JMIR Publications

ABSTRACT

Background:

Despite the introduction of the Web Content Accessibility Guidelines (WCAG) and legislations, a large number of websites remain poorly accessible to disabled users, especially those with sight impairment as the Internet has become a more visually complex environment. With increasing reliance on the Internet and almost two million people in the United Kingdom (UK) suffering from sight loss, it is important that they are not overlooked when developing online materials. A significant proportion of those affected have irreversible sight loss due to rare genetic eye disorders and many of them use the Internet as a primary source of information for their conditions. However, access to high-quality online health information with an inclusive design remains a challenge for many of them. We have therefore developed a new online resource on genetic eye disorders that aims to provide a holistic guide for patients, relatives and healthcare professionals called Gene.Vision.

Objective:

Based on a usability testing session of our website prototype, we wanted to identify key online accessibility features for sight impaired users and to explore whether the contents provided in our website were relevant and comprehensible.

Methods:

A face-to-face testing session with eight participants (five patients, two family members and one member of the public) and eight facilitators was conducted on a prototype website. Homepage design, navigation, content layout and quality, language and readability were explored through direct observation and task completion with the think-aloud method. A focused interview of the group was conducted to elicit further feedback. Qualitative data was gathered and analysed to identify core themes.

Results:

All participants had good computer literacy; 5 patients with sight impairment utilised visual aid software including iOS VoiceOver and Speak Screen, iOS Classic Invert, ZoomText 2020 and Windows magnifier. The features identified by our participants that will enhance accessibility and usability for sight impaired users are having a consistent website layout, structured information hierarchy with clear description of links, good chromatic and luminance contrast, predictable and easy navigation, adaptability to various assistive software and having readable and relevant contents. They reported that dynamic content (such as carousels) and large empty spaces reduced accessibility. Information on research, support available, practical advice, and links to charities were incentives for repeated website visits.

Conclusions:

We have demonstrated the importance of developing a website with a user-based approach. Through testing with our end users, we identified several key online accessibility features for people with sight impairment. Target end users should always be involved early and throughout the design process to ensure their needs are met. Search engine optimisation can be achieved if these design principles are adhered to