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Objective Design to Subjective Evaluations: Connecting Visual Complexity to Aesthetic and Usability Assessments of eHealth

ABSTRACT Objective: The visual complexity of a website is influential for users’ first perceptions and subsequent use of eHealth. Using two definitions of visual complexity, we conducted a comparative investigation of how design complexity and feature complexity – with different predicted relationships – affect users’ evaluations of web aesthetics and antecedents for technology acceptance (i.e., perceived ease of use and usefulness). Method: We used a 3 × 2 factorial online experiment (n = 277) to evaluate the effects of feature complexity (amount of information: low, mid, high) and design complexity (amount and organization: low, high). Outcomes were aesthetic evaluations, perceived ease of use, and perceived usefulness. Main effects and interactions were examined with multivariate analysis of variance (MANOVA). Indirect effects were examined with moderated-serial mediation models. Results: High design complexity led to significantly higher perceptions of aesthetics, perceived ease of use, and perceived usefulness of the website (all p<.01; = .03-.08). High feature complexity also led to greater aesthetic evaluations (all p<.01; = .05-.19) and perceived usefulness (p<.05; =.03), but not perceived ease of use (p>.05). Discussion: Exploring two dimensions of visual complexity, we found that not only what is shown, but also how this information is displayed had a significant impact on users’ impressions. When the visual information was well organized (higher design complexity), users rated the websites as more aesthetically pleasing, easier to use, and more useful. Similarly, providing individuals with more content (higher feature complexity) also led individuals to believe the websites were designed well, more dynamic, and had greater usability. Conclusion: Health websites with more visual information organized according to design principles are rated as more appealing, without sacrificing perceived usability.