Abstract
BACKGROUND:
Approximately 7.4% of Canadians over the age of 15 report being blind or partially sighted; this impacts their daily functioning in public spaces [1]. Technological advances have included the proliferation of self-serve kiosk in many consumer settings. However, absent from discussions of community accessibility is the experiences of Canadians who are blind or partially sighted.
OBJECTIVE:
To better understand the experiences of this population with self-serve kiosks.
METHODS:
A descriptive cross-sectional study design was used to analyze survey data collected as part of a survey by Canadian National Institute for the Blind (CNIB) of people who are blind, Deafblind partially sighted about their use of self-serve kiosks. 731 participants were surveyed, representing a response rate of 3.5% across Canada.
RESULTS:
64.14% of participants faced barriers in completing a task using self-serve technology. Human assistance was required to complete the tasks in most instances. 65.74% of participants reported they did not enjoy using self-serve kiosks and 60.90% of participants reported they would not continue to use self-serve kiosks in the future.
CONCLUSIONS:
The findings highlight a need to promote accessibility in the creation and implementation of self-serve kiosks in order to further their use and decrease exclusion of people who are blind and partially sighted.
Introduction
Persons with disabilities represent one of the largest minority groups in Canada, making up to approximately 27% of the total Canadian population [1]. Approximately 7.4% of the Canadian population over the age of 15 identify as being blind or partially sighted [1]. Persons who are blind or partially sighted are more likely to be unemployed, have lower income and education, and face greater overall discrimination than people without [2, 3, 4, 5]. Employment status, level of income and education, and the experience of discrimination can also influence mental health and psychosocial well-being (Aitken et al., 2018, King et al., 2018) [6, 7]. There is a growing awareness of the significant costs associated with not being fully accessible to persons who are blind or partially sighted for individuals and employers, with the annual global costs of lost productivity estimated at over $411 billion USD [5]. Exploring ways in which community integration and social participation can be furthered among persons who are blind and partially sighted is of critical importance.
Access to technology such as self-serve terminals and kiosks, is an important area for consideration among persons who are blind and partially sighted. Self-serve technology can be found in many critical services, such as the healthcare industry, banking, travel, and grocery stores. The inherent visual nature of this technology may present significant barriers [8]. On the other hand, the advancement and sophistication of accessible technology, including the integration of artificial intelligence, could contribute to the potential for improved access among persons with various sensory disabilities [9]. Exploring the lived experience of persons who are blind and partially sighted could lead to improvements in services available in a variety of sectors.
There is no single consistent definition for self-serve kiosks, or self-serve technology; they are described as a form of technology that provides key services to the general population and are designed to sell users a product or provide information [10]. Hagen and Eika Sandnes provide examples of the various forms of self-serve kiosk technology that people might encounter in the community, such as: ticket sales, self-serve banking, photo-manipulation and printing, local navigation such as in shopping centres, low-cost Internet access such as in Internet cafes or travel centres, education tuition payment, check-ins for appointments and travel, and general information [11]. Therefore, self-serve kiosks are technology that many people encounter throughout their daily lives in the community.
In addition, present-day self-serve kiosks most commonly rely on interaction through touch-sensitive displays. This current practice of a best fit for all is not ideal for everyone, especially for those who are blind or partially sighted [11]. Moreover, the display screen can often be difficult to read because of issues associated font size, font style and back-lighting [11].
