Development and Evaluation of eHealth Services Regarding Accessibility: Scoping Literature Review

Area of Science:

• Digital Health
• Health Informatics
• Human-Computer Interaction

Background:

• Accessibility is vital for inclusion, as per the Convention of Rights for People with Disabilities.
• Inaccessible eHealth design can exclude individuals with impairments and inadvertently cause disability.

Purpose of the Study:

• To investigate the development and evaluation of eHealth services concerning accessibility for people with impairments.
• To identify how accessibility is defined, explained, and addressed in eHealth service design and evaluation.

Main Methods:

• A scoping literature review following PRISMA-ScR guidelines.
• Searched four databases (PubMed, Scopus, IEEE, Web of Science) with PICO model (Population, Intervention, Comparison, Outcome) for accessibility in eHealth.
• Included 15 publications on 12 eHealth services after screening 8643 publications.

Main Results:

• Only 2 of 15 publications defined accessibility; 5 explained it, and 8 provided no explanation.
• Web Content Accessibility Guidelines (WCAG) were used in 5 studies; one used ISO and UNE standards.
• Eleven studies employed other methods like user tests, focus groups, and design workshops.

Conclusions:

• Most eHealth studies lack clear accessibility definitions, hindering operationalization and measurement.
• Accessibility guidelines and standards are underutilized in eHealth development and evaluation.
• There is a need for guidelines in complex intervention development to ensure systematic consideration of accessibility in eHealth.