Design for Sustainable Inclusion

Some approaches to representing the diverse range of capabilities within the population focus on representing those with severe losses in a single capability, such as vision or mobility. This approach follows the simplistic view that people are either able-bodied, or have a single severe capability limitation. This paper challenges this view using data from a population representative survey of the 2019 adult population in Germany. This survey asked participants whether they had any limitations in daily activities because of their vision, hearing, memory, concentration, hands, reach or mobility. Out of 1002 valid responses, 158 participants reported that something was ‘very limited’. However, 145 of these participants (92%) had a limitation in more than one capability category. Therefore, representing the diverse range of capabilities within the population necessarily requires describing people with co-occurring limitations. The full set of capability limitations for an individual is defined herein as their ‘capability fingerprint’. Within the German survey, the top 16 capability fingerprints represented 80% of the survey participants. Presenting the most prevalent capability fingerprints is advocated as a better approach for understanding the diversity of the population. These capability fingerprints could be used to develop population-representative personas, or to better understand the sample that took part in small-scale user research.

Immersive technologies, such as virtual reality (VR) and augmented reality (AR), enable many new possibilities for audio-visual content consumption, in particular as a means of allowing for various new experiences that either mimic or surpass what can be experienced in real life. Since immersive experiences can add variety to a daily routine and thus improve quality of life, VR and AR content may be especially attractive to individuals with disabilities and older people who are often home-bound due to limited mobility. However, for VR and AR to be able to reach their full potential, it is important to ensure the design of such systems is inclusive. As an initial step in this direction, this paper provides a set of high-level user requirements from eight focus groups that involved users with a range of disabilities/capability loss types and consequent access barriers to the full enjoyment of VR and AR content and experiences. We clustered the user requirements around the participants’ prioritised strategies for overcoming access barriers. These strategies are customisation, interaction, information, and adaptation for VR; and customisation, interaction, and awareness for AR. Overall, we identify several common high-level user requirements across both VR and AR, including the need to support users in fine-tuning settings and to have available a rich number of modalities to support flexible interaction.

The existing low-carbon behaviour change theories have not paid much attention to the particularity of the cultural values and experiences of older migrants in the UK. This paper reviews the relationship and role of the Low-carbon Behaviour Model, Theory of Planned Behaviour, Resilience Model, Acculturation Model, Ecological Systems Theory, Behavioural Change Wheel, and other relevant theories in the low-carbon behavioural transformation of older Chinese migrants. An integrated model was proposed to explore net-zero to Chinese older migrants.

This paper presents initial findings and principles attained from an ongoing knowledge transfer project between academia and industry partners, aiming to develop more inclusive later-living housing models against the background of current UK market stagnation and lack of suitability of existing stock.

Housing for later-living in the UK lacks meaningful community engagement and hence frequently fails to embody genuine needs beyond basic accessibility principles. Potential residents are frequently reduced to simplified statistics or uncomplicated representations of ‘third age’. The lack of engagement has contributed to unsuitable UK housing stock, inconsistent language use, and limited understanding of older peoples’ actual experiences and desires for their homes and communities. The UK faces the challenge of creating more human-centric, socially and economically sustainable spaces within homes and in the urban environment, whilst avoiding age segregation. In recent years this has been acknowledged, yet developments claiming to be designed for older cohorts continue to be poorly executed, through fragmented planning policies; failed designs; persistently institutionalised features and lack of inclusive understanding.

This paper will discuss the prevalence of limited inclusive intentions and outcomes, particularly in terms of older populations, in architecture, and the consequences of neglected community engagement within the architecture design process, pointing out uncodified methodologies and fragmented literature. The paper will present a successful example of a housing project for later living in Europe, and conclude by proposing a more human-centric approach and a set of initial inclusive design approaches and principles for housing.

Promoting physical activity (PA) to older adults is beneficial for healthy ageing and addresses challenges posed by population ageing. The variable characteristics of older adults makes it difficult for stakeholders to understand and address their needs. This study aims to find out the advantages and disadvantages of current ageing models and ways to promote PA for all populations. Literature related to ageing models and PA was reviewed, and 48 older adults from different places in the UK were interviewed. The challenge of inclusivity in ageing and four common ageing models were discussed. Finally, the study presents four ageing models to propose ways of promoting PA for people. By increasing the inclusivity of ordinary communities, the naturally occurring retirement community (NORC) could be appropriate for healthy ageing. Future researchers may want to do the data collection in a more systematic way to compare all the ageing models.

