Access Audit Research Articles

Towards Automated Accessibility Report Generation for Mobile Apps

Many apps have basic accessibility issues, like missing labels or low contrast. To supplement manual testing, automated tools can help developers and QA testers find basic accessibility issues, but they can be laborious to use or require writing dedicated tests. To motivate our work, we interviewed eight accessibility QA professionals at a large technology company. From these interviews, we synthesized three design goals for accessibility report generation systems. Motivated by these goals, we developed a system to generate whole app accessibility reports by combining varied data collection methods (e.g., app crawling, manual recording) with an existing accessibility scanner. Many such scanners are based on single-screen scanning, and a key problem in whole app accessibility reporting is to effectively de-duplicate and summarize issues collected across an app. To this end, we developed a screen grouping model with 96.9% accuracy (88.8% F1-score) and UI element matching heuristics with 97% accuracy (98.2% F1-score). We combine these technologies in a system to report and summarize unique issues across an app, and enable a unique pixel-based ignore feature to help engineers and testers better manage reported issues across their app’s lifetime. We conducted a user study where 19 accessibility engineers and testers used multiple tools to create lists of prioritized issues in the context of an accessibility audit. Our system helped them create lists they were more satisfied with while addressing key limitations of current accessibility scanning tools.

656: Breaking Barriers in Medical Education: An Accessibility Audit of Radiotherapy Teaching Materials

656: Breaking Barriers in Medical Education: An Accessibility Audit of Radiotherapy Teaching Materials

Revaluing the Eros Collection for Australian cultural histories

ABSTRACT The Eros Collection at Flinders University is the largest collection of materials produced by the sex industry and its affiliates in Australia. Acquired in 1997 and added to over the years, the varied collection (now part of the umbrella Australian Sexuality Collection) includes restricted or censored audiovisual and print materials – in short, porn. Thus this archive – typically a site of protection and care – comprises materials that many people think don’t deserve protection, and this ambiguous status has raised many challenges in terms of how the Collection is valued, researched, and utilized. The thorny question of the Collection’s value is traced in our research through interviews with Special Collections librarians involved with the Collection over different periods and an audit of Collection contents, access, and usage, which we analyse within the broader context of international porn archives and Australian media histories. The article examines how the Collection (specifically its pornographic material) shares key challenges faced by porn archives internationally, including public perception and access, and its uneasy fit within the Australian media histories. We argue that this neglected archive holds promise for understanding porn’s place in Australia’s audiovisual and cultural history.

Blockchain-enabled EHR access auditing: Enhancing healthcare data security

In the realm of modern healthcare, Electronic Health Records EHR serve as invaluable assets, yet they also pose significant security challenges. The absence of EHR access auditing mechanisms, which includes the EHR audit trails, results in accountability gaps and magnifies security vulnerabilities. This situation effectively paves the way for unauthorized data alterations to occur without detection or consequences. Inadequate EHR compliance auditing procedures, particularly in verifying and validating access control policies, expose healthcare organizations to risks such as data breaches, and unauthorized data usage. These vulnerabilities result from unchecked unauthorized access activities. Additionally, the absence of EHR audit logs complicates investigations, weakens proactive security measures, and raises concerns to put healthcare institutions at risk. This study addresses the pressing need for robust EHR auditing systems designed to scrutinize access to EHR data, encompassing who accesses it, when, and for what purpose. Our research delves into the complex field of EHR auditing, which includes establishing an immutable audit trail to enhance data security through blockchain technology. We also integrate Purpose-Based Access Control (PBAC) alongside smart contracts to strengthen compliance auditing by validating access legitimacy and reducing unauthorized entries. Our contributions encompass the creation of audit trail of EHR access, compliance auditing via PBAC policy verification, the generation of audit logs, and the derivation of data-driven insights, fortifying EHR access security.

