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Raised-bar guidance surfaces (GSs) are used internationally to help wayfinding by vision-disabled pedestrians, but they are little used in the United States. However, difficulties experienced by vision-disabled pedestrians in locating crosswalks and aligning to cross have been documented, and the installation of GSs with bars perpendicular to the crossing direction has been shown to improve locating the crosswalk and aligning to cross at noncorner crossings. The present research investigated the effect, for a total of 68 participants, of a raised-bar GS on locating crosswalks and aligning to cross at (primarily) corner crossings in three cities. Using 2- × 2-ft raised-bar GSs with bars oriented perpendicular to the crossing direction at corner crossings, and a 2-ft wide strip of GSs extending across the sidewalk at noncorner crossings, significant improvements in the accuracy of crossing starting position and alignment were observed. Accuracy in locating the crosswalk was quite good at corner crossings, and was not improved by the GS. Installation of a raised-bar GS with bars perpendicular to the crossing direction is recommended to help vision-disabled pedestrians align for crossing. At corner crossings, a 2- × 2-ft GS located beside the detectable warning surface at the bottom of curb ramps, on the side farthest from the intersection, is recommended. At noncorner crossings, a 2-ft wide strip of GS extending all the way across the sidewalk, with the bars oriented perpendicular to the crossing direction, is recommended.

To travel independently, pedestrians with visual impairments must be able to locate crosswalks and align accurately for crossing streets. This action is especially challenging where crossings are not located at street corners and cues for locating the crosswalk and aligning to cross in the direction of travel on the crosswalk may be inadequate. This research compared midblock and roundabout crossings with curb ramps and detectable warnings but no other consistent cues for locating the crosswalk and no cues specifically intended to provide alignment and heading information, with the same crossings with the addition of a 24-in.-wide prototype surface of raised bars oriented perpendicular to the direction of travel on the crosswalks. This treatment was installed beside the detectable warnings and extended across the sidewalk. It was hypothesized that this surface would assist with both locating the crosswalk and establishing accurate alignment with the crosswalk. Sixteen participants having little or no vision failed, on average, to locate the crosswalk on the initial approach on 2.4% of their attempts for crosswalks having the guidance surface, while without the guidance surface, participants failed to locate the crosswalk on the initial approach on an average of 17.9% of their crossing attempts. With the guidance surface, participants aligned correctly on average on 77.3% of their trials, while without the surface the rate of correct alignment was 52.1%.

Research has demonstrated that accessible pedestrian signals (APS) with push button-integrated speakers increase push-button use and increase the likelihood of starting to cross during the walk interval by pedestrians who are blind. However, consistently positive effects on locating the crosswalk or establishing or maintaining an accurate heading for crossing have not been found. Attempts have recently been made to configure APS to provide better audible information for these wayfinding tasks. A configuration that has been shown to improve heading accuracy provides audible tones from a speaker at the destination corner before the walk interval (to assist with establishing heading) and during the flashing "Don't Walk" interval (to assist with maintaining heading). Major concerns are that beaconing information may be ambiguous or misleading and result in dangerous crossing behavior at intersections where buildings create echoes of audible signal information and where beacons for multiple crosswalks might be...

This research extends the results of laboratory research on wayfinding at intersections for pedestrians who are blind. Standard accessible pedestrian signals (standard APS), a prototype beaconing APS, and a raised guide strip were evaluated for their ability to assist in establishing and maintaining a heading for street crossings. Experiments were conducted at large, complex signalized intersections in Alpharetta, Georgia; Austin, Texas; and Towson, Maryland. Both the guide strip and the beaconing APS resulted in more accurate street crossing performance than standard APS with respect to alignment (i.e., initial heading) accuracy, rates of being within the crosswalk, distance from the center of the crosswalk at various points during crossing, and the likelihood of being well outside the crosswalk [6 ft (2 m) or more]. For the most part, performance with the guide strip or the beaconing APS was equivalent. Limitations and additional concerns with respect to these two treatments are discussed.

The use of telemedicine brings about change in health-care organizations and opens up new possibilities for service delivery. The organizational environment is often crucial in determining whether or not telemedicine applications will be successful. To examine the concept of 'organizational readiness for telemedicine' as a factor to explain why telemedicine initiatives succeed or fail, the results were used of interviews with key informants, conducted in two studies: the Alliance for Building Capacity project and the National Initiative for Telehealth guidelines project. The data indicate that organizational readiness for telemedicine is a multifaceted concept that is related to planning and the workplace environment. A greater understanding of the factors within organizational readiness could help to avoid costly implementation errors. 'Readiness' needs to be systematically assessed and is important for long-term success.