Telemedicine has served as an effective tool in delivering healthcare to many users via technical modalities. However, non-digital native elderly users who primarily reside in rural communities may naturally feel a digital divide; subsequently having a negative user experience (UX) while navigating these applications. In addition to geographical residence, socio-cultural factors such as age, ethnicity, economic status, and/or education may be variables that cause their limited interaction with technology and lack of receptivity of its adoption. As a result, the functionality of telemedicine applications can pose a challenge without an adequate user interface (UI) design that emphasises their inclusivity. Hence it is important to consider demographic markers that can affect overall usability. The purpose of this paper is to identify and highlight the socio-cultural factors affecting rural elderly users that influence the perceived usefulness of telemedicine applications. Using a grounded theory approach, a qualitative study was conducted using a systematic review of existing literature for data collection to explore relevant usability challenges. Key factors were extracted using a thematic analysis method, with the aim of closing the gap in inclusivity by providing knowledge for further exploratory research – thereby offering opportunities to improve inclusion design for future research and tool development.

The world’s aging population is growing rapidly; consequently, the population with dementia is also significantly increasing. The relationship between the built environment and Health and Care Outcomes (HCOs) of people with dementia has been established by a considerable amount of research on dementia-friendly design. To implement the findings of studies on dementia-friendly design, an assessment tool of Architectural Variables (AVs) is required to evaluate the effectiveness of the design of built environments, such as healthcare facilities for people with dementia. Despite the existing assessment tools and studies conducted in the field of dementia-friendly design, systematically evaluating the AVs is not possible in practice, because of some challenges discussed in this paper. To address these challenges, this literature-based paper examines the capabilities of an assessment tool (toolkit) to systematically evaluate the dementia-friendly design of nursing homes. For this, three main aspects of the assessment tool including (a) the development base, (b) the users, and (c) the capability of being kept up to date are investigated to find out how they could contribute to the creation of a systematic assessment tool. This paper also proposes a methodology for the development of an assessment tool in three steps. First, the AVs and HCOs, and their interactions should be organised in a database. Second, a structured database of data collection methods and the available data should be developed. Third, the development of analytical relations should be done to provide assessments.

Independent Living has influenced strategies for ageing in place, impacting public policies regarding housing and care services. However, this approach remains challenging as products and services for older people are stigmatising, reducing adoption levels. This study aims to understand how people would integrate care for their future selves in a home environment via two coproduction sessions (online and in-person). A multi-generational group of participants with lived experience as informal caregivers provided insights about built environment aspects, home and neighbourhood, meaningful relationships and advanced activities of daily living for later life. Data was analysed qualitatively. The outcomes show how coproduction can be used to develop home and care concepts for aging in place, including insights about preferred home configurations and how physical and digital interactions with products available in the market can improve quality of life as people age. This research can be used as a reference for designing inclusive new-builds, home adaptations and assisted-living technologies and interfaces. By using this approach, independent living strategies could evolve to support positive interdependence networks of people to use digital and physical spaces involving and enhancing self-care and informal and formal care services.

Public spaces provide people with a platform for political, social, and cultural activities, greatly enhancing the quality of life for all. But not everyone benefits equally from these spaces. Across the world, women are seen to use public spaces differently from men for various reasons. This study is an attempt to understand the ongoing application of tools and methods that are used to study how women perceive and use spaces differently from men. It is a narrative-based review of the published papers on women-centric studies in urban public spaces to highlight the tools and methods being used. A total of 28 papers were reviewed, which included studies of countries from both Global North and Global South. The results show that the most common choice of method is direct observations, followed by surveys, in-depth interviews, mapping, and photography. The paper demonstrates that the most effective way to collect women-centric data is to apply mixed methods. It also reveals some interesting and unconventional methods, like crowdmapping and social media, that are being used to collect large-scale data without going into the field. The paper concludes with the need for an intersectional approach in selecting the tools and methods to identify how women’s sociocultural identities create varying degrees of exclusion from public spaces, and how these can be measured.

The design of the built environment of a healthcare setting impacts all users. As a result, it is becoming common practice to design and create healthcare environments that are inclusive of the needs of patients, staff and visitors. Translating how people interact with the environment into design requires a theoretical, methodological level of understanding the dynamics within the built environment. There are a number of social science concepts, methods and frameworks that demonstrate how individuals interact with environments. The aim of this chapter is to establish human geography, with a focus on indoor mobility and the concept of activity space, as a theoretical concept to explore the spatial and temporal movements of users of indoor healthcare environments. This new knowledge of spatial behavior can provide valuable insights into how indoor healthcare facilities work in practice and inform future design solutions based on users’ needs.

