Smartphone accessibility: understanding the lived experience of users with cervical spinal cord injuries.

PURPOSE: To explore accessibility challenges encountered by smartphone users with cervical spinal cord injuries (C1-C8).To investigate the suitability of current technology and make recommendations to help future technology meet user needs. METHODS: The study uses a mixed-method approach combining an inductive thematic analysis of nine semi-structured interviews with a quantitative analysis of thirty-nine questionnaires. RESULTS: The analysis generated four themes: 'the drive for independence and self-efficacy'; 'trying to make it work'; 'getting the right technology for me'; 'using the phone as and when I want to'. These themes highlighted how unresolved access issues and situational barriers limited independence and created unwanted privacy compromises for effective communication. There was a lack of information or support on available smartphone accessibility features and assistive technology (AT). Smartphone AT was regarded as overpriced, poorly designed and lacking the voices of people with disabilities. CONCLUSIONS: The smartphone's potential to improve quality of life, participation, and well-being is limited by accessibility challenges hindering independent and private smartphone use. Future design work should focus on improving accessibility, investigating reasons for AT's poor quality and high cost, and removing barriers to end-user inclusion. To enhance user awareness of available technology, stakeholders should build and maintain an open platform to act as an information source for peer and professional support on assistive technology.Implications for RehabilitationA smartphone's potential to empower, connect, and improve the quality of life of people with a cervical spinal cord injury (SCI) is limited by unresolved accessibility barriers, causing isolation.Standard interaction methods used by people with a cervical SCI to mitigate smartphone access barriers can require unwanted privacy compromises and limit independence.Participants struggled to find information and support on available accessibility solutions and assistive technologies that might enable easier smartphone use.Participants rarely used assistive technology (AT) to facilitate smartphone use, and available AT was regarded as expensive and poorly designed.