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Beyond Accessible Aisles? Psychosocial Inclusivity of Shopping Experience: an ethnographic investigation

Purpose: Although the importance of non-physical inclusivity has been recognised in inclusive design, the current understanding of psychosocial aspects in inclusive design is currently limited, disjointed and unstructured. This study reports a study of supermarket shopping experience of older individuals, designed and conducted to explore the concept of psychosocial aspects in older individuals’ supermarket shopping experience by identifying any possible psychosocial components. Empirical investigation i.e. non-participant observation was conducted with eight participants aged 60 and over. The results from the observational investigation were analysed and validated via multiple coding steps and multiple coders. Findings suggest four major dimensions including ‘cognitive’, ‘emotional’, ‘social’, and ‘value’ factors. These four factors define and affect psychosocial inclusivity of older adults’ supermarket shopping experience. Each factor is further detailed with a series of sub-themes, and key aspects in regard to each dimension are highlighted.


Introduction
An ageing population with more active roles in society and significant disposable income, related to an increasingly vocal community of individuals with disabilities, have been leading to the growing visibility of social inequality, isolation, and need for inclusivity beyond physical accessibility (Hedvall, 2013;Nickpour et al., 2012;Gaver & Martin, 2000;Demirkan, 2007;Imrie & Hall, 2003;Demirbilek & Demirkan, 1998). Theses numerous social issues can be seen to impact the daily lives of individuals who often lack social support and contact and who may suffer from unemployment, low economic status and discrimination (Salles, 2013).
Inclusive design is an approach for addressing these issues to move towards greater equality and diversity (Da Silva, 2013;McCarron et al., 2013;Suzman & Beard, 2011;Stephanidis & Emiliani, 1999). The purpose of inclusive design as a design philosophy is to provide better life opportunities for as many people as possible via the design of accessible services, products, and environments (Fletcher, 2011;Coleman et al., 2007). British Standards Institute (2005) defined the concept of inclusive design as "the design of mainstream products and/or services that are accessible to, and usable by, as many people as reasonably possible ... without the need for special adaptation or specialised design.". This paper adopts the British Standards Institute (2005) definition as an operational definition of the term 'inclusive design'. However, there is an argument that the application of inclusive design as a holistic and positive approach has been rather limited although it is generally recognised as good practice (Persson et al., 2015). Further, it can be noted that complex global socio-cultural challenges and life-style changes are highlighting issues of design exclusion beyond those which are purely physical or access related. The wider world of design has moved beyond 'physical' and has witnessed the emergence of new metaphysical fields including emotional design (Norman, 2005), pleasurable design (Jordan, 2002) experience design (Hassenzahl et al., 2010;Pullman & Gross, 2004;Hekkert et al., 2003), human-centred design (Giacomin, 2014;Brown, 2009) and meaning-centred design (Giacomin, 2017;Verganti, 2013). However, inclusive design has remained largely focused on the more physical and tangible aspects of functionality, usability and accessibility (Steinfeld, 2013). These are referred to as 'physical aspects' in this paper.
The emphasis on physical aspects in the field of inclusive design is also reflected in the existing regulations and policies in developed countries. These mainly focus on barriers to physical access (barrier-free access) (Persson et al., 2015;ANSI, 1998) in relation to the development and provision of infrastructure and technologies (Lim & Nickpour, 2015). It is now often noted that additional exploration, evaluation and development are needed in order to achieve holistic and genuine inclusivity within our increasingly complex and diverse societies (Frye, 2013;Hedvall, 2013;Nickpour et al., 2012;Gaver & Martin, 2000;Demirkan, 2007;Imrie & Hall, 2003;Demirbilek & Demirkan, 1998). Considering inclusive design's origin, history and context, it is perhaps not surprising that nonphysical aspects in inclusive design are currently scarce, neither systematically explored in the existing literature (Lim & Nickpour, 2015), nor in applications of inclusive design (Steinfeld, 2013). In this study, therefore, these non-physical aspects of inclusivity including psychological and social aspects are referred to as 'psychosocial aspects'.
The 'psychosocial' is usually described as a context-dependent and multidisciplinary concept. The term 'psychosocial' is defined as "the close relation between psychological factors (emotion, behaviour, cognition) and the socio-cultural context" (Psychosocial Working Group, 2003). It has been used mostly in medical and psychiatry journals since the 1950s, and since the 1990s its usage has increased (Roseneil, 2014). Psychosocial issues have been widely studied in psychology, social sciences, and the humanities (Roseneil, 2014).
Existing literature on inclusive design focusses mainly on accessibility and physical aspects of experience, thus there appears to be an opportunity for integrating further research which addresses the psychological and social aspects of inclusion. Table 2 provides a core set of definitions of the term 'psychosocial' and the most commonly used term, which is 'psychosocial intervention', identified through a review of the relevant literature from fields, including psychology, sociology, healthcare, ergonomics, and design. Quality of life/ maximising function/ behaviour-oriented/ emotion-oriented/ cognition-oriented/ simulation-oriented "To produce some beneficial effect on psychological distress or emotional adjustment of patients" (Rodgers et al., 2005) Health care (Improving quality of life and care) Psychological destress/ emotional adjustment "being any intervention that focuses on psychological and/ or social factors rather than biological factors" (Ruddy & House, 2005) Mental health (Improving quality of care) Psychological/ social "Any programme that aims to improve the psychosocial well-being of people." (Psychosocial Working Group, 2003) Complex emergencies (Improving psychosocial well-being) Well-being "Studies employing intervention techniques designed to utilize cognitive, behavioural or social mechanisms of action" (Cooke et al., 2001) Psychogeriatric (Improving psychosocial intervention for care givers) Cognitive/ behavioural/ social/ mechanisms of action As an initial step, an operational definition of the expression "psychosocial inclusivity in design" was required. Following a review via the search keywords psychosocial, sociology, healthcare, and ergonomics, a set of definitions of psychosocial were assembled into a database which served as the basis for a thematic analysis. This resulted in an operational definition of 'psychosocial inclusivity' in design which was adopted for the purpose of the current study: "provision of equal opportunities for better quality of life to as many people as possible by considering psychological social factors" Having established an operational definition of psychosocial inclusivity which is appropriate for design applications, the remaining sections of the paper included empirical investigation performed in order to identify possible components which contribute to the psychosocial inclusivity construct. To achieve this purpose, two research questions were established: a) Do psychosocial aspects affect older individuals' supermarket shopping experience? b) What are the possible psychosocial components that need to be considered for better inclusivity in shopping?