According to various legislation across jurisdictions, there is a requirement for organizations to make their web-based content and apps accessible (e.g. the Accessibility for Ontarians with Disabilities Act [AODA]) [12]. Inequitable access to self-serve technology has been explored in studies past research with a focus on persons who are blind or partially sighted [13, 14], and older adults [15]. While there are no specific studies focused on the use of self-serve kiosks for persons who are blind and partially sighted, there are studies about e-services and the applications on e-services can be similar to those in self-serve kiosks. One study conducted in Spain by Sala and colleagues showed that it was difficult for persons who are blind or partially sighted to complete tasks using various websites [14]. Sala and colleagues also found that this population required more human assistance, made more errors than the non-disabled group, and were more disoriented, as shown by coming across the same pages repeatedly [14]. In Finland, Immonen and colleagues found that individuals who needed support to use new e-services preferred having human interaction while using the service [15]. In Australia, Locke and colleagues conducted a survey asking persons who are blind and partially sighted about how they use smartphones [13]. These authors found that of the 845 individuals surveyed, 35% expressed their smartphone apps were not fully accessible, 65% wanted more information on the types of apps and smartphone features they could use, 65% wanted more training on how to use a smartphone, and 52% wanted more advocacy for the blind community to encourage smartphone and app developers to design technology with accessibility in mind. In summary, the population of people who are blind or partially sighted face accessibility challenges when using computers and smartphone technology. There is an urgent need to better understand how to improve accessibility features within self-serve technology given their prominent use across various sectors.
The existing research specific to self-serve kiosk technology and people who are blind or partially sighted is limited. Further, how self-serve kiosks act as barriers to community participation for people who are blind or partially sighted has not been studied. Exploring the experiences of this community with self-serve kiosks across Canada could provide information to improve these platforms.
Purpose
The purpose of this study was to better understand the experiences of Canadian adults who are blind, partially sighted, and Deafblind with self-serve kiosks. The secondary purpose of this study was to explore the extent to which income levels, gender, and education impact accessibility and usability needs, across sectors in which self-serve kiosks are encountered.
Research questions
The primary research question for this study was: What are the experiences of Canadian blind, Deafblind, and partially sighted adults with self-serve kiosks? We sought to explore the use of self-serve kiosks by people who are blind, Deafblind, or partially sighted, including how frequently they are using such technologies and in what sectors, and to identify some of the ongoing accessibility and usability needs.
Hypotheses
H0: The medians of each group compared (i.e., income, education, gender) will be equal. HA: At least one group median of the groups compared (i.e., income, education, gender) will differ from the other group medians.
Study design
A descriptive cross-sectional study design was used to analyze survey data collected as part of a survey by Canadian National Institute for the Blind (CNIB) of people who are blind, Deafblind, and partially sighted about their use of self-serve kiosks.
Sample
We took an exploratory approach to this research, as the population of people who are blind, Deafblind, or partially sighted can be difficult to reach. The survey was sent specifically to people within CNIB’s expansive network across Canada and was open from March 24, 2023 until April 14, 2023. Individuals who had previously consented to be on CNIB’s research email list or given permission to be contacted by the CNIB Foundation were contacted by email with information about this research. A total number of 20 942 individuals were contacted. Inclusion criteria for participation in the survey included being: at least 18 years of age; a Canadian resident; blind, partial-sighted, or deaf-blind; able to understand and use English or French, and; have a device that connects to the Internet.
Initially, the target sample size was 300 to 500 individuals to properly capture the experiences of this population with self-serve kiosks. Literature from various countries suggests that experiences with, and attitudes toward, self-serve kiosks are heterogeneous and therefore a large sample is required to capture the diversity of opinions and needs [13]. Informed consent was obtained from within the online survey. A power calculation was not completed to determine recruitment, as this was an exploratory study.
Measures
The survey consisted of questions focused on the following domains: technology use, attitudes towards technology; disability, user needs; experience with type of technology; future intention to use; and general demographics. Participants rated their own ability to use technology as one of the following: basic user, intermediate user, proficient user, or advanced user. In terms of self-reported anxiety while using self-serve kiosks, participants rated their anxiety on a scale from 1 to 10, with 1 representing “not at all” and 10 representing feeling anxious “all the time”. Self-reported confidence in using self-serve technology was also rated on a scale from 1 to 10, with 1 representing “not at all confident” and 10 representing “completely confident”. All data collected was categorical, with the exception of year of birth. Please see Appendix A for a copy of the full English-language survey.
