User factors affecting the use of digital services in five European regions and countries.

Digitalisation has great potential to reduce costs, improve access and enhance user experience. However, it could also increase inequality, with some people struggling to access and use digital services. It is important to understand who is likely to be excluded in this way and why. This can help to identify groups at particular risk of digital exclusion, inform efforts to overcome the barriers, and develop more inclusive digital services. This paper introduces a set of five linked datasets examining a range of user factors affecting the use of digital services. The datasets focus on the use of digital mobility services, but the data is useful in understanding the use of other digital services as well. The user factors considered include technology access, use and competence and attitudes towards digital technology. The datasets were the results of surveys in five European regions and countries (Germany, Italy, Barcelona Metropolitan Area, Flanders and the Netherlands). Samples were taken of the adult (age 16+) population with a total of 3,454 participants.

Codesigning a systemic discharge intervention for inpatient mental health settings (MINDS): a protocol for integrating realist evaluation and an engineering-based systems approach.

INTRODUCTION: Transition following discharge from mental health hospital is high risk in terms of relapse, readmission and suicide. Discharge planning supports transition and reduces risk. It is a complex activity involving interacting systemic elements. The codesigning a systemic discharge intervention for inpatient mental health settings (MINDS) study aims to improve the process for people being discharged, their carers/supporters and staff who work in mental health services, by understanding, co-designing and evaluating implementation of a systemic approach to discharge planning. METHODS AND ANALYSIS: The MINDS study integrates realist research and an engineering-informed systems approach across three stages. Stage 1 applies realist review and evaluation using a systems approach to develop programme theories of discharge planning. Stage 2 uses an Engineering Better Care framework to codesign a novel systemic discharge intervention, which will be subjected to process and economic evaluation in stage 3. The programme theories and resulting care planning approach will be refined throughout the study ready for a future clinical trial. MINDS is co-led by an expert by experience, with researchers with lived experience co-leading each stage. ETHICS AND DISSEMINATION: MINDS stage 1 has received ethical approval from Yorkshire & The Humber-Bradford Leeds (Research Ethics Committee (22/YH/0122). Findings from MINDS will be disseminated via high-impact journal publications and conference presentations, including those with service user and mental health professional audiences. We will establish routes to engage with public and service user communities and National Health Service professionals including blogs, podcasts and short videos. TRIAL REGISTRATION NUMBER: MINDS is funded by the National Institute of Health Research (NIHR 133013) https://fundingawards.nihr.ac.uk/award/NIHR133013. The realist review protocol is registered on PROSPERO. PROSPERO REGISTRATION NUMBER: CRD42021293255.

Differences in vision performance in different scenarios and implications for design.

To design accessibly, designers need good, relevant population data on visual abilities. However, currently available data often focuses on clinical vision measures that are not entirely relevant to everyday product use. This paper presents data from a pilot survey of 362 participants in the UK, covering a range of vision measures of particular relevance to product design. The results from the different measures are compared, and recommendations are given for relative text sizes to use in different situations. The results indicate that text needs to be 17-18% larger for comfortable rather than perceived threshold viewing, and a further 20% larger when users are expected to wear their everyday vision setup rather than specific reading aids.

Making the case for inclusive design.

This paper describes the University of Cambridge, Engineering Design Centre's (EDC) case for inclusive design, based on 10 years of research, promotion and knowledge transfer. In summary, inclusive design applies an understanding of customer diversity to inform decisions throughout the development process, in order to better satisfy the needs of more people. Products that are more inclusive can reach a wider market, improve customer satisfaction and drive business success. The rapidly ageing population increases the importance of this approach. The case presented here has helped to convince BT, Nestlé and others to adopt an inclusive approach.

Do best practice guidelines improve the legibility of pharmacy labels for the visually impaired?

PURPOSE: Reading pharmacy labels on medications is a challenging task for visually impaired people. Design for Patient Safety (DfPS) best practice guidelines exist on the presentation of information on pharmacy labels, but it is unclear to what extent current labels follow the guidance. It is also unclear whether labels produced to DfPS guidelines are more accessible to patients with impaired vision. METHODS: Twenty-four sample labels were obtained from six different pharmacy chains. Experimental labels were constructed reflecting a typical pharmacy label, an ideal label constructed to DfPS guidelines, and a large print label. 20 normally-sighted subjects read labels under habitual conditions (mean VA -0.14 log MAR, Snellen equivalent 6/4.4), and under two conditions of simulated visual impairment (mean VA +0.41 and +0.69 logMAR, Snellen equivalents 6/15.4 and 6/29.4). Outcome measures were speed and accuracy of label reading. RESULTS: Median font size for the primary directions on the sample labels was 9.5 point (range 8-10 point), rather than the recommended minimum size of 12 point. In the mild visual impairment condition, using the ideal label improved accurate reading speed by 58% over the typical label, and using the large print label improved accurate reading speed by about 100%. In the moderate visual impairment condition, 65% of subjects were able to see sufficient of the directions to be able to take the medication appropriately with the ideal label, and 80% with the large print label, as compared to 20% with the typical label. CONCLUSIONS: DfPS best practice guidelines were not fully met by any of the pharmacy labels in this sample. With unimpaired vision, label design had little impact on legibility. However, the results provide evidence that preparing pharmacy labels according to DfPS guidelines improves their relative legibility in simulated visual impairment. These findings need extending to those with actual visual impairment, but the current results strengthen the argument for conformance to DfPS guidelines.