Participant demographics
The two key beneficiaries of inclusive design are older population and individuals with disabilities (Hedvall, 2013;Nickpour et al., 2012;Gaver & Martin, 2000;Demirkan, 2007;Imrie & Hall, 2003;Demirbilek & Demirkan, 1998). In this paper, older individuals were selected as a key audience. The World Health Organization (WHO, 2007) defines 'older person' as an individual above "chronological age of 60 or 65". This is also the retirement age in most developed countries, e.g. 60 years for females and 65 years for males in the UK are state pensionable age (Mein et al., 2000). The United Nations (UN, 2007) refers to the older population as aged 60 and over. In this study, WHO terminology and definitions were adopted to refer to the target group i.e. 'older person/people' above 60 years of age, alongside similar terms such as 'older individuals', 'elderly people', 'senior citizens' and 'older adults'.

Activity and context
Inclusive design is applied in diverse contexts e.g. the design of transport systems; premises; built environment and facilities; education; products and goods; services (Casserley & Ormerod, 2003). Within the contexts, a practical implication for psychosocially inclusive design is often evaluated via 'Instrumental Activities of Daily Living' (IADL: housework; preparing meals; taking medication managing money; shopping for groceries or clothing; use of the telephone or other forms of communication; transportation within the community). IADL are essential activities for independent living (Spector et al., 1987), particularly by older individuals (Katz, 1983;Lawton & Brody, 1970).
Within IADL, it has been argued that shopping is the activity that is strongly affected by both physical and non-physical aspects including individuals' socioeconomic status ( Aylott & Mitchell, 1998). Shopping is also frequently related with other daily activities e.g. money management, personal transportation, and preparing meals (Spector et al., 1987) Furthermore, older individuals' supermarket shopping is considered as one of the most important contributors to choice of diet and independent lifestyle (Lang & Hooker, 2013;Thompson et al., 2011). Physical aspects of store environment e.g. parking access, the availability of food products in appropriate sizes, accessibility of products on the shelves, and queues at checkouts (Moschis et al., 2004;Hare, 2003;Hare et al., 2001;Goodwin & McElwee, 1999;Dychtwald, 1997;Moschis, 1992) have been discussed as significant issues that impact supermarket shopping experience of older individuals. While physical inclusivity issues are evident, combinations of health, psychological, and social factors such as social isolation, mental illness (Davies & Knutson, 1991), social interaction (Moschis et al., 2004;Leventhal, 1997), and entertainment (Tongren, 1988), the attitude of staffs also significant issues that affect the older individuals' supermarket shopping experience.
These have been suggested that supermarket shopping affects older individuals' physical, psychological and social well-being (Amarantos et al., 2001). These aspects of well-being are related to quality of life of human, which is defined by Felce and Perry (1995) as "a multi-faceted concept comprised of subjective evaluations of material, physical, emotional and social well-being". In this study therefore, supermarket shopping was chosen as the ethnographic context since it involves a rich mixture of not only physical but also psychosocial considerations.

