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L’accessibilité universelle est une préoccupation majeure des pays développés, particulièrement dans les villes. Cependant, on observe une grande confusion quant à la signification de ce concept dont la définition change d’un auteur à l’autre et dont aucune ne couvre toutes les dimensions identifiées par l’ensemble des textes. Il y a aussi de nombreuses propositions, plus ou moins articulées, de différents types de design visant son atteinte. Le Comité montréalais d’étude sur l’accessibilité universelle, qui comprend des chercheurs, des représentants de regroupements d’organismes communautaires, ainsi qu’une représentante de la Direction de la diversité sociale de la Ville de Montréal, a mené les travaux de clarification de ces concepts à la base de la présente synthèse. Ce texte propose une définition formelle de l’accessibilité universelle basée sur une méthode de sélection et d’analyse de contenu des références les plus pertinentes. Cette analyse cherchait à préciser au mieux la nature du concept, ses objets et contexte d’application, sa visée sociale, la population visée et un groupe ciblé en particulier, les conditions d’utilisation, ainsi que les critères généraux d’évaluation. La même démarche terminologique a été menée pour définir les types de design contributifs à l’accessibilité universelle et pour en proposer une classification dynamique dans un processus évolutif. Ces précisions terminologiques sont proposées comme fondement au développement d’une approche interdisciplinaire, multisectorielle et multidimensionnelle de l’accessibilité universelle. Enfin, les problèmes de son évaluation sont soulignés.

ObjectiveTo develop and validate a questionnaire to assess the usability of clinical decision support systems (CDSS) and to assist in the early identification of usability issues that may impact patient safety and quality of care.DesignMixed research methods were used to develop and validate the questionnaire. The qualitative study involved scale item development, content and face validity. Pilot testing established construct validity using factor analysis and facilitated estimates for reliability and internal consistency using the Cronbach’s alpha coefficient.SettingTwo hospitals within a single National Health Service Trust.ParticipantsWe recruited a panel of 7 experts in usability and questionnaire writing for health purposes to test content validity; 10 participants to assess face validity and 78 participants for the pilot testing. To be eligible for this last phase, participants needed to be health professionals with at least 3 months experience using the local hospital electronic patient record system.ResultsFeedback from the face and content validity phases contributed to the development and improvement of scale items. The final Healthcare Systems Usability Scale (HSUS) proved quick to complete, easy to understand and was mostly worded by potential users. Exploratory analysis revealed four factors related to patient safety, task execution, alerts or recommendations accuracy, the effects of the system on workflow and ease of system use. These separate into four subscales: patient safety and decision effectiveness (seven items), workflow integration (six items), work effectiveness (five items) and user control (four items). These factors affect the quality of care and clinician’s ability to make informed and timely decisions when using CDSS. The HSUS has a very good reliability with global Cronbach’s alpha 0.914 and between 0.702 and 0.926 for the four subscales.ConclusionThe HSUS is a valid and reliable tool for usability testing of CDSS and early identification of usability issues that may cause medical adverse events.

Background Smart home technologies have the potential to support aging in place; however, older people’s perceptions of the value of smart homes may be influenced by their access to the information gathered by the technology. This information is needed to support their informed decision-making. Limited research has been conducted on how best to design visualizations of smart home data in keeping with the needs and wishes of older people. Objective We aimed to investigate the design options that impact the usefulness of smart home systems, older people’s information needs, their perceptions of data visualization, and the ways they would like information displayed to them. Methods We used a qualitative approach to empower the participants as co-designers. Data collection comprised a sequence of methods such as interviews, observation, focus groups, scenario design, probes, and design workshops. Each phase informed the next. Overall, 13 older adults (n=8, 62% female and n=5, 38% male; aged 65-89 years) consented to participate. A thematic approach was used to analyze the data set, and participants were actively involved in designing the in-home interface, which enabled them to better conceptualize their needs. Results The information collected was clustered into 5 themes: enabling home, health, and self-monitoring; enabling opportunities for social inclusion and engagement; enhancing cognitive abilities; customizability of the display; and promoting inclusion in recreation and leisure activities. These themes informed 5 design sessions in which participants co-designed visual metaphors for the themes based on their own experiences in an age-inclusive manner. Together, the participants produced a user-friendly prototype, which they chose to call My Buddy. They found it useful to receive social and cognitive triggers, as well as recommendations for special diets or activities based on their mood, health, and social status. Conclusions Smart home data visualization is much more than a nice-to-have option. Visualization is a must-have feature because it deepens the understanding of the information collected and means that technology provides information of value and relevance to older people. This may improve the acceptability and perceived utility of in-home technology. By understanding what older people want to know from smart home technology and considering how to visualize data in ways that work for them, we can provide an appropriate in-home interface. Such an interface would suggest ways or opportunities to connect and socialize; stimulate contact with close friends or family members; maintain awareness of health and well-being; provide support in decision-making, cognitive tasks, and daily life activities; and monitor health status. Older adults are the best co-designers for the development of visual metaphors that resonate with their own experiences. Our findings promote the development of technologies that foreground and reflect the information needs of older people and engage them as designers of the display.

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