Dissertation Title: Accessible Public Health Emergency Information & Communication Technology: Shifting from a Culture of Remediation to a Culture of Accessibility and Inclusion by Design

Dissertation Chair: Dr. Erin Vinoski Thomas

Dissertation Abstract: 

Objectives. People with intellectual and developmental disabilities (IDD) face additional challenges both in and outside the context of a public health emergency (PHE). With substantial increases in PHE-related content available on the Web and the percentage of U.S. adults seeking PHE information online, it is essential that Web-based information and communication technology (ICT) is fully accessible to people with IDD to prevent health disparities in PHEs. This research, conducted across two studies, aimed to provide a multidimensional assessment of federal COVID-19 webpage accessibility levels and an in-depth exploration of adults with IDD’s existing knowledge of and experience with filing accessibility complaints for federal ICT.  

Methods. The first study used WAVE automated accessibility testing to evaluate 18 federal agencies’ COVID-19 webpages’ compliance with accessibility standards. Study 2 included qualitative interviews with 16 people with IDD about their experiences accessing PHE information on federal webpages and filing accessibility complaints, and applied methods of reflexive thematic analysis to analyze the data. 

Results. In study 1, the total number of potential accessibility violations in the cumulative sample from all WAVE categories to assess greater accessibility was 3,004. Total potential accessibility violations of strictly errors and contrast errors categories to assess compliance only in the cumulative sample was 112. Across both groupings, the Department of Defense had the greatest number of accessibility violations, while other agencies varied to/from low or mid-range violations. Cross-cutting themes were categorized into common technological accessibility barriers (plain language, page structure and assistive technology compatibility, timeliness) and common structural, systemic, and institutional accessibility barriers (agency responsiveness, community advocacy). Identified areas for improvement included efficiency and prioritization of people with IDD from federal agencies. 

Conclusions. Integrated findings from both studies generated six recommendations related to plain language and simplified data; inclusive ICT development; centralized accessibility-related information; accessible formatting for people with diverse IDDs and assistive technologies; appropriate follow up; and updated legislation. Applying a health equity lens that frames recommendations with the understanding that accessibility improvements will benefit all users—not just those with IDD—is a promising approach to gain buy-in from decision makers when presenting related research.