Assistive Technology Outcomes Research Research Articles

Factors impacting community living outcomes among former long-term nursing home residents using the interdependence-Human Activity Assistive Technology (i-HAAT) model

ABSTRACT Despite an increased application of social theory in assistive technology (AT) outcomes research, there continues to be a gap in integrating AT conceptual models in research design, data analysis, and results interpretation. This paper merged two preexisting AT models, the Human Activity Assistive Technology model (HAAT) and the interdependence frame for AT into a novel framework, the interdependence-HAAT model (i-HAAT). This model was used to examine the outcomes of former long-term nursing home residents using AT. The model was also used as a framework to facilitate quantitative variable identification and categorization, emphasize the interconnectivity between domain variables, and explore the infrastructural supports necessary for the successful community reintegration of deinstitutionalized AT users. Meaningful integration of theory into practice is the essential next step in generating socially responsive research that addresses AT consumer needs and moves the field forward.

Psychometric Properties of the Spanish Version of Psychosocial Impact of Assistive Devices Scale in a Large Sample of People With Neuromuscular, Neurological, or Hearing Disabilities.

Assistive technology (AT) is any device, software, or equipment designed for and used by individuals with disabilities to engage in everyday activities and achieve independence. However, the usefulness of those technology-based or supported treatments is a complex issue that has led to the development of various conceptual models for assistive technology outcomes research and practice as well as different assessment tools that help to explore the effect of technology on people's lives. One of those instruments is the Psychosocial Impact of Assistive Device Scale (PIADS), a 26-item questionnaire that measures the psychosocial impact of interventions, using assistive devices in three quality-of-life domains: competence, adaptability, and self-esteem. PIADS scale has been translated and adapted to several languages, and it has been successfully used to measure AT outcomes in different disability profiles to predict abandonment or even as a relevant determinant of future adoption of eHealth. Quinteiro (2010) adapted PIADS to Spanish for the first time, although no studies have yet been published to systematically study its psychometric properties. Therefore, the purpose of this study was to evaluate measurement properties of the Spanish version of PIADS scale by means of a dataset obtained from its application to a large sample (n = 417) of people with neuromuscular, neurological, or hearing disabilities that used different assistive devices. The results will provide valuable indicators about the measurement quality of the Spanish PIADS scale and will help to promote the use of reliable and valid AT outcome assessment tools for research and clinical purposes.

Towards improving the quality of assistive technology outcomes research

Background The Assistive Technology Device Outcomes Research (ATDOR) checklist was developed as a reporting guideline for researchers to enhance the quality of research in this field. The checklist contains 13 items that cover outcome domains unique to assistive technology devices (ATDs). The ATDOR was intended to be an adjunct to existing publication guidelines for outcomes research. Purpose The aim of this investigation was to examine the ability of the ATDOR checklist to identify strengths and weaknesses in ATD outcomes research publications that may not be detected using another publication guideline designed for outcomes research. Methods Twenty original ATD outcome studies were scored using the Template for Intervention Description and Replication (TIDieR) checklist, and the ATDOR in two evaluation rounds. In the first round, articles were scored using the TIDieR alone. In the second round, they were scored using the TIDieR and ATDOR together. The difference in percentage scores between the two evaluation rounds was examined using the Wilcoxon signed rank-sum test for paired data. Results There was a statistically significant difference in the percentage scores between the two evaluation rounds (Wilcoxon statistic = 10, Z = −3.547, p<.000). Conclusion When used alongside the TIDieR, the ATDOR adds significant value to evaluations of reporting quality on assistive technology outcomes research. As this field continues to grow, researchers are invited to join in efforts to standardise reporting to promote healthier outcomes for ATD users. Implications for rehabilitation Reporting guidelines that evaluate research studies enhance their reporting quality and promote healthier outcomes for ATD users. The Assistive Technology Device Outcomes Research (ATDOR) checklist was shown to be a useful tool for achieving a minimum standard of reporting in the field of assistive technology. As the field of assistive technology continues to explore different methodologies, ongoing efforts to develop and update reporting guidelines are necessary in order to capture the future needs of this research area.