Patient First Strategies for Reducing Inequities in HAI Prevention

Background: Inequities in healthcare-associated infections (HAI) incidence and prevention measures are critically important to understand (Chen,2021). While evaluations are beginning to characterize these disparities by infection type (Gettler, 2023), our work expands this by characterizing disparities by prevention strategies. By better understanding how evidence-based prevention strategies are implemented at the patient level, infection preventionists and hospital epidemiologists can better design strategies that provide equitable care to all patients. Methods: Beginning January 2023, gender, race, ethnicity, spoken language, and age group fields were added to daily chlorhexidine gluconate (CHG) treatment and C. difficile test order compliance data captured via electronic medical record. In July 2023, fields on recorded race, ethnicity, and gender were added to well-established foley and vascular access real-time peer audit tools that are used by infection preventionists (IPs). Each prevention strategy variable was summarized by demographic variables and differences in compliance were measured using chi-square tests. Results: 899 vascular audits and 420 foley audits were completed by IPs between July – December 2023. In 2023, there were 114,066 opportunities for CHG Treatment and 1,991 C. difficile test orders. Missing data varied by metric but ranged from 0-60%. Statistically significant differences by race were found in 3 of 8 components (i.e., intact seal, secured catheter and absence of dependent loop) in the foley audit (p < 0 .01) and compliance with C. difficile test ordering (p < 0 .01). No differences in race were found in vascular access audits or CHG treatment. No differences in gender or ethnicity were noted in foley, vascular access audits, CHG treatment compliance, or C. difficile testing. Differences in gender and age were found in CHG treatment compliance (p < 0 .001). Conclusions: By focusing more on patient level process measures rather than only presenting stratified outcomes data, we can identify targeted opportunities for improvement in health equity before our patients develop an HAI. Further evaluations should also focus on assessing the clinical relevance of statistical findings to better inform intervention strategies. Separately, efforts are needed to improve completeness and integrity of demographic data in the electronic medical record.

Quantitative Interpretation of Universal Design Features in Shopping Malls: A Case Study in Kolkata, India

United Nations Sustainable Development Goal 11 indicates the need for and importance of inclusive public spaces as a prerequisite towards sustainable cities. Shopping malls in urban India attract a significantly large population daily, making them an important typology of urban structures which deserve universal design. Thus, in this paper, universal design features of shopping malls in Kolkata have been considered. Despite a significant increase in the number of elderly and specially-abled people, civic administration in Kolkata has not been able to successfully implement the national guidelines on inclusiveness in its shopping malls. Five shopping malls from the Kolkata Municipal Corporation were considered case areas for the fieldwork. The accessibility audit checklist included in the ‘Harmonized Guidelines and Standards for Universal Accessibility in India 2021’ published by the Ministry of Housing and Urban Affairs, Government of India, has been used in this paper. It was found that the accessibility percentage of shopping malls ranges between 14.4% and 44.8%, indicating the lack of universal design considerations. Pearson’s correlation between the year of establishment and the accessibility percentage of each case area was found to be −0.66, indicating an alarming deterioration in universal design considerations over the years. On comparing the accessibility performance with the diverse user groups, it was found that individual wheelchair users are likely to face the most difficulty in the case areas with a median accessibility value of 41.46%. This research indicated that accessible continuity in shopping malls in Kolkata can be imparted only by implementing case-specific universal design assessment through a primary survey.

Evaluation of the Fetal Alcohol Spectrum Disorder Hub Australia website.

To evaluate use and utility of the Fetal Alcohol Spectrum Disorder (FASD) Hub Australia website. Online REDCap user survey incorporating the Website Evaluation Questionnaire, open ended questions, Google metrics data and an accessibility audit. Seventy-six participants: researchers (32%), health professionals (29%) and policymakers/advocates (16%) completed the survey. Most were from Australia (95%) and were likely or very likely to recommend the FASD Hub to colleagues (92%), friends (74%) and patients (72%). The mean Website Evaluation Questionnaire score was at least 3.45/5 for all dimensions (ease of use, hyperlinks, structure, relevance, comprehension, completeness, layout, search option); range 3.45 (search option) to 4.04 (relevance). Participants found the content trustworthy (92%) but wanted more information for, and to support, Aboriginal and Torres Strait Islander peoples, and improved search capacity. Google metrics identified 25,534 unique users over 6 months (82% new users); 83% aged 18-44 years, 72% female and 35% international. Users found the FASD Hub accessible, authoritative and useful and suggested improvements.

Review of: "Audit of Dialysis Vascular Access in a Sub-Saharan Tertiary Hospital"

Review of: "Audit of Dialysis Vascular Access in a Sub-Saharan Tertiary Hospital"

Hidden Inequities of Access

Despite ongoing efforts to improve database accessibility, aggregated database vendors concede that they do not have complete control over document accessibility. Instead, they point to the responsibility of journal publishers to deliver articles in an accessible format. This may increase the likelihood that users with disabilities will encounter articles that are not compatible with a screen reader. To better understand the extent of the problem, a document accessibility audit was conducted of randomly selected articles from EBSCO’s Library & Information Source database. Full-text articles from 12 library science journals were evaluated against two measures of screen reader compatibility: HTML format (the optimal format for screen readers) and PDF accessibility conformance. Findings showed inconsistencies in HTML format availability for articles in the selected journals. Additionally, the entire sample of PDF articles failed to meet the minimum standard of PDF Universal Accessibility of containing a tagged structure. However, all PDF articles passed accessibility permissions tests, so could be made accessible retroactively by a third party.

