Accessibility is increasingly framed as a rights and justice issue, yet many organizations still treat it as compliance rather than learning. This study examines how accessibility professionals conceptualize and operationalize accessibility across organizational contexts. Drawing on semi-structured interviews (n = 14) and one dyadic group discussion (n = 2), analyzed through reflexive thematic analysis, we identify four themes: empathy as organizational competence; policy, governance, and change management; technology, digital transformation, and collaboration; and capacity building for inclusive education and workplaces. The findings show that accessibility is operationalized not solely through technical standards but also through organizational learning, shared responsibility, and role-specific competence development. We contribute an empirically grounded, cross-sector account of how accessibility is translated from strategy into everyday practice, while delimiting the study to professional perspectives rather than compliance outcomes.

This study describes the development of a three-step method called Participatory Research through Design using a co-design and dialogue approach to enhance cognitive accessibility in eHealth services in public healthcare. The method is a combination of Participatory Design, Participatory Action Research and Research through Design (RtD). Together with participants with lived experiences of cognitive impairments we explored the existing personal eHealth services with Participatory Cognitive Barrier Walkthrough and co-designed a prototype for enhanced cognitive accessibility. We used an explorative study design constructing the prototype that presents the preferred state, where the participants’ contributions are embedded in the design (e.g., visualization of high-cost protection for healthcare, notifications, read aloud functionality, and photos of drugs). The ownership of the targeted eHealth services was outside the research project, and the co-designed prototype was used as a dialogue tool with stakeholders from the product owner perspective. We propose that our Participatory RtD approach enhances understanding of end-user perspectives in a given context and promote dialogue around complex eHealth services.

In a rapidly transforming technological landscape, higher education institutions struggle to meet the demands of industry in providing timely and appropriate upskilling and reskilling opportunities for the workforce. Under the umbrella of “advanced digitalisation”, a term prominent in European discourse, covering a wide range of new digital technologies within the Industry 4.0 and Industry 5.0 paradigms in manufacturing, ICT and engineering, we use scoping review methods to explore the unique challenges and interventions in this area, highlighting potentials for further research. Our scoping review examines 81 peer reviewed Scopus-indexed papers, outlining the current global research on the challenges and interventions in upskilling the workforce for advanced digitalisation. Our results show that research in this area is most prevalent in Europe, North America, and Asia and is most frequently done within the manufacturing and ICT sectors. Due to the fast pace of advanced digitalisation, close collaboration between education providers and industry is required to develop relevant and appropriate upskilling opportunities. We underline the importance of developing strategic management and change management knowledge alongside technology skills. We also highlight the importance of inter- and trans- disciplinary knowledge development. While determining skill needs has attracted substantial research focus, businesses may struggle with developing strategic upskilling plans despite being aware of their skills needs. We conclude that interventions that foster situated engagement and hands-on experience are vital for the future of upskilling.

The aim of this study was to describe prerequisites for online collaboration for user participation in co-design of online digital services as perceived by people with impairments and to develop requirements for how online collaboration should be designed to be accessible for all participants. An exploratory study was conducted in parallel to activities in two co-design projects. Researchers, accessibility experts, designers and 31 members of disability organisations participated. All participants had lived experience of impairments. Data was co-analysed by all participants using a qualitative thematic analysis with an inductive approach. Sixty-three requirements for accessible online collaboration were identified pertaining to four themes: digital tools and accessibility; preparation of an online collaboration activity; performing and participating in an online collaboration activity; and documenting and evaluating an online collaboration activity. Conclusion: the co-design process can be strengthened by transition to online collaboration, owing to the possibility of having more frequent interaction, economising the participants’ energy and the design process being more transparent. Using accessible online tools, careful planning, and meeting preparation, and establishing a trustful and convivial atmosphere during each activity, are the cornerstones for accessible online collaboration. People with impairment can participate in online collaboration if the activities meet accessibility requirements.