Legislation, standards, and policies (LSP) are essential means to promote and regulate accessibility, i.e., inclusion of vulnerable groups in society, especially concerning healthcare services. This study aims to analyse how public policies relate to inclusive design (ID) by promoting accessibility and inclusion in a Brazilian oncology service. We performed an exploratory case study; we analysed the Brazilian LSP, conducted in-depth interviews, and carried out non-participant observation. The results were analysed through thematic analysis and categorised into the following themes: service access, architectural and environmental aspects, information and communication aspects, technological aspects, and attitudinal aspects. In summary, we found that despite Brazilian LSP promoting the inclusion of patients in health services, the observations and interviews showed that there are many gaps in the area of inclusion and accessibility. The results highlight the complexity of working within political and regulatory contexts when implementing and managing such public policies. Then implementation and management should not be ignored, as they ensure the effectiveness of ID; long-term and ongoing actions at different levels of policy, implementation, and management must be taken to provide a more comprehensive understanding of ID in healthcare services.

Research that aims to support human-centred architectural design increasingly recognises people as everyday designers. What remains unclear, however, is how architects can design in ways that support everyday design. We addressed this question in a one-week course in architectural engineering. The course started from a real-world design brief – the redesign of a child oncology ward – and combined design exercises with lectures, discussions with various experts, observational exercises in a school, and watching a TV-documentary together to gain insight into the design of care environments, and children’s everyday practices. As data we use individual and group student work and as themes for analysis we select lessons learned and design interventions suggested by the students in relation to the question we started from. In terms of implications we emphasise attention to people’s involvement in practices as strategy in designing for everyday designers, integrating possibilities for user-feedback as part of design proposals in architectural education, and TV-documentaries as possible sources of information in designing for sensitive and hard-to-enter contexts like hospital wards.

This paper presents the results of an expert usability evaluation study focusing on the accessibility, medical exigency, and user independence of a COVID-19 Home Testing Kit that employed a smartphone app for communication. The paper also proposes a set of guidelines for designing medical testing kits employing smartphones as a bridge technology. Researchers have argued for co-design approaches for usable technology for disabled consumers. Acknowledging disabled users as experts of their contexts of use and using their valuable lived experiences with day-to-day technologies are essential steps in inclusive design. Engaging design researchers’ experiences of working with disabled users, we revisit these challenges in the context of this kit to evaluate the effectiveness both for accessibility and usability. Since our test discovered several design issues with the interaction design of the kit and the assistive technology embedded in the testing process, we argue for more comprehensive models for designing medical testing kits that would integrate both assistive technologies and other elements seamlessly and accessibly. The designer/engineer’s ability to view technology design as one element in a larger usability ecosystem, including nontechnological factors, is central to an independently performable home test. Other important factors are: designer/engineer’s familiarity and comfort with disability, prior experience of working in a disabled community, use of similar existing assistive technology designs for this user group, and an understanding of the complexity of the users’ environment where technology is employed.

This paper provides a narrative review of dyslexia literature to illuminate some broader topics to consider when designing assistive technology for adults with dyslexia. It introduces the fundamental underlying concerns of adults with dyslexia who face stigmatisation and discrimination, both real and perceived, at work. In doing so, it provides insight into how multidimensional stigmatisation is experienced and its consequences for assistive technology use and design. As a way to avoid existing pitfalls, a co-design approach is introduced to explore and define solutions to address multidimensional stigmatisation, including assistive technology use and design for research work. For designers and researchers, this means starting with the correct problem. Collaborating, exploring, and taking action helps construct a picture, interpret the real issues, and determine if progress is being made in a better direction. Ongoing and future work focuses on preliminary aspects to evaluate assistive technology-related stigma for doctoral students with dyslexia. The study intends to develop a standardised scale to measure perceived multidimensional stigmatisation among doctoral students with dyslexia.