Choosing method for the study
A Non-participant observation (fly-on-the-wall observation) (Robson and McCartan, 2016) which is the one of the human centred design tools (Giacomin, 2014) was selected as an empirical investigational method to identify any psychosocial aspects of the supermarket shopping experience which emerge in the real-world. Ishikawa et al. (2013) argued that supermarket shopping reflects both personal preference and correlates with the individuals' socio-economic circumstances. The three main marketing categories relative to best known UK supermarkets are presented in Table 2. The supermarket brands are presented based on their marketing distinction of high, middle, or low -cost supermarkets (Pechey & Monsivais, 2015), and their market share and number of stores are provided for reference (USDA Foreign Agricultural Service, 2016). Therefore, older individuals (n=8) who use the medium-cost supermarkets at least once in a fortnight were chosen as participants for the observational investigation. The participants are consisted of three males and five females. Prior to starting the investigation, a research ethics approval was sought and granted by the research Ethics Committee of Brunel University. The ethical and consent forms were provided at the beginning of the investigation.

Observational study protocol
Non-participant observational investigations were conducted to identify any psychosocial aspects by observing older individuals' real-time supermarket shopping experience. As a familiarisation stage, an initial interview was carried out for approximately 30 minutes at the beginning of each observation session at the participant's home. The actual observation session began from the participants' outward journey to the supermarkets. After completing the observation, a final interview of was conducted in each participant's home for approximately 30 to 60 minutes which sought further information and feedback.

Observational study data analysis
The data from the observations were analysed by two coders (one final year PhD researcher in design and one design researcher with over 15 years experience) using qualitative data analysis methods including the domain and taxonomic coding, process coding, and NVivo10 software. The analysis process followed the 'six phases of thematic analysis' (Braun & Clarke, 2006): familiarisation with the data; generating initial codes; searching for themes; reviewing themes; defining and naming themes; producing the report. The analysed data was reviewed by a design researcher with over 15 years experience. The '15-point checklist of criteria for good thematic analysis' (Braun and Clarke, 2006) was adopted for reviewing the final results of the data analysis.

Results
Findings from the observational investigation were categorised under four main groups which are 'Psychosocial aspects'; 'Physical aspects' (physical factors e.g. accessibility, usability, efficiency, etc.); 'Shopping' (supermarket-related factors e.g. store items, facilities and environments, surrounding facilities, etc.); 'General background' (individual's socio-demographic characteristics, physical condition, etc.). The results pertaining to the concept of psychosocial inclusivity, which is the 'Psychosocial aspects' category, and the discussion of the interpretations are presented below.

Psychosocial aspects
The psychosocial aspects category includes four main themes: Cognitive factors, Social factors, Emotional factors, and Value factors. The four main themes along with their associated subthemes are presented in Table 3. The themes, sub-themes and codes are ordered according to their frequency of occurrence which was extracted from the thematic coding database of the observational investigation.  (n=1) Happiness (n=12) Self-esteem Self-satisfaction (n=5) Self-confidence (n=3)

Cognitive factors
The 'Cognitive' factors theme consisted of two sub-themes which are 'Cognitive judgement' and 'self-awareness'. The 'Cognitive judgement' sub-theme in turn consisted of the codes of Preference (supermarket products and services; Life style, social, public related, etc.); Familiarity; Helpfulness (supermarket products and services). 'Self-awareness' sub-theme included Self-awareness of health and Self-awareness of age. The codes of each sub-theme were presented in the Table 3. Messick (1994) and Lazarus (1991) argues that the notion of 'Cognition' is a broad and over-arching concept among various areas of application. The general definition of the term cognition is "the mental action or process of acquiring knowledge and understanding through thought, experience, and the senses." (Oxford English Dictionary, 2017). On the other hand, Messick (1994) defined the term 'cognitive styles' as "characteristic modes of perceiving, remembering, thinking, problemsolving, and decision making, reflective of information-processing regularities that develop in congenial ways around underlying personality trends". This definition was used to describe the cognitive factors in this study. The 'Cognitive factors' theme contains behaviour, attitude, and thinking of participants in their supermarket shopping experiences. the most frequently mentioned sub-themes and codes by the participants were Preference of supermarket products and services

