The experiences, needs and barriers of people with impairments related to usability and accessibility of digital health solutions, levels of involvement in the design process and strategies for participatory and universal design: a scoping review

Objective Globally, the number of digital health solutions is increasing, but they are not always designed with access and utilisation for people with impairments in mind. Development efforts have often not included the voice and requirements of people with impairments, who make up 15% of the world’s population, despite the fact that this can help ensure broad access and utilisation. Little attention to and limited inclusion of people with impairments in the development of digital health solutions results in continued and reinforced inequalities in health services provision for people with impairments. This review investigates the needs and barriers of people with impairments related to use of digital health solutions and strategies to foster user participation, access and utilisation of digital health solutions. Methods This scoping review, based on the Joanna Briggs Institute Manual, had five phases: 1) identification of aim and research questions, 2) literature search in five databases (April/May 2020), 3) literature screening based on predetermined inclusion and exclusion criteria, 4) data extraction, and (5) reporting results. Results The literature search resulted in 5968 sources, of which 25 met our inclusion criteria. People with impairments appreciate digital health solutions that are designed to meet their specific impairment-related challenges. The reported needs and barriers related to technological design varied depending on the individuals’ challenges. The literature reported different types of participatory co-design strategies to foster access and utilisation of digital health solutions. Conclusion This scoping review support needs for increased awareness among developers to design solutions that meet people’s needs, contexts and states of health. By applying universal design as a strategy and including people with different types of impairments, starting in the idea creation phase of digital health solutions and throughout the development, developers can design solutions with better accessibility. Digital health solutions that are accessible and usable have a tremendous opportunity to foster health equity and achieve health promotion, prevention and self-care. This in turn can contribute to closing the gap between different population groups, reduce disparities and get the most from available healthcare services.

Inclusive Education Through Accessible Mobile Serious Games

Accessibility has been defined as the ability of an object to be used despite the condition or disability of a person. However, it is a feature that often has not been taken into account in the design of products or services, and the mobile serious game market is no exception. Accessibility guidelines were defined through the consolidation of different initiatives and good practices of video game developers as well as groups interested in providing accessibility to video games. Once the guidelines were defined, a method for evaluating the accessibility of mobile serious games was developed and applied in a mobile serious game. The purpose of this document is to propose an evaluation tool for those who wish to develop accessible mobile serious games for people with impairments and improve inclusive education.

Disability, Education and Development Perspectives from Tokelau

<p>This thesis is concerned with the issue of people with disability accessing education. The contemporary international dialogue about how best to include people with disability in education recommends developing regular education systems to cater for the full diverse range of learners' needs and abilities. This approach is part of an Inclusive Education philosophy and is designed as a response to all populations who experience exclusion from education, including people with disability. By examining people's opinions, experiences, attitudes, aspirations, perceptions, knowledge, and understanding about disability, education and development, this thesis aims to identify the challenges of including people with disability in education and society in the context of a small Pacific Island developng nation, and the ways in which these challenges can be addressed. In doing so, it contributes to the growing body of literature which raises awareness of the experiences of exclusion faced by people with impairments; as well as the literature exploring disability issues from a social and rights-based perspective in developing countries. Semi-formal interviews were conducted with ten participants from Tokelau, New Zealand and Samoa to garner traditional, modern and personal perspectives about disability, education and development. The main findings of the research are that although disability is still predominantly understood within a medical, religious or deficit-model paradigm in Tokelau, some historical attitudinal barriers to inclusion may be shifting. This is occurring as people become better informed about disability through education, personal experiences and awareness of the causes of disability. Consequently, there is some indication that the younger generation are less likely to stigmatise the cause of disability because of their exposure to scientific explanations and increased familiarity and comfort with human rights concepts. People in Tokelau called for raising public awareness about disability causes and issues. Another finding of the research is that although there is a perception from some that the rhetoric of human rights is demanding and antithetical to the culture, responsibility is more easily accepted because it is considered in line with traditional communal values and social systems of support like inati (sharing of resources). Terminology aside, the concepts involved in Inclusive Education reflect traditional Tokelauan beliefs about treating people equally and with fakaaloalo (respect), alofa (love) and poupouaki (support). Although the inclusion of disability issues into the international human rights framework through the UN 2006 Convention on the Rights of Persons with Disabilities is not yet widely known in Tokelau, human rights concepts are beginning to be introduced and understood at the community level, and they are seen in the constitutional documents and education policies of Tokelau. Support and partnership from New Zealand is welcomed in enabling locally developed inclusive services in Tokelau. Overall, the research suggested that inclusive philosophies and approaches within the education system in Tokelau are emerging, and that it is an opportune time to develop capacity and services for ensuring that people with impairments can access education. Despite material and human resourcing difficulties, there is a general willingness to include people with impairments in society and a strong preference for a collaborative community wide approach.</p>