Data collection
Participants completed the online survey between March 24, 2023 and April 14, 2023. In order to participate, individuals clicked on a hyperlink in an email invitation circulated by the CNIB. The hyperlink opened an online survey via Survey Monkey consisting of a short screening survey to verify inclusion criteria. Eligible participants were then invited to click another hyperlink that redirected them to a longer survey that took approximately 20 minutes to complete. Participants could choose to skip questions or select “prefer not to answer” to any question.
Data analysis
Frequencies and percentages were calculated for categorical data. Means and standard deviations were calculated for non-categorical data. Data was inspected for outliers by plotting data from each group being compared (i.e., income groups, gender groups, and education groups) on a box plot, and calculating the median. A Shapiro-Wilk test was completed to test for normality between groups. A Kruskal-Wallis test, a nonparametric test, was completed to check for statistical significance within groups for each variable. Post-hoc Wilcoxson rank-sum tests were completed for each comparison to look for statistical significance between groups. A post hoc test with a Bonferroni correction was applied to the outcome of each post-hoc Wilcoxson rank-sum test result to reduce the risk of type I error. The approach also included Kruskal Wallis tests to explore how other social determinants of health, such as income, education, and sexual identity impact one another, as the literature has found that these variables are relevant to the use of technology [16]. STATA BE version 17.0 was used for all statistical calculations, with an alpha level set at 0.05.
Theory
The Unified Theory of Acceptance and Use of Technology (UTAUT) guided exploration of the experiences described by the blind, partially sighted, and Deafblind community, and to explore options for moving forward [17]. This theory proposes that the likelihood of adopting technology is dependent on performance expectancy, effort expectancy, social influence, and facilitating conditions. Performance expectancy is defined as the degree to which a person believes that the technology will help them perform. Effort expectancy is the degree of ease associated with use of the technology. Social influence is the degree to which a person perceives others think they should use the new technology. Lastly, facilitating conditions are defined as the degree to which a person believes that the infrastructure and support exists to use the technology. All four of these components are moderated by age, gender, experience, and voluntariness of use [17]. The Social Model of Disability [18] was also considered when developing survey questions, completing the analysis, and formulating recommendations. This model proposes that people are limited by disabling environments and stigmatizing attitudes, rather than an impairment within the individual [18].
Results
Sample size
Initially, there were 679 (92.89%) English-language and 52 (7.11%) French-language individuals who started the survey, for a total of 731 participants. Participants dropped out at various points in the survey process. A total of 23 participants were excluded from the survey because they did not meet inclusion criteria for age, and 13 participants were excluded because they did not identify as being blind, Deafblind, or partially-sighted.
Demographic information
Income distribution
Income distribution
A total of 465 participants inputted their year of birth, with a mean age of 59 years (SD
Education level distribution
Most participants (72.69%) had at least a college diploma, vocational school, or trade school education (see Table 2 for a breakdown of descriptive statistics).
472 (92.55%) of the 510 participants answering the initial question about type of visual disability identified as being blind or partially sighted, 20 participants (3.92%) identified as being Deafblind, 13 (2.55%) of participants reported they did not have a seeing disability and were excluded from the survey, and 5 participants (0.98%) preferred not to answer.
Types of self-serve kiosks used in the last 6 months
Types of self-serve kiosks used in the last 6 months
A wide range of encounters with self-serve kiosks in different service sectors were documented by participants (See Table 3). The most commonly encountered self-serve kiosks were located in retail (245 participants) or banking/financial institutions (255 participants).
Reasons for not using self-serve kiosk technology
Reasons for not using self-serve kiosk technology
A total of 163 (26.94%) of participants identified as basic or low-users of technology, 128 (21.16%) identified as intermediate users of technology, 169 (27.93%) identified as proficient users, and 145 (23.97%) identified as advanced users of technology. Participants reported a variety of reasons for not using self-serve kiosks, with most citing they prefer in-person assistance instead (26.37%), find the technology difficult to use (17.25%), and have unmet disability needs (12.94%) (see Table 4).
