How to Test Accessibility in HealthTech Apps

Automated testing tools

Automated accessibility testing tools are software applications designed to automatically evaluate websites, web applications, and digital content for accessibility issues based on established accessibility guidelines and standards. These tools help identify potential barriers that could hinder people with disabilities from effectively using and navigating digital content. Automated accessibility testing tools are particularly useful for quickly identifying common accessibility issues, but they are not a substitute for manual testing and user testing with individuals with disabilities. Some examples of popular automated accessibility testing tools are DubBot, Wave, Axe, etc.

While automated accessibility tools are helpful for spotting common issues, they may miss some, especially those tied to user interactions, context, and subjective user experiences. For a thorough accessibility assessment, it’s recommended to blend automated, manual, and user testing involving individuals with disabilities. Manual testing and human judgment are crucial for interpreting and addressing complex accessibility challenges.

Testing using keyboard navigation

When testing accessibility using only a keyboard, these are some of the common steps you should follow:

• The first step in manual testing is to throw away your mouse. Try navigating the page, including all menus and interactive elements, using only the keyboard.

• Use the TAB, ENTER, SPACE, and UP and DOWN ARROW keys for navigation.

• TAB through the page to see if it’s in the logical order. See if you can activate all interactive elements using the ENTER or SPACE keys.

• Pay attention to features like videos, audio files, calendars, Flash content, and photo carousels.

Testing using screen readers

Accessibility testing using screen readers is crucial for assessing website and app accessibility for visually impaired individuals. Screen readers are software applications that convert digital content into synthesized speech or output it as Braille, enabling blind or visually impaired users to access and interact with digital content. When conducting screen reader tests, follow keyboard navigation steps and listen to how the screen reader interprets the page.

Testing parsing errors

Parsing involves writing clean code for HTML, CSS, or JavaScript in a way that browsers and assistive technologies can easily understand. This baseline test requires error-free element and attribute syntax, as well as properly nested start and end tags, to avoid errors that could prevent user agents from parsing the content reliably. If the content cannot form a data structure, different user agents, including assistive technologies, may interpret it differently or even fail to parse it altogether.

Some of the important components to check:

• Elements have complete start and end tags: ensure that your HTML includes both start () and end tags () wherever necessary. Missing end tags can cause semantic information from one element to spill over to the next, affecting assistive technology users who rely on semantic information for browsing.

• Elements are properly nested: HTML has strict standards for element nesting. Avoid placing a div tag inside a span or a li tag inside a div without the appropriate ul or ol tags. While some of these bugs may become apparent during automation testing and HTML validation, it’s best practice to prevent them to ensure a smooth experience across all assistive technologies.

• Avoid duplicate attributes: duplicate attributes, such as providing the same attribute multiple times to a single element (e.g., using alt text twice for an img tag or applying a title attribute twice to a form control), can lead to HTML validation failures. While they may not always directly impact assistive technologies, it’s important to maintain valid HTML.

• Ensure unique IDs: developers should confirm that every element on a page has a unique ID. Reusing the same ID for multiple elements can lead to automation failures and affect assistive technologies. Duplicate IDs can disrupt the retrieval of information associated with the first occurrence of ID. Once the duplicate ID is provided, assistive technologies will not provide correct information even if other WAI-ARIA attributes are correct. For example, if both ‘First name’ and ‘Last name’ fields share the same ID ‘username’ screen, readers may read both as ‘First name’ after the association is established. Automation tools can help identify duplicate IDs.

Optimizing mobile app accessibility through screen reader testing

When it comes to ensuring the usability and inclusivity of websites and applications, accessibility testing using screen readers is a crucial part, particularly for individuals with visual impairments. Screen readers are specialized software applications that convert digital content into synthesized speech or Braille, making it possible for blind or visually impaired users to access and interact with digital content effectively.

How to conduct accessibility testing using a screen reader

• Installation and setup

• Begin by installing and configuring your chosen screen reader on your testing device.

• Familiarize yourself with screen reader commands

• Take the time to familiarize yourself with the commands used to control the screen reader.

• Navigating through content

• Pay close attention to how the screen reader announces headings, landmarks, and other structural elements. Ensure that the hierarchy and structure of the content are accurately conveyed.

• Evaluating alternative text

• Listen to how the screen readers read alternative text (alt text) for images. Confirm that images have descriptive alt text that effectively communicates their meaning to users who rely on this information and cannot see them.

• Testing interactive elements

• Interact with buttons, links, form fields, and other interactive elements using the screen reader. Verify that these elements provide clear auditory cues regarding their purpose and functionality.

• Testing forms and error messages

• Fill out forms and observe how the screen reader announces form fields, labels, and validation errors. Ensure that users are provided with clear and accurate instructions.

• Evaluating dynamic content

• Test dynamic content like dropdown menus, accordions, and modals to ensure that the screen reader accurately conveys changes in content or state.

• Verifying multimedia content

• Test multimedia content, such as videos and audio players, to confirm that captions, transcripts, and other alternatives are available to users with disabilities.

• Noting interaction feedback

• Pay attention to how the screen reader provides feedback for user interactions. Verify that users receive sufficient information about their actions and the resulting changes.

• Documenting issues

• Take notes of any accessibility issues you encounter while using the screen reader. These notes will be helpful when communicating these issues to developers for remediation.

  Remember that proficiency in conducting accessibility testing with a screen reader may require some practice. Additionally, consider involving individuals with visual impairments in your testing process to gain valuable insights into their user experience, helping you identify issues that might not be apparent to someone who does not regularly use a screen reader.

Ensuring color accessibility for a better user experience

When it comes to color usage, the recommended contrast ratio is 4.5:1 and above. Proper contrast ensures readability, making content accessible to a wider audience. For example, using dark grey text on a black background can be challenging to read, while white text on a black background provides a high-contrast solution.

The readability of text is also influenced by font size and weight. While certain contrasts may work well with larger text, they can become difficult to decipher with smaller or thinner fonts.

Color choices become especially critical when conveying information. It’s important to note that individuals with color blindness may face challenges in distinguishing between similar shades, such as green and red. To address this, consider supplementing color cues with additional elements, such as icons, to signify different states or messages, such as success or failure.

To stay informed about important considerations, you might find resources like the “Colorblind Accessibility Manifesto” valuable. By being mindful of color contrast, text readability, and the specific needs of users with color blindness, you can significantly improve the accessibility of your content, resulting in a better user experience for all.