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✪ Assessing the usability of complex psychosocial interventions: The Intervention Usability Scale

Authors:

Aaron R. Lyon, Michael D. Pullmann, Jedediah Jacobson, Katie Osterhage, Morhaf Al Achkar, Brenna N. Renn, Sean A. Munson, & Patricia A. Areán

University of Washington affiliated authors are displayed in bold.

✪ Open Access

Published: February 2021

Read the full text in the open access journal Implementation Research and Practice

Abstract:

Background

Usability—the extent to which an intervention can be used by specified users to achieve specified goals with effectiveness, efficiency, and satisfaction—may be a key determinant of implementation success. However, few instruments have been developed to measure the design quality of complex health interventions (i.e., those with several interacting components). This study evaluated the structural validity of the Intervention Usability Scale (IUS), an adapted version of the well-established System Usability Scale (SUS) for digital technologies, to measure the usability of a leading complex psychosocial intervention, Motivational Interviewing (MI), for behavioral health service delivery in primary care. Prior SUS studies have found both one- and two-factor solutions, both of which were examined in this study of the IUS.

Method

A survey administered to 136 medical professionals from 11 primary-care sites collected demographic information and IUS ratings for MI, the evidence-based psychosocial intervention that primary-care providers reported using most often for behavioral health service delivery. Factor analyses replicated procedures used in prior research on the SUS.

Results

Analyses indicated that a two-factor solution (with “usable” and “learnable” subscales) best fit the data, accounting for 54.1% of the variance. Inter-item reliabilities for the total score, usable subscale, and learnable subscale were α = .83, α = .84, and α = .67, respectively.

Conclusion

This study provides evidence for a two-factor IUS structure consistent with some prior research, as well as acceptable reliability. Implications for implementation research evaluating the usability of complex health interventions are discussed, including the potential for future comparisons across multiple interventions and provider types, as well as the use of the IUS to evaluate the relationship between usability and implementation outcomes such as feasibility.

Plain language abstract

The ease with which evidence-based psychosocial interventions (EBPIs) can be readily adopted and used by service providers is a key predictor of implementation success, but very little implementation research has attended to intervention usability. No quantitative instruments exist to evaluate the usability of complex health interventions, such as the EBPIs that are commonly used to integrate mental and behavioral health services into primary care. This article describes the evaluation of the first quantitative instrument for assessing the usability of complex health interventions and found that its factor structure replicated some research with the original version of the instrument, a scale developed to assess the usability of digital systems.

**This abstract is posted with permission under the Creative Commons Attribution 4.0 International License**

✪ Use of Human-Centered Design to Improve Implementation of Evidence-Based Psychotherapies in Low-Resource Communities: Protocol for Studies Applying a Framework to Assess Usability


Authors:

Aaron R Lyon, Sean A Munson, Brenna N Renn, David C Atkins, Michael D Pullmann, Emily Friedman, & Patricia A Areán

University of Washington affiliated authors are displayed in bold.

✪ Open Access

Published: September 2019

Read the full text in the open access journal JMIR Research Protocols

Abstract:

Background

This paper presents the protocol for the National Institute of Mental Health (NIMH)–funded University of Washington’s ALACRITY (Advanced Laboratories for Accelerating the Reach and Impact of Treatments for Youth and Adults with Mental Illness) Center (UWAC), which uses human-centered design (HCD) methods to improve the implementation of evidence-based psychosocial interventions (EBPIs). We propose that usability—the degree to which interventions and implementation strategies can be used with ease, efficiency, effectiveness, and satisfaction—is a fundamental, yet poorly understood determinant of implementation.

Objective

We present a novel Discover, Design/Build, and Test (DDBT) framework to study usability as an implementation determinant. DDBT will be applied across Center projects to develop scalable and efficient implementation strategies (eg, training tools), modify existing EBPIs to enhance usability, and create usable and nonburdensome decision support tools for quality delivery of EBPIs.

Methods

Stakeholder participants will be implementation practitioners/intermediaries, mental health clinicians, and patients with mental illness in nonspecialty mental health settings in underresourced communities. Three preplanned projects and 12 pilot studies will employ the DDBT model to (1) identify usability challenges in implementing EBPIs in underresourced settings; (2) iteratively design solutions to overcome these challenges; and (3) compare the solution to the original version of the EPBI or implementation strategy on usability, quality of care, and patient-reported outcomes. The final products from the center will be a streamlined modification and redesign model that will improve the usability of EBPIs and implementation strategies (eg, tools to support EBPI education and decision making); a matrix of modification targets (ie, usability issues) that are both common and unique to EBPIs, strategies, settings, and patient populations; and a compilation of redesign strategies and the relative effectiveness of the redesigned solution compared to the original EBPI or strategy.

Results

The UWAC received institutional review board approval for the three separate studies in March 2018 and was funded in May 2018.

Conclusions

The outcomes from this center will inform the implementation of EBPIs by identifying cross-cutting features of EBPIs and implementation strategies that influence the use and acceptability of these interventions, actively involving stakeholder clinicians and implementation practitioners in the design of the EBPI modification or implementation strategy solution and identifying the impact of HCD-informed modifications and solutions on intervention effectiveness and quality.

Trial Registration

ClinicalTrials.gov NCT03515226 (https://clinicaltrials.gov/ct2/show/NCT03515226), NCT03514394 (https://clinicaltrials.gov/ct2/show/NCT03514394), and NCT03516513 (https://clinicaltrials.gov/ct2/show/NCT03516513).

International Registered Report Identifier (IRRID)

DERR1-10.2196/14990

**This abstract is posted with permission under the Creative Commons Attribution 4.0 International License**