Social factors
The 'Social' factors theme consisted of four sub-themes: 'Support and Service', 'Social activity', 'Socialising', and 'Public attitude'. The 'Support and service' sub-theme included Support from others; Social service. The 'Social activity' sub-theme included Hobbies (classes, clubs, etc.); Volunteering activities. The 'Socialising' sub-theme included Having guest (entertaining, hosting etc.); Interaction with others in the super market. The 'Public attitude' sub-theme included Public awareness and language; Generational differences. The codes of each sub-theme were presented in the Table 3. Kaslow et al. (2007) have proposed that the concept of 'social factor' as "physical environment, external stressors, family environment, interpersonal relationships, social support and isolation, role models, social expectations, value system, sociocultural factors, and culture.".
Social factors strongly influence on individuals' quality of life including human well-being (Larson, 1996) and have interdependency with physical, emotional, and mental factors. 'Social factors' in this study referred to any support, services, activities, public awareness and attitude which can affect participants' thought, feeling, and behaviour in their shopping experience. The codes of Interaction with others in the supermarket (n=32), Hobbies (n=19), and Public awareness and language (n=7) were the most repeatedly mentioned by the participants. Indicative examples of participant comments include: [Interaction with others in the supermarket] "I don't want to do online shopping because I like to go and see things and people." [Female,80] [Hobbies (classes, clubs, etc.)

Value factors
The 'Value' factors theme consisted of three sub-themes; 'Satisfaction', 'Happiness', and 'Selfesteem'. The 'Satisfaction' sub-theme included the codes of Sense of belonging; Social and public related satisfaction; Life-satisfaction; Reliability and Trust. The 'Self-esteem' sub-theme included the codes of Self-satisfaction and Self-confidence. The codes of each sub-theme were presented in the Table 3.
The concept of 'value' is a multi-faceted and wide-spanning notion used in diverse fields such as physics, music, chemistry, ethics, mathematics, marketing, and business (Gil Saura et al., 2008;Zeithaml, 1988). Diener and Suh (1997) have proposed three bases: continuous choice; judgement of satisfaction; judgment with reference to cultural norms or value system, that an individual can identify what is valuable or not to them. In this study, the Oxford English Dictionary (2017) definition: "principles or standards of behaviour; one's judgment of what is important in life." was used as reference. Therefore, participants' feelings and thoughts regarding their shopping experiences as well as themselves were extracted in this theme. [Social and public related Satisfaction] "Because I go to supermarket, I see more neighbours and talk to them and also get local information. It's amazing" (Female,85)

Discussion
This study aimed to address two research questions: a) Do psychosocial aspects affect older individuals' supermarket shopping experiences? b) What are the possible psychosocial components that need to be considered for better inclusivity in shopping? These research questions were addressed through the empirical investigation i.e. observations. The psychosocial aspects of older individuals' supermarket shopping that emerged from the data were named Cognitive, Social, Emotional and Value factors. Many of the components for psychosocial aspects have been identified via various previous research. However, specific details of these themes including code are not well established in the existing literature. This could also explain that psychosocial aspects are less explicit and visible, and thus more elusive and complex in terms of its definition, measurement, and improvement.

Cognitive factors:
The results suggested that older individuals' shopping experience is influenced by a number of 'cognitive' factors which can be grouped under the sub-themes of 'Cognitive judgement' and 'Self-awareness'.
However, Self-awareness of health and age, which had not been identified in the previous researches, were identified as an additional sub-theme in this paper. In one instance, the participant who made the different choice of supermarket due to awareness of her back pain.

Emotional factors:
The results suggested that older individuals' supermarket shopping experience is affected by both physical and 'emotional' factors including feelings of pleasure and frustration.
Existing literature on supermarket shopping emphasises emotional reaction as an important factor mainly considered by supermarkets for marketing purposes. It was stressed that the emotional reaction as one of the key drivers for consumer decision making (Ambler et al., 2004).
This study stressed a richer scope of considerations through identifying the positive or negative emotions experienced by older individuals during their supermarket shopping activities. In one instance, an older shopper stressed strong negative emotions of Embarrassment, and Selfconsciousness in the process of renting a mobility scooter for use in store. The participant needed to que for a considerable amount of time and had to speak to customer services and security in order to borrow a mobility scooter and its key for use in supermarket. In such case, the supermarket aimed at physical inclusion through providing mobility assistance and improving accessibility, convenience, and usability for shoppers. However, the shopper experienced psychosocial exclusion, feeling embarrassed, uncomfortable and self-conscious due to the unnecessarily complex process of renting a scooter. This suggests that focussing only on physical inclusivity in supermarket stores can lead to experiences of negative emotion for the older shoppers.