Augmentative and alternative communication (AAC) users are highly diverse as their communication needs depend on many factors, such as motor ability, cognition, age, education level, and overall preferences. This chapter introduces the concept of tinkerability for AAC. We conjecture that Tinkerable AAC (TAAC) has the potential to empower AAC users, developers, and researchers to fine-tune, adapt, and explore better communication solutions in tandem with the system. We present a framework for tinkerable AAC that concretely links its qualities to AAC research and development areas and subareas. To demonstrate the viability of tinkerable AAC, we present a tinkerable predictive text entry system for it. It allows users to adjust many aspects of the system during use, ranging from the text prediction algorithms in the back end to the parameters underpinning the keyboard layout in the front end. In addition, it also allows AAC system developers to adopt state-of-the-art language models and enables AAC researchers to carry out in-situ research experiments. We discuss the design space opened up by tinkerable AAC and its potential in empowering the AAC community to co-design individually tailored solutions for users.

Deaf pilots in France are currently allowed to fly planes with the help of a second pilot handling voice and radio communication. Yet they are not allowed to pilot independently. Fans4All is an association that aims at making aeronautics more accessible to pilots who are hearing or speech impaired (HSI). In this paper we present our experience as a multidisciplinary design team (including two HSI pilots) working towards this goal. We present current and past steps to develop a Multimodal Sensory Communication Device (MSCD) composed of a touchscreen tablet and a haptic jacket, as well as the visual vocabulary to define messages between HSI pilots and air traffic controllers. Moreover, we present our approach combining quantitative and qualitative methods for evaluation. We hope that our work will help to make aeronautics more accessible to people with impairments.

This paper discusses the potential of applying generative design to assistive devices. The concept of a cyber-physical human system is presented. An example case of generative design to explore innovative design solutions with novel features is presented. Outstanding challenges and gaps in research are discussed.

This work describes the application of user-centred design (UCD) and co-creation tools in the design and development process of an online toolkit that aims to tackle the digital divide in the mobility sector. UCD and co-creation approaches aim to address and understand users’ needs. This paper details the process of co-creation of the toolkit and reflects on its current results. The design process was based on a first phase of understanding the context and defining the users and their needs, followed by a second phase of co-creating the solution and a final phase of evaluating and testing the toolkit usage and co-creation process. A set of mixed methods employed based on UCD and involving different target groups as end-users has resulted in qualitative data that will feed and strengthen the process of co-creation and the final implementation of the toolkit. Beyond the set of tools presented on the website, the approach followed promotes co-creation, collaboration, and participation as key elements to enhance inclusion and accessibility in mobility ecosystems.

The Inclusive Design Wheel (IDW) is an established inclusive concept design process, emphasizing iteration and early-stage evaluation. However, a structured evaluation of its effectiveness in practice has not been previously conducted. This paper describes how the IDW process was adapted for use in the design of digital mobility services. It was then trialled on five pilot projects in Italy, Spain, Belgium and the Netherlands. Questionnaires were completed by participants (both pilot partners and end-users) and interviews were held with pilot partners at the end of the project. Initial insights from the pilot experiences and the evaluation are described. The pilot teams found the IDW helpful and particularly valued its help in structuring the design process and offering clear steps and tools. Insights for improving the IDW focus on the importance and role of co-creation, issues with recording iteration and the balance between structure and flexibility. Implications are highlighted for improving the Inclusive Design Wheel and for inclusive design processes more generally.

Degree award gaps have been reported for every university in the UK, and they are often unexplained. Reducing the award gaps between white and minority ethnic students in the UK is an effort to achieve equality, diversity and inclusion (EDI), an increasingly important agenda for higher education institutions. This paper reports a study at Brunel Design School, focusing on the award gaps and the learning experience of the minority ethnic students. Focus group and individual interviews were conducted with 25 student volunteer participants in Spring 2022, in addition to student EDI group discussions. It was found that English language skills play an important role in their learning experience and assessment outcomes. Despite the lack of training in English academic writing, the majority of the participants preferred reports rather than video/audio assessment. The students’ suggestions and the relevant strategies proposed by published studies will be used to address degree gaps, and improve minority ethnic students’ learning experience at Brunel Design School, as part of the action research.

The design of products has an impact on the quality of life of people with disabilities. They can indeed amplify or attenuate the situation of disability. For example, a smartphone can serve as an environmental control or as an alternative communication tool but it can only be used by people with severe motor limitations if it is compatible with assistive technologies. Inclusive innovation is a process that involves excluded groups, such as people with disabilities or elderly, and improves their quality of life and inclusion into society. One of the major challenges of inclusive innovation is to raise the awareness in those who design innovation. Gamification has proved to foster learners’ engagement. For this reason we developed an Inclusive Innovation card game aimed at training students and professionals (designers, engineers, entrepreneurs, marketing, living labs, …) in the Inclusive Innovation process. In this article, we describe the card game and its implementation within student and professional contexts.