Designing Search User Interfaces for Visually Impaired Searchers: A User-centred Approach

PhDThe Web has been a blessing for visually impaired users as with the help of assistive technologies such as screen readers, they can access previously inaccessible information independently. However, for screen reader users, web-based information seeking can still be challenging as web pages are mainly designed for visual interaction. This affects visually impaired users’ perception of theWeb as an information space as well as their experience of search interfaces. The aim of this thesis is therefore to consider visually impaired users’ information seeking behaviour, abilities and interactions via screen readers in the design of a search interface to support complex information seeking. We first conduct a review of how visually impaired users navigate the Web using screen readers. We highlight the strategies employed, the challenges encountered and the solutions to enhance web navigation through screen readers. We then investigate the information seeking behaviour of visually impaired users on the Web through an observational study and we compare this behaviour to that of sighted users to examine the impact of screen reader interaction on the information seeking process. To engage visually impaired users in the design process, we propose and evaluate a novel participatory approach based on a narrative scenario and a dialogue-led interaction to verify user requirements and to brainstorm design ideas. The development of the search interface is informed by the requirements gathered from the observational study and is supported through the inclusion of visually impaired users in the design process. We implement and evaluate the proposed search interface with novel features to support visually impaired users for complex information seeking. This thesis shows that considerations for information seeking behaviour and users’ abilities and mode of interaction contribute significantly to the design of search user interfaces to ensure that interface components are accessible as well as usable

Improving accessibility for people with dementia: web content and research

The Internet can provide a means of communication, searching for information, support groups and entertainment, amongst other services, and as a technology, can help to promote independence for people with dementia. However, the effectiveness of this technology relies on the users’ ability to use it. Web content, websites and online services need to be designed to meet the abilities and needs of people with dementia, and thus the difficulties that these users encounter must be explored and understood.The primary aim of this thesis is to investigate web content accessibility for People with Dementia and develop recommendations for improving current guidelines based on accessibility needs. The secondary aim is to support people with dementia having a voice within research through development of accessible ethical processes.Qualitative data were collected with a scoping study using questionnaires about everyday technology use (people with dementia and older adults without dementia); and in-depth interviews to explore difficulties and web accessibility issues. A document analysis was conducted on Web Content Accessibility Guidelines (ISO/IEC40500:2012) for inclusion of the needs of people with dementia followed by review of Web Usability Guidance (ISO9241-151:2008) to consider how gaps relating to the unmet accessibility needs for people with dementia could be met. The scoping study found that both people with dementia and older adults without dementia use everyday ICT to access the Web. Both groups described difficulties with web interface interactions, which refined the research scope to web content accessibility. The interview data with people with dementia (n=16) and older adults without dementia (n=9) were analysed using Grounded Theory techniques. It was found that both user groups experienced the same types of difficulties using the Web, but that dementia symptoms could exacerbate the difficulties from usability issues (older adults without dementia) into accessibility issues for people with dementia. Navigation was a key issue for both groups, with a range of web content design elements contributing to accessibility issues with navigation for people with dementia. The document analysis found that the accessibility guidance did not address all the accessibility issues encountered by people with dementia. However, the usability guidance did address many of the accessibility issues for web content navigation experienced by people with dementia. The research provides recommendations for improvements to web content accessibility guidelines including content from usability guidelines, and amendments to current guidelines and success criteria. A new ethical recruitment/consent process was developed and tested as part of the research process and is recommended for use in future research to support engagement of people with dementia.</div

Training Needs and Development of Online AT Training for Healthcare Professionals in UK and France

Background: Assistive Technology (AT) solutions for people with disabilities has become part of mainstream care provision. Despite advantages of AT on offer, abandonment and non-compliance are challenges for healthcare professionals (HCPs), introducing this technology to clients. Studies of abandonment reveal that 1/3 of all devices provided to service users end up stored unused. Key need is training to make informed decisions about AT tailored to individual needs and circumstances. In an online survey undertaken by the ADAPT project, HPCs identified AT training needs and barriers. Currently, a programme is being developed aimed at introducing AT concepts and enhancing practices to a wide range of HCPs. Method: Survey questions explored gaps, availability, qualifications and barriers to AT training in England and France. A series of consultation meetings with ADAPT partners took place. An advisory group consisting of longstanding AT users and their formal/informal carers and HCPs (occupational therapist, speech and language therapist, psychologist and biomedical engineer) contributed to the discussions on survey findings, development and evaluation of AT training for HCPs, key content areas and means of delivery. Key results: HCPs had no AT specific qualifications (UK 94.6%; FR 81.3%) nor in-service AT training (UK 65.1%; FR 66.4%). They either did not know of AT courses (UK 63.3%) or knew that none existed (FR 72.5%). Barriers to AT training were mainly local training (UK 62.7%, FR 50%) and funding (UK 62.7%, FR 55.7%). Some training priorities were clearer for French HCPs – overall knowledge of AT devices (82.1%, UK 45.8%), customization of AT (65.3%, UK 30.1%), assessing patient holistically (53.4%, UK 25.3%), educating patient/carers (56.5%, UK 28.3%) (p < 0.001). Variances may be due to differing country-specific HCP education approach. A third of both groups highlighted also abandonment, client follow-up, powered wheelchair training and prescribing AT. To bridge gaps in knowledge and identified training needs of HCPs, the online interactive training programme starts by introducing foundations of AT, including definitions, types/uses of AT, legislation/policies and AT in practice. More specialist units build and expand on specific areas, e.g. AT for mobility, communication, assessment and evidence-based practice. The biopsychosocial model of Health and World Health Organisation’s (WHO) International Classification of Functioning, Disability and Health (ICF) framework underpin development of content. ICF shifts focus from disability to health and functioning, in line with a social model of rehabilitation. E-learning comprises existing videos, AT textbook material and bespoke animated presentations. Selfassessment and evaluation of training are embedded and learners receive certificate of completion. Training was piloted to a group of HCPs trainees and postregistration HCPs who commented on relevance of AT content, clarity, accessibility of presentation, and usefulness. Users found training very useful, especially legislation/policies and AT literature. Conclusion: Overall, survey results suggest that both UK and French HCPs’ training on AT solutions is limited and highly variable. There is need for crosschannel AT professional competencies, availability of work-based training and funding support. Development of online, interactive training aims to increase professional confidence and competence in this area as well as the evidence base for AT