Social factors:
The results suggested that older individual's shopping experience is influenced by 'social' factors such as gaining motivation for shopping; feeling positive or negative emotions; and choosing supermarket products and services, stores or transportation. The social factors were found to involve four sub-themes of: Support and service, Social activity, Socialising, and Public attitude.
However, several social related sub-themes including 'Support and service', 'Social activities', 'Socialising', and 'Public attitude', were newly identified through this study, possibly for the first time. On various occasions, participants stressed how their shopping experience was mainly driven or significantly affected by social factors e.g. going to supermarket to see or meet people, spending time with partner, or shop for neighbours physically unable to shop. This emphasises why design for social inclusivity beyond physical inclusivity should be a key consideration.

Value factors:
The results suggested that older individual's supermarket shopping experience is influenced by certain values (happiness, satisfaction, and self-esteem) which have a important influence. In one instance, feelings of 'happiness' when seeing the sunset on the way back from supermarkets or shopping with a partner appear to be difficult to separate from the particular shopping interactions and events.
The existing literature re-confirmed results Life-satisfaction and Self-satisfaction. Literature supports the association between shoppers' shopping experience and their well-being at supermarkets and malls (Grzeskowiak et al., 2016;Wagner, 2007;Lavin, 2005). Additionally, satisfaction with the state of health is considered as one factor that influence older individuals' shopping behaviour (Ishikawa et al., 2016).
However, results suggested further sub-themes including 'happiness' and 'self-esteem' as relevant values and several new codes were also identified. The satisfaction with the participants' life or society through their shopping experiences were implied (e.g. choosing fair trade items; having trust in services or products in the store; or feeling a sense of belonging by engaging with others). This emphasises the association between quality of shopping experience and certain values which considering 'core values' of older individuals can lead to better shopping experiences.
In addition to considering each component (i.e. Cognitive, Emotional, Social, and Value) individually, the data collected from this study proposes the need for evaluating the psychosocial components in cognition because of the obvious correlations identified in the data. Various statements collected from the data base as part of the study involved joint concept, with codes from more than two themes being used to explain the same need, thought, or desire. This is specifically important when designing for psychosocially inclusive supermarket shopping experiences for older individuals so as to adopt a convergent, holistic, and connected approach. Therefore, the dimensions can be used by design professionals and academics or third parties to consider the concept of psychosocial aspects in design of better supermarket shopping experience. The results also can be developed as a complete set of toolkit or framework by conducting further research

Limitations
A methodological limitation of the current study was the sampling and data collection. Due to recruitment difficulties, there was a gender imbalance in participants (Male: 3 and Female: 5). While there is not one specific sample size which is generally preferred by the research community, due to the various factors which should be considered in study design (Robson and McCartan, 2016), the total sample size of eight individuals might be considered to be small from some points of view.
The scope of this paper was limited to older individuals' shopping experiences. When it comes to the wider concept of inclusive design, further key contexts and IADL beyond shopping need to also be investigated in order to thoroughly explore the concept of psychosocial inclusivity. The current findings from this paper provide only initial dimensions in order to extend the concept of psychosocially inclusive design but can also be considered a preliminary step.

Conclusions
The findings from this study suggest: (a) the importance and significance of psychosocial inclusivity supermarket shopping of older individuals and in design and (b) a partial list of components for psychosocial inclusivity in design which can be extended via further studies.
In this study, the older individuals' supermarket shopping was selected as a first context in order to explore the nature and also the role of psychosocial inclusivity in design. The investigation was performed by using the human centred design method of observation with a total of eight older individuals. Through the investigation, several psychosocial aspects of supermarket shopping of older individuals were identified and categorised based on their implications or meaning using thematic coding analysis, under the four major themes which are 'cognitive', 'emotional', 'social', and 'value' factors (Table 3).

Future work
This study is part of a research project aiming to explore the notion of psychosocial inclusivity in design by identifying a definition and set of dimensions of psychosocial inclusivity in design. In this study, the partial components for the dimensions of psychosocial inclusivity in design were identified based on the older individuals' supermarket shopping experience. Further contexts should be studied so as to provide universal practicality and validity of the results. Validation, refinement and detailing of the four dimensions and their sub-themes is the subject of on-going research which is being performed using ethnographic interviews and creative workshops in the personal mobility and built environment contexts, conducted with people with disabilities chosen from a diverse demographic group.