One of the most powerful findings of the study was that the accessibility changes—such as clearer visuals, simplified navigation, and larger buttons—did not only help participants with fine-motor impairments. These improvements also made the app easier to use for non-disabled users, demonstrating the broader value of inclusive design. This principle, often called universal design, shows that when technology is built with marginalized users in mind, everyone benefits.

Accessibility Enhances Usability for All

The study underscored that participants contributed insights that developers would not have identified on their own. For example, feedback about button size and hand positioning reflected the lived experience of navigating technology with fine-motor impairments. By incorporating this input, the researchers were able to redesign the app in ways that meaningfully improved usability. Disabled people are not just test subjects but essential co-creators of knowledge and design.

Arizona State University

When accessibility features like larger buttons, adjustable fonts, and high-contrast visuals were added, participants’ ability to use the app improved dramatically. Tasks that were once frustrating became manageable and empowering, tasks that could be completed independently. These changes highlight that accessibility isn’t one-size-fits-all—it requires flexibility. It affirms disabled users’ agency by allowing them to shape technology to fit their bodies, rather than forcing their bodies to fit rigid design norms.

Customization is Key to Inclusion 

Shew emphasizes that disabled people are often skilled innovators, developing creative adaptations and practices to navigate inaccessible environments. These lived forms of expertise rarely get acknowledged in AI and tech spaces, which tend to view disability only as a problem to be solved. By overlooking disabled ingenuity, the tech industry misses valuable insights that could lead to more inclusive and imaginative designs.

Disability as Innovation

Justice requires moving from “research on” to “research with” disabled communities. The article emphasizes participatory and community-based approaches, where disabled people are co-creators of research questions, design, and application. This shift redistributes power and ensures that studies are more relevant to disabled people’s lived experiences. It also aligns with disability studies’ emphasis on centering disabled voices as experts in their own lives.

The Need for Participatory Research Models

Zhou, L., Saptono, A., Setiawan, I. M. A., & Parmanto, B. (2020). Making Self-Management Mobile Health Apps Accessible to People With Disabilities: Qualitative Single-Subject Study. JMIR mHealth and uHealth, 8(1), e15060. https://doi.org/10.2196/15060

Making Self-Management Mobile Health Apps Accessible to People with Disabilities: A Qualitative Single-Subject Study Reference

Disabled Users are Experts 

Shew highlights that AI and robotics are usually designed without meaningful input from disabled people, leading to tools that miss or even clash with their real needs. When disabled voices are excluded from decision-making, technologies often reproduce ableist assumptions about what counts as “helpful” or “normal.” Including disabled communities as co-creators could shift design priorities toward accessibility and justice rather than fixes.

Exclusion in Tech Design

The article examined how adults with cerebral palsy and spinal cord injuries used the self-management app iMHere 2.0, focusing on accessibility barriers related to fine-motor impairments. Through qualitative testing and interviews, researchers found that the original app design posed significant usability challenges, but introducing customizable features—such as adjustable font sizes, larger buttons, high-contrast displays, and edge-aligned controls—dramatically improved performance and satisfaction. The study underscores the importance of participatory, user-centered design in digital health, showing that accessibility is not a secondary feature but a critical element for equity and inclusion in mobile health technologies.

Making Self-Management Mobile Health Apps Accessible to People with Disabilities: A Qualitative Single-Subject Study 

The study makes clear that accessibility cannot be treated as an afterthought or patched onto an already finished product. True equity in digital health requires disabled people to be included in every stage of development, from early brainstorming to testing and evaluation. This shifts responsibility away from individuals struggling to adapt to inaccessible systems, and places it on developers and institutions to design inclusively from the start.

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