Abstract
BackgroundHome modifications provided by occupational therapists (OTs) are effective in improving daily activity performance and reducing fall risk among community-dwelling older adults. However, the prevalence of home modification is low. One reason is the lack of a centralized database of OTs who provide home modifications.ObjectiveThis study aimed to develop and test the usability of a mobile app directory of OTs who provide home modifications in the United States.MethodsIn phase 1, a prototype was developed by identifying OTs who provide home modifications through keyword Web searches. Referral information was confirmed by phone or email. In phase 2, community-dwelling older adults aged older than 65 years and OTs currently working in the United States were purposefully recruited to participate in a single usability test of the mobile app, Home Modifications for Aging and Disability Directory of Referrals (Home Maddirs). Participants completed the System Usability Scale (SUS) and semistructured interview questions. Interview data were coded, and themes were derived using a grounded theory approach.ResultsIn phase 1, referral information for 101 OTs across 49 states was confirmed. In phase 2, 6 OTs (mean clinical experience 4.3 years, SD 1.6 years) and 6 older adults (mean age 72.8 years, SD 5.0 years) participated. The mean SUS score for OTs was 91.7 (SD 8.0; out of 100), indicating good usability. The mean SUS score for older adults was 71.7 (SD 27.1), indicating considerable variability in usability. In addition, the SUS scores indicated that the app is acceptable to OTs and may be acceptable to some older adults. For OTs, self-reported barriers to acceptability and usability included the need for more information on the scope of referral services. For older adults, barriers included high cognitive load, lack of operational skills, and the need to accommodate sensory changes. For both groups, facilitators of acceptability and usability included perceived usefulness, social support, and multiple options to access information.ConclusionsHome Maddirs demonstrates good preliminary acceptability and usability to OTs. Older adults’ perceptions regarding acceptability and usability varied considerably, partly based on prior experience using mobile apps. Results will be used to make improvements to this promising new tool for increasing older adults’ access to home modifications.
Highlights
BackgroundDifficulties performing activities of daily living (ADLs), such as bathing, dressing, or toileting, place older adults at increased risk for adverse outcomes, including poorer health and frailty, premature institutionalization, and mortality [1,2,3,4]
In the United States, home modifications and the accompanying services provided by occupational therapists (OTs) are often privately funded, grant funding may be available from state or local governments, public programs, or nonprofit organizations to help cover the cost of home modifications for low-income individuals [19]
The principal findings of this study are the development of a centralized database of OTs who provide home modifications that is accessible as a mobile app, Home Maddirs, and preliminary evidence to suggest that the mobile app is acceptable and usable to OTs
Summary
BackgroundDifficulties performing activities of daily living (ADLs), such as bathing, dressing, or toileting, place older adults at increased risk for adverse outcomes, including poorer health and frailty, premature institutionalization, and mortality [1,2,3,4]. Home modifications provided by occupational therapists (OTs) are effective in improving daily activity performance and reducing fall risk among community-dwelling older adults. Objective: This study aimed to develop and test the usability of a mobile app directory of OTs who provide home modifications in the United States. In phase 2, community-dwelling older adults aged older than 65 years and OTs currently working in the United States were purposefully recruited to participate in a single usability test of the mobile app, Home Modifications for Aging and Disability Directory of Referrals (Home Maddirs). Barriers included high cognitive load, lack of operational skills, and the need to accommodate sensory changes For both groups, facilitators of acceptability and usability included perceived usefulness, social support, and multiple options to access information. Results will be used to make improvements to this promising new tool for increasing older adults’ access to home modifications
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