A total of 601 participants responded that the frequency with which they required human assistance when using a self-serve kiosk was “always” (332 participants, 55.24%), “sometimes” (196 participants, 32.61%), “rarely” (49 participants, 8,15%), and “never” (24 participants, 3.99%).
Confidence in using new technology
In terms of confidence, Table 5 outlines how confident participants reported they felt in using new technology. Of the 482 participants who responded. 78 participants, or 16.18%, indicated a confidence level of 7. This was the median and also the most common response.
Anxiety using new technology
A total of 488 participants responded to the question about anxiety and using new technology; responses to this question are outlined in Table 6. The most common response, which was also the median, was that people experienced at least a 5 out of 10 on the anxiety scale (93 participants, 19.06%), with 0 representing not at all anxious and 10 representing experiencing anxiety all of the time.
Only 285 people answered the question about the level of difficulty in using self-serve kiosks, with 1 equating to not at all difficult and 5 meaning extremely difficult. The median response to the level of difficulty using self-serve kiosks was 3 out of 5. The table below summarizes the results of this question.
Level of difficulty using self-serve technology
Reasons for task incompletion
Ninety-nine participants (34.14%) responded that they were able to complete their desired task using self-serve technology, while 186 (64.14%) indicated they were unable to do so. Various reasons were given for why participants were unable to complete their tasks (see Table 8). Though frequencies were calculated for participant responses, percentages of participant responses could not be calculated because participants were only asked to select which reasons applied to them so we do not know the total number of respondents for this question. Most commonly, participants reported poor colour contrast and font size (109 participants), lack of audio instructions and screen reading capabilities (104), and human assistance not being available or helpful (92) as the primary reasons for task incompletion.
Interestingly, human assistance was reported to have been requested “always” by 119 (41.03%) participants, compared with 138 (47.59%) of participants needing human assistance “sometimes”, 30 participants (10.34%) selecting “rarely”, and 4 participants (1.03%) “never” requesting human assistance. As outlined in Table 8, however, human assistance was not always available or helpful.
Features to address needs with self-serve kiosks
Features to address needs with self-serve kiosks
A number of accessibility features were identified as addressing participants’ needs with using self-serve kiosks and are listed in Table 9. Of note, the most commonly reported desired accessibility features were audio and audible instructions (431 participants), clear and easy to follow instructions and menus (344 participants), enlarged information on screen and enlarged fonts (304 participants), multiple mechanisms to request human assistance (303 participants), and feedback and cues on important actions and error correction (296 participants).
Participants reported a number of features as being important in the development and implementation of self-serve kiosks. The accessibility features identified as being most important (rating of 5 out of 5) by the majority of participants were, in order of preference: protection of personal information, security and privacy (403 participants, 84.49%), seeking input from clients with all disabilities at the decision-making stage prior to purchase or implementation of the technology (295 participants, 62.37%), ability to increase or decrease the font size (288 participants, 60.50%), braille, large print and easy to read instructions (258 participants, 54.43%), automatic audio speech output for screens & touchscreens (259 participants, 54.41%), extra time to process instructions and complete tasks (250 participants, 52.19%), immediate in-person guidance from company regardless of disability (244 participants, 51.59%), tactile keyboards or features to help orientation and important buttons (238 participants, 50.21%).
The majority of participants (65.7%) reported they did not enjoy using self-serve kiosks, and 61% reported they would not continue to use self-serve kiosks in the future.
