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Web accessibility and mental disorders. difficulties experienced by people with depression and anxiety on the Web
Web accessibility and mental disorders. difficulties experienced by people with depression and anxiety on the Web
Background: Mental disorders are a significant public health issue due to the restrictions they place on participation in all areas of life and the resulting disruption to the families and societies of those affected. People with these disorders often use the Web as an informational resource, platform for convenient self-directed treatment and a means for many other kinds of support. However, some features of the Web can potentially erect barriers for this group that limit their access to these benefits, and there is a lack of research looking into this eventuality. Therefore, it is important to identify gaps in knowledge about “what” barriers exist and “how” they could be addressed so that this knowledge can inform Web professionals who aim to ensure the Web is inclusive to this population. Objective: The objective of this work was to identify the barriers people with mental disorders, especially those with depression and anxiety, experience when using the Web and the facilitation measures used to address such barriers. Methods: This work involved three studies. First, (1) a systematic review of studies that have considered the difficulties people with mental disorders experience when using digital technologies. A synthesis was performed by categorizing data according to the 4 foundational principles of Web accessibility as proposed by the World Wide Web Consortium. Facilitation measures recommended by studies were later summarized into a set of minimal recommendations. This work also relied data triangulation using (2) face-to-face semistructured interview study with participants affected by depression and anxiety and a comparison group, as well as (3) a persona-based expert online survey study with mental health practitioners. Framework analysis was used for study 2 and study 3. Results: A total of 16 publications were included in study 1’s review, comprising 13 studies and 3 international guidelines. Findings suggest that people with mental disorders experience barriers that limit how they perceive, understand, and operate websites. Identified facilitation measures target these barriers in addition to ensuring that Web content can be reliably interpreted by a wide range of user applications. In study 2, 167 difficulties were identified from the experiences of participants in the depression and anxiety group were discussed within the context of 81 Web activities, services, and features. Sixteen difficulties identified from the experiences of participants in the comparison group were discussed within the context of 11 Web activities, services, and features. In study 3, researchers identified 3 themes and 10 subthemes that described the likely difficulties people with depression and anxiety might experience online as reported by mental health practitioners. Conclusions: People with mental disorders encounter barriers on the Web, and attempts have been made to remove or reduce these barriers. This investigation has contributed to a fuller understanding of these difficulties and provides innovative guidance on how to remove and reduce them for people with depression and anxiety when using the Web. More rigorous research is still needed to be exhaustive and to have a larger impact on improving the Web for people with mental disorders.
World Wide Web, mental disorders, systematic review, accessibility, interaction design, Web-based interaction, depression, anxiety, interview, persona, expert study, eHealth, usability, user experience, facilitators, barriers
Bernard, Renaldo
2020
English
Universitätsbibliothek der Ludwig-Maximilians-Universität München
Bernard, Renaldo (2020): Web accessibility and mental disorders: difficulties experienced by people with depression and anxiety on the Web. Dissertation, LMU München: Faculty of Medicine
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Abstract

Background: Mental disorders are a significant public health issue due to the restrictions they place on participation in all areas of life and the resulting disruption to the families and societies of those affected. People with these disorders often use the Web as an informational resource, platform for convenient self-directed treatment and a means for many other kinds of support. However, some features of the Web can potentially erect barriers for this group that limit their access to these benefits, and there is a lack of research looking into this eventuality. Therefore, it is important to identify gaps in knowledge about “what” barriers exist and “how” they could be addressed so that this knowledge can inform Web professionals who aim to ensure the Web is inclusive to this population. Objective: The objective of this work was to identify the barriers people with mental disorders, especially those with depression and anxiety, experience when using the Web and the facilitation measures used to address such barriers. Methods: This work involved three studies. First, (1) a systematic review of studies that have considered the difficulties people with mental disorders experience when using digital technologies. A synthesis was performed by categorizing data according to the 4 foundational principles of Web accessibility as proposed by the World Wide Web Consortium. Facilitation measures recommended by studies were later summarized into a set of minimal recommendations. This work also relied data triangulation using (2) face-to-face semistructured interview study with participants affected by depression and anxiety and a comparison group, as well as (3) a persona-based expert online survey study with mental health practitioners. Framework analysis was used for study 2 and study 3. Results: A total of 16 publications were included in study 1’s review, comprising 13 studies and 3 international guidelines. Findings suggest that people with mental disorders experience barriers that limit how they perceive, understand, and operate websites. Identified facilitation measures target these barriers in addition to ensuring that Web content can be reliably interpreted by a wide range of user applications. In study 2, 167 difficulties were identified from the experiences of participants in the depression and anxiety group were discussed within the context of 81 Web activities, services, and features. Sixteen difficulties identified from the experiences of participants in the comparison group were discussed within the context of 11 Web activities, services, and features. In study 3, researchers identified 3 themes and 10 subthemes that described the likely difficulties people with depression and anxiety might experience online as reported by mental health practitioners. Conclusions: People with mental disorders encounter barriers on the Web, and attempts have been made to remove or reduce these barriers. This investigation has contributed to a fuller understanding of these difficulties and provides innovative guidance on how to remove and reduce them for people with depression and anxiety when using the Web. More rigorous research is still needed to be exhaustive and to have a larger impact on improving the Web for people with mental disorders.