Enhancing Educational Environments: Retrofitting for Improved Accessibility and Inclusion of Person with disabilities (PWDs) in Schools

Accessibility and inclusion of Persons with disabilities (PWDs) is an essential requirement in every school building. This is in line with the latest amendments to Uniform Building By-Laws 2022 gazetted by the Sabah Local Government, and Malaysian Standard (MS). All public buildings including schools, were made compulsory to provide accessibility and inclusion of Persons with disabilities (PWDs). A lack of accessibility contributed to dull educational environments for teachers and students. The aim of this research is to develope a framework for enhancing educational environments for retrofitting existing schools. Research method employed for this study is data collection from questionnaire gathered from the overall school’s plan layout with building retrofit of Universal Design (UD) elements and access audit for star rating compliance with inclusive design assessment. It is also an opportunity to identify any issues with school constraints that make it difficult to meet the Uniform Building By-Laws (UBBL) requirements through the focus group access audit group. Research finding shows that less building retrofit elements been built according to the Malaysian Standards (MS) to schools in Kota Kinabalu. In conclusion, all existing and current-use schools are deserved to be retrofitted with quality Universal Design (UD) elements such as ramps, handrails, disabled car parks, covered walkways, signage, wayfinding, lift, disabled-toilet, etc. Thus, the level of accessibility can be achieved with satisfaction and equivalency to Malaysian Standard through the introducing of framework for enhancing educational environments of retrofitting Inclusive design for PWDs.

Disability Inclusion: Accessibility of Library and Information Services to People with Visual Impairment in Public Libraries in Harare: Zimbabwe. The Missing Link:

The major thrust of the research study was mainly driven by the need to determine the accessibility and effectiveness of library and information services to students with visual impairment in Harare. Provision of library and information services to students and other people with visual impairment is a right enshrined in the United Nations Convention on the rights of people with disabilities (UNCRPD,2006). The study was informed by the interpretivism research philosophy which in part entails listening, observations and recording. The qualitative research approach was used by way of interviews, observations, documentary analysis and focus groups. In line with the approach, the study relied on the phenomenological research design. The population included former and current university students with visual impairment in Harare. The sample therefore covered thirty former and current Higher education students in Harare. The study established that the physical accessibility of public libraries to students with visual impairment leaves a lot to be desired and therefore needs concerted effort to address. Secondly the study also found out that the expertise of library staff in assisting students with visual impairment also needs to be revisited with a view to improving service provision to the constituency of students with visual impairment. It was also revealed that in the libraries themselves, there was limited access to library reading and study materials. In some cases, these materials were non-existent. The use of third parties to assist students with visual impairment was also found to be shortchanging students since this depended on several competing interests on the part of the person being assisted and the one assisting. The study also established that while sighted users could use electronic ways to access library services, this did not apply to users with visual impairment. The study recommended that the institution needed a library policy for users with visual impairment. There was need for advocacy to improve accessibility. There was also a need for an accessibility audit or needs analysis. Library resources also needed to be increased in both quality and quantity.

Purple hiring: a revolution in workplace inclusivity: how industries are embracing persons with disabilities (PWD) through innovative practices?

PurposeThe purpose of this paper is to explore the best practices for Purple Hiring, a new paradigm for workplace inclusivity that emphasizes the recruitment and retention of Persons with Disabilities (PWD).Design/methodology/approachThe paper is based on a review of existing literature and interviews with experts in the field of disability inclusion.FindingsThis paper explores the best practices for Purple Hiring, including tailored interview processes, assistive technology integration, flexible work arrangements, mentorship and peer support, accessibility audits and design thinking, inclusive leadership training, diversity and inclusion committees, collaborative partnerships, recognition and awards and continuous learning and adaptation.Originality/valuePurple Hiring is a new paradigm for workplace inclusivity that has the potential to transform the way the people work and live. By embracing the unique talents and capabilities of PWD, organizations can create a more diverse, equitable and productive workplace.

TRANSPORTATION BARRIERS CONFRONTED BY MOBILITY-CHALLENGED TRAVELLERS IN KLANG VALLEY

Accessibility enables individuals' full participation in society, which results in social justice and equity, thus promoting social sustainability. However, research indicates that physical barriers in the built environment impede disabled people, resulting in marginalisation when their inclusion is tied to physical space. Commonly, accessibility of the built environment is evaluated using an access audit with a predetermined checklist. Little effort has been made to explore disabled people's life experiences accessing the city centre. This qualitative study involves twenty go-along interviews with mobility-challenged travellers to learn about their experiences using land transportation from around Klang Valley to Kuala Lumpur city centre. Mobility-challenged travellers, notably wheelchair users, still need help to reach their destination with the current transportation services. In general, transportation use in Klang Valley has several issues, including the lack of accessible facilities and lack of safety concerns from service providers. These issues have psycho-emotional impacts on disabled people.