Disability, Education and Development Perspectives from Tokelau

<p>This thesis is concerned with the issue of people with disability accessing education. The contemporary international dialogue about how best to include people with disability in education recommends developing regular education systems to cater for the full diverse range of learners' needs and abilities. This approach is part of an Inclusive Education philosophy and is designed as a response to all populations who experience exclusion from education, including people with disability. By examining people's opinions, experiences, attitudes, aspirations, perceptions, knowledge, and understanding about disability, education and development, this thesis aims to identify the challenges of including people with disability in education and society in the context of a small Pacific Island developng nation, and the ways in which these challenges can be addressed. In doing so, it contributes to the growing body of literature which raises awareness of the experiences of exclusion faced by people with impairments; as well as the literature exploring disability issues from a social and rights-based perspective in developing countries. Semi-formal interviews were conducted with ten participants from Tokelau, New Zealand and Samoa to garner traditional, modern and personal perspectives about disability, education and development. The main findings of the research are that although disability is still predominantly understood within a medical, religious or deficit-model paradigm in Tokelau, some historical attitudinal barriers to inclusion may be shifting. This is occurring as people become better informed about disability through education, personal experiences and awareness of the causes of disability. Consequently, there is some indication that the younger generation are less likely to stigmatise the cause of disability because of their exposure to scientific explanations and increased familiarity and comfort with human rights concepts. People in Tokelau called for raising public awareness about disability causes and issues. Another finding of the research is that although there is a perception from some that the rhetoric of human rights is demanding and antithetical to the culture, responsibility is more easily accepted because it is considered in line with traditional communal values and social systems of support like inati (sharing of resources). Terminology aside, the concepts involved in Inclusive Education reflect traditional Tokelauan beliefs about treating people equally and with fakaaloalo (respect), alofa (love) and poupouaki (support). Although the inclusion of disability issues into the international human rights framework through the UN 2006 Convention on the Rights of Persons with Disabilities is not yet widely known in Tokelau, human rights concepts are beginning to be introduced and understood at the community level, and they are seen in the constitutional documents and education policies of Tokelau. Support and partnership from New Zealand is welcomed in enabling locally developed inclusive services in Tokelau. Overall, the research suggested that inclusive philosophies and approaches within the education system in Tokelau are emerging, and that it is an opportune time to develop capacity and services for ensuring that people with impairments can access education. Despite material and human resourcing difficulties, there is a general willingness to include people with impairments in society and a strong preference for a collaborative community wide approach.</p>

Enabling people with impairments to use Airbnb

Paid peer-to-peer accommodation networks, including Airbnb, have been accused of excluding people with impairments. This study analyses host and guest posts on the Airbnb hosting community to (1) reveal key barriers preventing people with impairments from fully participating in peer-to-peer accommodation trading, and (2) identify solutions to overcoming these barriers, using as theoretical framework the social model of disability. The key conclusion is that we may be witnessing a fundamental shift in the nature of barriers: as the growing peer-to-peer accommodation sector increases the quantity and variability of accommodation options, the primary challenge is no longer a lack of suitable accommodation (physical barrier), but the identification of suitable accommodation (informational barrier). Informational barriers are potentially easier to overcome.

‚können‘ als kommunikative Ressource zur Markierung des Möglichkeitsraums bei Teilhabeeinschränkungen

To people with impairments, communicating their capabilities to participate in social life is a central issue. In this paper, we examine these very capabilities in the context of the use of the German modal verb können. We show that in the present data – group conversations from ‘Future Workshops’ embedded in the research project ‘Gut leben in NRW’ – the modal verb functions as a communicative resource which participants use to mark and articulate their own capabilities on a linguistic as well as interactional level, to negotiate them and to position themselves along with it. On the methodological level, concepts from two different disciplines are linked: the social science capability approach of Sen (2010) and Nussbaum (1999) and conversation analysis according to Deppermann (2008 [1999])

A Review of RAY WILKINSON, JOHN P. RAE, GITTE RASMUSSEN (eds.), ATYPICAL INTERACTION: THE IMPACT OF COMMUNICATIVE IMPAIRMENTS WITHIN EVERYDAY TALK. Cham: Palgrave Macmillan, 2020, XXIII+470 pp.

The collection of articles under review includes conversation analytic studies of interactions involving the participation of at least one person with communicative impairments (aphasia, dementia, dysarthria, etc.). The authors concentrate on how these impairments influence interaction—the organization of repair in particular—as well as on issues of participants’ adaption to impairments, collaboration, the agency of people with impairments, and practices of face maintenance. Three more general issues connected to this field of study are discussed in the review. The first issue is a choice of analytic categories and the application of the category of repair. This category seems justified since participants frequently have to clarify the meaning of their partners’ actions. However, this choice may appear problematic if one does not take into account that interactions with people with impairments have their own progressivity, which differs from the progressivity of ordinary conversation. The second issue is the role of nonverbal actions, which is crucial in circumstances where some of the participants lack verbal resources. The third issue concerns the problem of the understanding which participants try to achieve in the course of interaction and which researchers try to achieve in the course of analysis. This task becomes more challenging in comparison to ordinary conversations. On the one hand, actions of persons with impairments are sometimes ambiguous and require special interpretative efforts from their partners. On the other hand, there is always a risk that the partner will interpret actions of impaired person inadequately.

The Gift of Peace, Christians with Impairments, and the Church

One of the demands facing the church is the call for unity with Christians with profound intellectual and physical impairments. As the church becomes a community of justice with and for people with impairments, she is an instrument of God's shalom. However, too many of our sisters and brothers with impairments find themselves on the outside looking in. How can the church continue to move toward a more complete welcome and participation? Responding to this theological question precedes clinical or legal concerns. The best the world has to offer is not what the church needs, though she can learn from reasonable professional approaches. The message and peace of Christ can undo the walls of separation that keep Christians with impairments out. Such a transformation would be a sign that the church is being built up in peace, and would offer a model of true communion among a diversity of people.