Oral Presentation Australian and New Zealand Stroke Organisation Conference 2026

Usability, feasibility, and preliminary efficacy of CommuniKey: A browser extension for web accessibility in post-stroke aphasia. (138899)

Sarah J Wallace 1 2 3 , Jennifer Lee 1 2 3 , Ryan Deslandes 1 2 3 , Phill Jamieson 1 2 3 , Kim Barron 1 2 3 , Savita Datta 1 2 3 , Pippa Evans 1 2 3 , David A Copland 1 2 3 , Leanne Togher 4 , Kirstine Shrubsole 1 2 3 , Annie Hill 5 6 , Janet Wiles 7 , Alexander Haslam 8 , Peter Worthy 2 3 7
  1. School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, QLD, Australia
  2. Queensland Aphasia Research Centre, The University of Queensland, Herston, Queensland, Australia
  3. Surgical, Treatment and Rehabilitation Service Education and Research Alliance, The University of Queensland and Metro North Hospital and Health Service, Herston, QLD, Australia
  4. School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
  5. Centre of Research Excellence in Aphasia Recovery and Rehabilitation, Melbourne, Australia
  6. Department of Speech Pathology, La Trobe University, Melbourne, VIC, Australia
  7. School of Electrical Engineering and Computer Science, The University of Queensland, Brisbane, Queensland, Australia
  8. School of Psychology, The University of Queensland, Brisbane, QLD, Australia

Background/Aims: People with post-stroke aphasia face significant barriers to digital access1, affecting self-management, health information-seeking, and social participation2. This study evaluates CommuniKey, a co-designed web accessibility browser extension, through a field trial and accessibility audit.

Methods: A two-phase mixed-methods design was used. Phase 1 was a two-week field trial with 16 participants with aphasia, assessing self-efficacy, digital health literacy, usability, and acceptability. Interaction data were collected via automated logs and feedback forms. Interviews and focus groups explored participants' experiences of use. Quantitative data were analysed descriptively and with paired-sample t-tests; qualitative data via Reflexive Thematic Analysis. Phase 2 was an independent accessibility audit of CommuniKey-rendered web pages against Web Content Accessibility Guideline criteria.

Results: All 16 field trial participants completed the study. Digital health literacy improved significantly post-trial (t(15)=2.38, p=.03); self-efficacy did not (t(15)=.51, p=.62). Usability was good (System Usability Scale mean=76.72, SD=14.16) and acceptability ratings (UTAUT-2) were highest for perceived ease of use (effort expectancy mean=6.27), infrastructure to support use (facilitating conditions mean=5.93), and intention for future use (behavioural intentions mean=5.69). Key qualitative findings included that participants valued the simple, customisable interface but felt constrained by desktop-only availability; confident independent use required one-on-one training; and engagement with CommuniKey generated a sense of digital agency and investment that extended beyond the trial. CommuniKey partially met WCAG 2.2 Level AA standards.

Conclusion: CommuniKey is a usable, feasible, and acceptable browser extension for people with post-stroke aphasia, with preliminary evidence of improved digital health literacy following use. Future priorities include mobile deployment.

  1. Menger F, Morris J, Salis C. Aphasia in an internet age: wider perspectives on digital inclusion. Aphasiology 2016;30:1–21. doi:10.1080/02687038.2015.1109050
  2. Menger F, Morris J, Salis C. The impact of aphasia on Internet and technology use. Disabil Rehabil 2020;42:2986–96. doi:10.1080/09638288.2019.1580320