Equity analysis audit of access and utilisation of Special Care Dental Services by ethnicity and social demographic markers.

To identify and investigate any differences in utilisation of the, Sussex Community NHSFT, Special Care Dental Service (SCDS) across multiple demographic factors, including ethnicity, socio-economic groups and age in the Crawley area. Data were audited for all new patients seen at the Crawley Special Care Dental Centre from November 2020-October 2021. Demographic data were compared to population data from the 2011 Census. Deprivation data, using Index of Multiple Deprivation, were also examined against utilisation and failure to attend appointments. A total of 1250 new patients accessed the Crawley SCDS between November 2020 and October 2021. The data suggests good equity to the service being utilised by the local community; the proportions of patients utilising the service over the course of a year from different ethnic groups reflected the demographic profile of Crawley. The proportion of failed appointments showed no correlation with deprivation decile. There was also no association between ethnic group and proportion of failed appointments. Ensuring equal utilisation of healthcare for all population groups has become a priority for healthcare providers. This audit found minimal inequities in utilisation of the Special Care Dental Service at Crawley.

The Accessibility of Data Visualizations on the Web for Screen Reader Users: Practices and Experiences During COVID-19

Data visualization has become an increasingly important means of effective data communication and has played a vital role in broadcasting the progression of COVID-19. Accessible data representations, however, have lagged behind, leaving areas of information out of reach for many blind and visually impaired (BVI) users. In this work, we sought to understand (1) the accessibility of current implementations of visualizations on the web; (2) BVI users’ preferences and current experiences when accessing data-driven media; (3) how accessible data representations on the web address these users’ access needs and help them navigate, interpret, and gain insights from the data; and (4) the practical challenges that limit BVI users’ access and use of data representations. To answer these questions, we conducted a mixed-methods study consisting of an accessibility audit of 87 data visualizations on the web to identify accessibility issues, an online survey of 127 screen reader users to understand lived experiences and preferences, and a remote contextual inquiry with 12 of the survey respondents to observe how they navigate, interpret, and gain insights from accessible data representations. Our observations during this critical period of time provide an understanding of the widespread accessibility issues encountered across online data visualizations, the impact that data accessibility inequities have on the BVI community, the ways screen reader users sought access to data-driven information and made use of online visualizations to form insights, and the pressing need to make larger strides towards improving data literacy, building confidence, and enriching methods of access. Based on our findings, we provide recommendations for researchers and practitioners to broaden data accessibility on the web.

Interpreting Universal Mobility in the Footpaths of Urban India Based on Experts’ Opinion

In this research, expert opinions on universal mobility in the footpaths of urban India have been critically appraised. Universal mobility (as a component of universal design) is still a largely ignored urban parameter in India despite an increase of 732.20% in the specially-abled and 105.25% in the elderly between 1911 and 2011. A total of 257 experts from the field of architecture and planning hailing from 66 cities in India were interviewed for this research. It was found that despite nationally implemented universal design guidelines, footpaths in 42.8% of the cities do not have universal mobility. In total, 74.7% of the respondents identify the dimension of the footpath as the most important factor for implementing universal mobility. The results of this study indicate the importance of universal design in improving the quality of life in Indian cities, and how urban local bodies can play a significant role in the process by using Public Private Partnership (hereafter, PPP) models and a new accessibility audit checklist.

Walkability Assessment of First Mile Last Mile Public Transport System of Neighbourhood in Kuala Lumpur, Malaysia and Singapore for Persons with Disabilities: A Comparative Study

Information on public transport infrastructure factors affecting mobility and walkability within neighbourhoods among PWD in cities of Kuala Lumpur, Malaysia and Singapore is limited. The study objective was to explore the accessibility of numerous facilitators and barriers in built environment within first mile last mile (FMLM) public transport in naturally occurring retirement community (NORC) neighbourhood within Kuala Lumpur and using Singapore as a benchmark. The research using Direct Observation technique was conducted through Access Audit on six routes at two locations, namely Malaysia (i.e., MY1, MY2, MY3) and Singapore (i.e., SG1, SG2, SG3), with a particular focus on five groups of PWD (Physical, Learning, Blind, Deaf, Elderly). The collected data were analysed for various environmental facilitators and barriers concerning connectivity, comfort, attitude, legibility, and safety of the FMLM public transport in the neighbourhoods. Four FMLM access to public transport determinants emerged and described in order of occurrence frequency in Malaysia case study: transportation service determinant, built environment characteristic, social environment determinant and individual attributes determinant. Different PWD groups had different vulnerabilities and prone to environmental barriers of FMLM in public transport system in Kuala Lumpur as opposed to Singapore. Therefore, it is proposed that walkability of FMLM neighbourhood to be integral component of PWD accessibility, connectivity, and safety when designing built environment in Malaysia.