Conversational agents are increasingly being introduced in healthcare to enhance access to healthcare and address limited healthcare resources. The aim of this study was to explore experiences of a conversational agent for symptom checking and triage tool assessing the urgency and appropriate level of care implemented in public healthcare from a cognitive accessibility perspective.With a Participatory Action Research approach this study includes: 1) A Participatory Cognitive Barrier Walkthrough in workshops with people with cognitive impairment (n=7), product owner representatives (n=4), and researchers (n=5), followed by a workshop for improvement suggestions; 2) A paired interview with healthcare system specialists (n=2).The data from the study was analysed using reflexive thematic analysis, resulting in five themes: ‘The design of the eHealth service created expectations that were not met during interaction; ‘The eHealth service uses a difficult language’; ‘The eHealth service trigger negative emotions and reactions’; ‘The layout and graphic design of the eHealth service is difficult and sometimes misleading’; and ‘The eHealth service lack in trustworthiness’. The findings show the importance of including people with lived experience of cognitive impairment, to expose and find solutions for cognitive accessibility issues

Background: The adoption of eHealth accelerated during the COVID-19 pandemic. Inequalities in the adoption of eHealth during the COVID-19 pandemic have been reported, but there are few such studies among people with impairment. Objectives: This study aimed to investigate self-reported use and difficulty in the use of eHealth before the COVID-19 pandemic compared to during late social distancing restrictions in Sweden, among people with and without impairment, as well as between different types of impairment. Methods: A cross-sectional survey was distributed twice by snowball sampling to people with self-reported impairment and a general population matched by age, gender, and county. Use and difficulty in the use of six eHealth services were compared between groups using chi-square test and logistic regression with year interaction terms, reported as odds ratio adjusted (aOR) for gender and age with 95% CI. Results: The surveys included 1631 (in 2019) and 1410 (in 2021) participants with impairment, and 1084 (in 2019) and 1223 (in 2021) participants without. Participants with impairment, compared to those without impairment, reported less use and more difficulty in booking health care appointments online, digital identification, and the Swedish national web portal for health information and eHealth services (1177.se), both before and during the pandemic (P = .003 or lower). Video health care appointments were the exception to this disability digital divide in eHealth as video appointment adoption was the most likely among participants with attention, executive, and memory impairments (interaction term aOR 2.10, 95% CI 1.30‐3.39). Nonuse and difficulty in the use of eHealth were consistently associated with language impairments and intellectual impairments. For example, language impairments were inversely associated with use of the logged-in eHealth services in 1177.se in 2021 (aOR 0.49, 95% CI 0.36‐0.67) and were associated with difficulty in the use of 1177.se in 2019 (aOR 2.24, 95% CI 1.50‐3.36) and the logged-in eHealth services in 1177.se in 2021 (aOR 1.89, 95% CI 1.32‐2.70). Intellectual impairments were inversely associated with the use of the logged-in eHealth services in 1177.se in 2021 (aOR 0.19, 95% CI 0.13‐0.27). Conclusions: This repeated cross-sectional survey study, including participants with diverse types of impairment and a control group without impairment, reveals persisting disability digital divides, despite an accelerated adoption of eHealth across the pandemic. eHealth services were not accessible to some groups of people who were identified as being at risk of severe disease during the COVID-19 pandemic. This implies that all people could not use eHealth as a measure of infection protection.

Lifelong learning in higher education (HE), epitomised by Massive Open Online Courses (MOOCs), is valuable for re-skilling and upskilling Sweden's industry workforce in (advanced) digital competencies to remain globally innovative and competitive. Meanwhile, Sweden's non-regulatory approach towards MOOC deployment in HE meant that their accreditation by universities faces strenuous systemic challenges. However, since 2019, one university began accrediting an AI mass-market MOOC following a nationally unique system-divergent innovation, which this case study unpacks by responding to three research questions. First, what were the underlying processes of this system-divergent innovation, and how and why did it occur? Second, what were its key success factors? Furthermore, how sustainable is it? This reflexive case study draws on eight semi-structured interviews with university staff and faculty, which were deductively analysed based on topical literature and concepts from system-divergent innovation and structuration theory. Generated themes were called challenges-as-opportunities and spanned bureaucracy, finances, technological infrastructures, deroutinisation, internal conflicts and external pressure. These themes and their discussion inform policy on three tiers: governmental, sectoral, and institutional. This original work highlights that mmMOOCs' accreditation by universities can play a significant role in bridging lifelong learning and HE in Sweden, and calls for digital maturity and national contagion.