A Survey of Assistive Technology (AT) Knowledge and Experiences of Healthcare Professionals in the UK and France: Challenges and Opportunities for Workforce Development

Background: Assistive Technologies (AT) in healthcare can increase independence and quality of life for users. Concurrently, new AT devices offer opportunities for individualised care solutions. Nonetheless, AT remains under-utilised and is poorly integrated in practice by healthcare professionals (HCPs). Although occupational therapists (OTs), physiotherapists and speech and language therapists (SLTs) consider that AT solutions can offer problem-solving approaches to personalised care, they have a lesser understanding of application of AT in their practice. In this paper, we report findings of a survey on AT knowledge and experiences of HCPs in UK and France. Training needs also explored in the survey are presented in a separate paper on development of online training for the ADAPT project. Method: A survey of 37 closed/open questions was developed in English and French by a team of healthcare researchers. Content was informed by published surveys and studies. Email invitations were circulated to contacts in Health Trusts in UK and France ADAPT regions and the survey was hosted on an online platform. Knowledge questions addressed AT understanding and views of impact on user’s lives. Experience questions focussed on current practices, prescription, follow-up, abandonment and practice standards. 429 HCPs completed the survey (UK = 167; FR = 262) between June and November 2018. Key results: Participants were mainly female (UK 89.2%; FR 82.8%) and qualified 10+ years (UK 66.5%; FR 62.2%). A key group in both countries were OTs (UK 34.1%; FR 46.6%), with more physiotherapists and SLTs in UK (16.8%, 16.8%; vs. FR 6.5%, 2.3%), and more nurses in France (22.1% Vs. UK 10.8%). More HCPs were qualified to degree level in France (75.2%; UK 48.5%, p < 0.001). In terms of knowledge, all HCPs agreed that AT helps people complete otherwise difficult or impossible tasks (UK 86.2%; FR 94.3%) and that successful AT adoption always depends on support from carers, family and professionals (UK 52.7%; FR 66.2%). There were some notable differences between countries that require further exploration. For example, more French HCPs thought that AT is provided by trial and error (84.7%, UK 45.5%, p < 0.001), while more UK HCPs believed that AT promotes autonomous living (93.4%; FR 42.8%, p < 0.001). Also, more French HCPs considered that AT refers exclusively to technologically advanced electronic devices (71.8%, UK 28.8%, p <0.001). In both countries, top AT prescribers were OTs, physiotherapists and SLTs. Respondents had little/no knowledge in comparing/choosing AT (UK 86.8%; FR 76.7%) and stated they would benefit from interdisciplinary clinical standards (UK 80.8%; FR 77.1%). A third of HCPs did not know if AT users had access to adequate resources/support (UK 34.1%; FR 27.5%) and rated themselves as capable to monitor continued effective use of AT (UK 38.9%; FR 34.8%). Conclusion: Knowledge and application of AT was varied between the two countries due to differences in health care provision and support mechanisms. Survey findings suggest that HCPs recognised the value of AT for users’ improved care, but had low confidence in their ability to choose appropriate AT solutions and monitor continued use, and would welcome AT interdisciplinary clinical standards

Enabling mobile microinteractions

While much attention has been paid to the usability of desktop computers, mobile com- puters are quickly becoming the dominant platform. Because mobile computers may be used in nearly any situation--including while the user is actually in motion, or performing other tasks--interfaces designed for stationary use may be inappropriate, and alternative interfaces should be considered. In this dissertation I consider the idea of microinteractions--interactions with a device that take less than four seconds to initiate and complete. Microinteractions are desirable because they may minimize interruption; that is, they allow for a tiny burst of interaction with a device so that the user can quickly return to the task at hand. My research concentrates on methods for applying microinteractions through wrist- based interaction. I consider two modalities for this interaction: touchscreens and motion- based gestures. In the case of touchscreens, I consider the interface implications of making touchscreen watches usable with the finger, instead of the usual stylus, and investigate users' performance with a round touchscreen. For gesture-based interaction, I present a tool, MAGIC, for designing gesture-based interactive system, and detail the evaluation of the tool.Ph.D.Committee Chair: Starner, Thad; Committee Member: Abowd, Gregory; Committee Member: Isbell, Charles; Committee Member: Landay, james; Committee Member: McIntyre, Blai