Data comparisons
Income and ability to use technology
Groups with higher income generally rated their ability to use technology significantly higher than the groups with lower income. The Kruskal-Wallis test revealed that there was a statistically significant difference in ability to use technology scores in at least two of the income groups, chi2 with ties (6)
Income and confidence with new technology
The Kruskal-Wallis test was used to reveal that there was no statistically significant difference in confidence using new technology between income groups, chi2 with ties (6)
Education and ability to use technology
Groups with higher levels of education rated their ability to use technology significantly higher than the groups with lower levels of education. The Kruskal-Wallis test revealed that there was a statistically significant difference in ability to use technology scores in at least two of the education groups, chi2 with ties (6)
Education and confidence with new technology
Overall, higher education is associated with an increased confidence among participants with new technology. The Kruskal-Wallis test revealed that there was a statistically significant difference in at least two of the education groups, chi2 with ties (6)
Gender identity and ability to use technology
Participants identifying as gender nonbinary or non-conforming reported significantly higher ability to use technology when compared with males and females. The Kruskal-Wallis test revealed that there was a statistically significant difference in at least two of the gender identity groups, chi2 with ties (3)
Gender identity and confidence with new technology
The Kruskal-Wallis test showed that there was no statistically significant difference in any of the gender identity groups for confidence with new technology, chi2 with ties (3)
Discussion
There was a wide distribution of participant responses related to comfort with using technology, confidence in using technology, and anxiety with using technology. Most participants reported having at least a college education and a moderate amount of anxiety using self-serve kiosks. The majority of participants reported they were unable to complete their task using self-serve technology for a variety of reasons such as poor colour contrast and font size, lack of audio instructions and screen reading capabilities, and human assistance not being available or helpful. Furthermore, most of the participants reported they needed human assistance at least sometimes, yet also noted human assistance was often inadequate or unavailable.
There was a wide range of encounters with self-serve kiosks in different service sectors documented by participants. The most commonly encountered self-serve kiosks were located in retail and banking/financial institutions. The majority of participants reported they did not enjoy using self-serve kiosks and most participants reported they would not continue to use self-serve kiosks in the future. The findings from this research are consistent with the existent literature that suggests that income and a person’s perceived ability to use technology are correlated [19], and that level of education can impact the adoption of technology [20]. Participants with lower incomes and less education generally reported a statistically significant reduced ability to use self-serve kiosks. Participants with less education also reported less confidence with self-serve kiosks.
Participants identified several helpful accessibility features to address their needs with using self-serve kiosks. Of note, the most commonly reported accessibility features that participants desired were audible instructions, clear and easy to follow instructions and menus, enlarged information on screen and enlarge fonts, and multiple mechanisms to request human assistance. Protection of personal information, security and privacy, and seeking input from clients with all disabilities at the decision-making stage prior to purchase or implementation of the technology were the two most commonly reported user needs by participants.
Given the lack of literature regarding self-serve technology as a whole, we examined how the findings from this paper relate to the Unified Theory of Acceptance and Use of Technology (UTAUT) [17] and Social Model of Disability [18]. Our survey found that participants who are blind, partially sighted, or Deafblind did not want to continue self-serve kiosks in the future. Effort expectancy, or the degree of ease associated with use of the technology, could be seen as being related to enjoyment using self-serve kiosks; this population generally reported that they did not enjoy using them and did not want to continue to use them. Effort expectancy also relates to the number of reports by participants indicating they required at least some human assistance while using self-serve technology, as well as often not being able to complete their designated task. Although we did not directly survey participants on social influence, or the degree to which a person perceives that others believe they should use the new technology, it can be argued that as the trend of automation continues, it is likely that self-serve technology will become more prevalent and used by others. Facilitating conditions are defined as the degree to which a person believes that the infrastructure and support exists to use the technology. These conditions can be compared to the significant accessibility issues participants had using self-serve kiosks. Lastly, social moderators, such as income and education, were found to have an impact on participants’ confidence and ability to use technology.
The Social Model of Disability [18] proposes that blind, partially-sighted and Deafblind people are limited by disabling environments. Unfortunately, self-serve technology as it currently stands, is yet another environmental barrier that can restrict community participation for many people who are blind and partially sighted. There is a need to address the accessibility concerns highlighted by this population.