The Web Accessibility Directive (WAD) is part of the European Union’s work for digital inclusion. The WAD obligates that public sector bodies’ websites meet accessibility standards and provide an accessibility statement on the website informing about inaccessible content, and a feedback mechanism for reporting accessibility issues or requesting inaccessible content in an accessible format. The objective of this study was to evaluate how healthcare providers in Sweden have applied accessibility statements on their websites as regulated by law. A descriptive study using a mixed methods approach was conducted, by quantitative descriptive data analysis of the healthcare providers’ accessibility statements compliance to requirements and qualitative data analysis of the written information provided in the accessibility statement. All but one of the 37 evaluated healthcare providers published an accessibility statement. None of the healthcare providers fully met the requirements for accessibility statements, and no one complied with the intention of the law, i.e. to provide accessible health information and eHealth services. There was no or minor progress between the first and the latest published accessibility statement. The possibility to declare no or partial compliance with the law, or claim disproportionate burden, and the lack of enforcement procedures, risk producing symbolic actions e.g., publishing accessibility statements without intention to abide by the law. We suggest that the directives for accessibility statements should be advanced regarding comprehensiveness, understandability, and usefulness. It is suggested that the assessment protocol developed for this study may be used for future evaluations of accessibility statements.

Technology-enhanced learning (TEL) is a research field occupied with how teaching and human learning can be supported through the help of digital tools for increased efficiency, effectiveness, learnability, and pedagogical values by applying verified learning theories supported by analyses of the data generated by the students’ activities. Research in TEL is closely related to a social mandate that is becoming eminent in education nowadays: digitalizing education in an accessible, ethical and sustainable way. Most literature on TEL has focused on technological aspects, pedagogical approaches, ethical considerations or accessibility concerns in isolation, often within different research communities. Also, with generative AI's broad and unpredictable impact, these gaps could widen further. This commentary paper aims to bridge these gaps by offering an integrated perspective addressing all three aspects—technology, pedagogy, and accessibility—while examining intersections and implications from multiple viewpoints. From a historical perspective, various educational technologies have facilitated the scaling of different pedagogies and contributed to students' understanding by enhancing personalized learning, expanding visualization possibilities, and improving access to learning materials. While television and radio enabled remote learning, technological advancements in recent decades have significantly increased accessibility, such as radio and TV learning programs, to the emergence of e-learning platforms, adaptive learning systems, and artificial intelligence-driven educational tools. However, it is essential to acknowledge that, despite these advancements, technology-supported educational tools often remain more accessible to learners from developed countries or those with a high socio-economic background who can afford the costs and possess the necessary skills for effective use of these tools.

The pandemic meant great strides to use the opportunities of digitalization. Initially, the pandemic meant that many businesses became digital. Meetings were conducted using digital tools, and teaching was diverted to synchronous or asynchronous lectures and lessons through digital forums. Many experienced the transition from the physical to the digital workplace beyond all expectations. Over time, people came to talk about it as the “new normal". After the pandemic, one could see an increasing return to the workplace, discussing how it will take place and what they learned during the 18-month lock-down that the pandemic entailed. Many workplaces continue fully or partially to work from home, while others take the opportunity to discuss what worked well and should be kept and what aspects of the physical workplace that the digital transformation did not manage to recreate that should be regained. Few organizations believe they will return to exactly how things were before the pandemic. Still, the future includes solutions where people will be more or less in both physical and digital spaces. Hybrid meetings and teaching will be the “new new normal”. In connection with the return to the physical workplace, we see increased problems with hybrid meetings and teaching, achieving equal participation and difficulties creating creative learning situations for everyone. There is little knowledge about good and bad hybrid meetings and teaching, but there is a need to increase understanding about what constitutes good hybrid meetings and teaching forms. This includes what technical tools are available and how these can be used, what pedagogical methods and tools can be used to do this effectively with quality, and what leadership methods are required to implement this in a good way. The purpose has been to explore technical, pedagogical and leadership conditions for implementing hybrid meetings and teaching opportunities. We used several different research methods; literature studies with the aim of mapping the current state of knowledge in the area, study visits and field studies with the aim of meeting and interviewing various representatives from the operation and to observe how the operation is conducted in practice, and action research discussing and co-creating with the problem owners tools intended to benefit the entire organization. The case of the project is “folkbildning”, liberal adult education with the purpose of democratically and equally enabling citizens in society to absorb new knowledge and values ​​through, for example, study circles, libraries, conferences, and lectures outside the traditional school world. Folkbildning is characterized by committed teachers who have a holistic perspective on the participants and the ability to capture people who, for some reason, do not participate in the formal education system through a lower degree of formality. Folkbildning, in relation to the overall education system, has played the role of a pioneer and experimental workshop in exceptionally difficult areas when it comes to the questions of who, what, and how. The narrow framework for who could be educated has been broken and has contributed to increasing equality in participation from the perspective of class, gender, region, and generation. Based on the results of the project, we have developed guidelines on pedagogics, leadership, and technology that can be used to run your digital or hybrid meetings and education.