test.” You currently have one copy and would like to print copies of the document to give to patients. Use the CDC DTBE website to find this information. When you find the answer, click on the green answer button and select the format that the document is in.
  6. Order Questions & Answers: You would like to order “Questions and Answers about TB.” What is the maximum amount that you can order? When you find the answer, click on the green answer button and select the maximum amount available for order.
  7. TB Transmission & Travel: Next month you will travel to South Africa. You know that South Africa has a high rate of TB. You would like to find information on travel to help reduce the risk of TB transmission. Use the CDC DTBE website to find this information. When you find the answer, click on the green answer button and select the page title where you found this information.
  8. Find Spanish Information: You would like to find a document with general TB information in a language other than English. Does the CDC DTBE website offer documents in Spanish?  When you find the answer, click on the green answer button and select an answer.
  9. State TB Contact: You would like to find TB data for your local area. You notice that the CDC DTBE website provides state data but not county data. You would like to contact the state TB control program to get information. Use the CDC DTBE website to find the state TB control program contact for Tennessee. When you have found the answer, click the green answer button and select the correct telephone number for the Tennessee state TB control program contact.
  10. TB Cases: How many TB cases were reported in the United States in 2008? Once you find the answer, click the green answer button and select the correct number.

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