Limitations
Participants were recruited via an email circulated through CNIB; they completed a single online survey. As a result, the population of participants from this study is potentially subject to selection bias. For example, the participants in this study all had an email address with which they received the survey, meaning that they likely have at least some confidence or ability to use technology. In addition, as this was an exploratory study with a purposive convenience sample, no power calculation was completed a priori. Although we achieved our goal of obtaining a sample size of at least 500 people, this sample is not necessarily representative of the 7.4% of Canadians who are blind or partially sighted. There was missing data with several questions, as participants had the option of skipping questions they did not wish to answer. As with any survey, all data was self-reported. The survey did not actually define the concept of a self-serve kiosk at the beginning of the survey and instead relied on participants having an understanding of what this entails; the multiple examples of self-serve technology that participants were asked about were provided closer to the end of the survey. This may have impacted participants’ responses to the survey questions. Finally, this study only analyzed a portion of the circulated survey; further analysis of the complete dataset and a complete gender analysis would be helpful.
Recommendations
There are significant barriers to using self-serve kiosk technology for people who are blind and partially sighted. The results of this study suggest that the following findings should be considered in order to promote inclusion and accessibility:
There should be adequate policy in place to guide self-serve technology training for users with disabilities and training to promote understanding of how disability can impact its use for agencies designing and employing this technology. Currently, Accessibility Standards Canada CSA/ASC B651.2 has updated their policies to include accessible design for self-serve interactive devices. However, this policy does not include training and instead focuses more on the overall physical design of the technology. Training for users may be particularly important for those who have lower levels of income, education, comfort with technology, and confidence with technology. Incorporate a diverse group of people who are blind or partially sighted in the development of training for service providers and service users. This collaborative approach is critical to ensure relevance of training on how to use this technology. One consideration to this point is who would conduct this training; people who are blind or partially sighted should be able to take on this role. More research is needed on what this training should entail, in what context it should be delivered, and who would be responsible. However, the results of this study suggest that the population of people who are blind or partially sighted should lead the development of this training through disability organizations. Agencies should have adequate numbers of staff on site to assist people with disabilities should they require assistance. This is particularly important in circumstances wherein there is a lack of privacy and when there are no other options but self-serve kiosk. In addition, in-person interactions with staff serve functions in addition to its original purpose. For example, there are social functions related to its use; it is not just a matter of efficiency of the product. This is yet another reason for human assistance to be offered. If self-serve kiosks have audio output, concern for privacy is important. This becomes a multi-layered issue when the user is dependent on others for assistance; those in need of help should not have to give up their privacy in return for assistance. The results from this study suggest that Bluetooth technology, options to integrate personal technology such as a tablet, and headphone jacks are some ways to protect personal privacy. The process of development and integration of self-serve technology is important to consider; people with disabilities should be consulted in advance of its implementation.
Overall, self-serve technology is not accessible to many people who are blind or partially sighted. There is a need to ensure that people who are blind, partially sighted, and Deafblind, are consulted in the development and implementation of self-serve kiosks in different settings in order to develop best practice guidelines for accessibility. Until then, organizations and vendors utilizing self-serve kiosks should have alternative means for people to complete their tasks. Future research could examine the accessibility of other ICT technological platforms commonly used in everyday life to develop best practice guidelines and remove barriers; longitudinal studies to track impact of changes over time would also be helpful.
Footnotes
Conflict of interest
The authors listed above declare that the results of this study are presented honestly, without conflict of interest or data manipulation.
Ethics approval
This survey study was reviewed and approved by two university/hospital based ethics review boards. Upon completion of the longer survey, participants were asked if they would like to be included for a draw of one of three $100 Amazon gift cards.
Appendix A: English survey instrument and consent form
Survey Instrument and Consent Form.
Accessibility and Usability of Self-Serve Kiosks for Canadians with Sensory Disabilities.
Research Team and Project Overview
