Co-design of a web accessibility browser extension for people with post-stroke aphasia: Understanding experiences and priorities in the first stage of an experience-based co-design study

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Abstract
Background: In an era of unprecedented technology growth, many health and support services are now accessed through web content, creating both new opportunities and barriers for people with disabilities. Web-use requires communication skills, which can be problematic for people with aphasia (language/communication impairment). This study, the first stage of the ‘Bridging the Digital Divide’ project, aimed to explore experiences of web-use, identify priorities for improving access, and identify corresponding human-centred design principles. Methods: Experience-based co-design and human-centred design approaches were used. Focus groups were held with people with aphasia ( n = 9), family members ( n = 8), and health professionals ( n = 10). Each focus group had two sequential phases: an experience-gathering discussion and a structured prioritisation activity. Participants shared their experiences of accessing healthcare, information, and support services online. Reflexive thematic analysis was applied to the experience data, touchpoints were identified, and findings were synthesised into a generalised experience map organised around six components of Internet use. Priorities for improving web accessibility were established using the nominal group technique. Each stakeholder group generated and ranked priorities, which were subsequently pooled across groups and analysed using qualitative content analysis. Key priorities were mapped to human-centred design principles to guide future co-design. Results: Experience data produced six themes: (1) Aphasia-aware design, (2) Confidence building through support and practice, (3) Challenges to online service access, (4) Searching is hard when you can’t find the right words, (5) Written information online is overwhelming, and (6) Finding new ways to connect with peers. Priorities for improving web accessibility included greater access to learning and support resources, new technology and tools, communication-accessible design, inclusive and tailored technology, and help from a real person. These priorities were linked to four design principles: (1) Simple language, (2) Simple interface, (3) User customisation, and (4) Development of training materials and resources. Conclusion: People with aphasia experience challenges accessing services and information online. New and tailored technology, and awareness of communication-accessible design, were identified as priorities for improving access. These findings will be used to iteratively co-design and develop a web-browser extension in the next stage of research.
Funding Information
  • National Health and Medical Research Council
  • Medical Research Future Fund Consumer-led Research Grant (MRF2019367)
  • University of Queensland Foundation Research Excellence Award (2022001684)

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