Evaluation and Design Accessibility of Mosque’s Facilities for People with Disabilities

The condition of the grand mosques in the Boyolali, Surakarta, and Karanganyar areas currently does not consider facilities that can accommodate people with disabilities. This study aims to improve the accessibility of mosque facili-ties and provide proposals for designing facilities that are accessible for mosque worshipers, including those with disabilities. The object of this re-search consists of several great mosques located in Boyolali, Surakarta, and Karanganyar. The accessible congregation is used to conduct access audits using a questionnaire to assess the level of accessibility as well as to deter-mine the priority of the selected mosque, and then design the mosque facili-ties using AutoCAD software concerning the Regulation of the Minister of Public Works and Public Housing No. 14 of 2017. The results of the congregation show that 4 mosques are not accessible and 1 mosque is less accessible. Based on the analysis, it shows that the Madaniyah Great Mosque located in Karanganyar was chosen to be the object of the proposed improve-ment because it has the highest accessibility index value and the current condition of the mosque is the most likely to be repaired, so that mosque facilities are accessible for people with disabilities. The proposal to improve facilities at the Great Madaniyah mosque is to provide a unique parking lot with a size of 5 m x 2.3 m, provide an incline with a slope of 5° and have handrails on both sides, provide two types of ablution places, namely with a seat and no seat, provide toilets equipped with kick plates, automatic hinges, panic buttons, and handrails; provide lifts with handles on all sides and a lift size of 120 cm x 230 cm; provide signs or signs in unique parking lots; add signposts; provide a particular prayer area and a special lane located close to the entrance to the prayer area.

Accessibility audit of a health care institute in India: Are people with disabilities being provided their rights?

BackgroundPoor accessibility of health care facilities is a major barrier for differently abled people when seeking health care. Yet, accessibility is rarely audited. This study reports findings from the first assessment of the accessibility in a health care institution of national importance. This study also assumes importance from various laws and legislation that assure equality and rights for people with disabilities (PWDs). Keeping the objectives in mind, this study was performed with an aim to study the situational analysis of the health institution of national importance for assessing the compliance of hospital premises for being disabled friendly, to find any lacunae, and to suggest remedial measures based on the study finding. The aim was to conduct a content and quality review of research into the hospital experiences of PWD and to identify gaps. MethodsThis was a hospital-based cross sectional study done in a period of 30 days. The gap analysis was performed with validated checklist provided by Central Public Works Department, Government of India (CPWD). ResultsOut of total 126 pointers, 45 pointers were found to be totally compliant, 30 pointers were found to be partially compliant, and remaining 51 pointers were found to be not applicable to the hospitals. ConclusionThis assessment of the accessibility of health care facilities showed that that it is feasible to undertake these audits on a large scale, and these audits should be repeated in other settings. It highlights important gaps in accessibility, increasing the risk of the violation of the right to health of PWDs.

The Inclusion, Diversity, Equity and Accessibility audit. A post-occupancy evaluation method to help design the buildings of tomorrow

Notwithstanding the increased number of regulations there is a general lack of awareness about Inclusive Design among building industry professionals. This is partly due to the scarcity of available tools to evaluate occupancy feedback on inclusion, diversity, equity and accessibility.How can we implement a tool to evaluate occupancy feedback on inclusion, diversity, equity and accessibility that works for the building industry?This study aims to inform the development of a post-occupancy method to evaluate Inclusion, Diversity, Equity and Accessibility (IDEA) in the built environment.This article reports the results of a multifaceted Delphi study which culminated with co-designing the IDEA audit, a post-occupancy evaluation method to collect data on people's perceptions of inclusion, diversity, equity and accessibility.With the IDEA audit, researchers, building owners, design teams, developers, facility managers, tenants, and organisation leaders can achieve a baseline of understanding of what people feel in regard to inclusion, diversity, equity and accessibility, clearly identify pockets of inconsistency and use data to decide how to address challenges and points of exclusion.