Consumer perspectives on assistive technology outcomes

Purpose: The current study explored domains of assistive technology (AT) device outcomes that are most valued by AT users. A secondary objective was to identify elements in the device acquisition process that affect outcomes.Method: Focus groups were conducted at geographically dispersed locations within the USA. The groups were moderated by experienced AT practitioners who followed a detailed procedure emphasizing a nominal group facilitation technique.Results: Twenty-four adult AT users, representing a range of ages and disability populations, participated in four focus groups. Many had over 15 years of experience with multiple device types. Qualitative analysis yielded 13 threads that embodied salient outcome domains (e.g. independence, subjective well-being, participation in work and school, cost-effectiveness) and key factors associated with the device acquisition process (e.g. lengthy periods of frustration, variable quality of service providers). Ironically, these data were evoked only after the term “outcomes” was omitted from focus group questions.Conclusions: AT outcomes studies are needed that report data regarding (a) the impact of AT on participation, (b) costs of AT provision and (c) key elements in the AT service delivery process. Future studies will be further strengthened to the extent that their methodologies actively assimilate consumer perspectives.Implications for RehabilitationConsumers highly value the impact of AT devices on their independence, subjective well-being and participation in work and school.The process of acquiring assistive technology devices is often lengthy and frustrating for consumers.Future AT outcomes research should report descriptive data regarding service delivery processes, as well as long-term impacts for consumers.Practitioners and researchers should avoid the use of potentially confusing professional jargon when administering surveys to consumers.

Assistive Technology Outcomes Research: Contributions to Evidence-Based Assistive Technology Practice

Assistive Technology Outcomes Research: Contributions to Evidence-Based Assistive Technology Practice

Development and Evaluation of a New Taxonomy of Mobility-Related Assistive Technology Devices

This article reports on the development of a new taxonomy for mobility-related assistive technology devices. A prototype taxonomy was created based on the extant literature. Five mobility device experts were engaged in a modified Delphi process to evaluate and refine the taxonomy. Multiple iterations of expert feedback and revision yielded consensual agreement on the structure and terminology of a new mobility device taxonomy. The taxonomy uses a hierarchical framework to classify ambulation aids and wheeled mobility devices, including their key features that impact mobility. Five attributes of the new taxonomy differentiate it from previous mobility-related device classifications: (1) hierarchical structure, (2) primary device categories are grouped based on their intended mobility impact, (3) comprehensive inclusion of technical features, (4) a capacity to assimilate reimbursement codes, and (5) availability of a detailed glossary. The taxonomy is intended to support assistive technology outcomes research. The taxonomy will enable researchers to capture mobility-related assistive technology device interventions with precision and provide a common terminology that will allow comparisons among studies. The prominence of technical features within the new taxonomy will hopefully promote research that helps clinicians predict how devices will perform, thus aiding clinical decision making and supporting funding recommendations.

Treatment Theory, Intervention Specification, and Treatment Fidelity in Assistive Technology Outcomes Research

ABSTRACT Recent reports in the rehabilitation literature have suggested that treatment theory, intervention specification, and treatment fidelity have important implications for the design, results, and interpretation of outcomes research. At the same time, there has been relatively little discussion of how these concepts bear on the quality of assistive technology (AT) outcomes research. This article describes treatment theory, intervention specification, and treatment fidelity as interconnected facets of AT outcome studies that fundamentally affect the interpretation of their findings. The discussion of each is elucidated using case examples drawn from the AT outcomes research literature. Recommendations are offered for strengthening these components of AT outcomes research.

Mobility-Related Assistive Technology Device Classifications

This article evaluates six mobility-related device classifications for their ability to support assistive technology outcomes research. Our evaluation considered classifications that had been created for various purposes, including those created to support third-party reimbursement decisions, consumer education and safety, and research. Classifications were excluded if their scope was limited to a single mobility device domain. The six classifications were analyzed according to a common framework: (1) purpose, (2) completeness, (3) granularity, and (4) research applications. Although each classification addresses three principal mobility device domains (ambulation aids, manual wheelchairs, and powered mobility devices), the analysis revealed a range of detail with which each domain is described. Some classifications were hampered by their use of unclear idiosyncratic terminology, whereas others conflated multiple device features within device categories. The analysis suggests that existing classifications do not fully meet the needs of assistive technology outcomes researchers. Creation of a common taxonomy of mobility devices is needed to serve the needs of the assistive technology outcomes research field.

Accommodation Outcomes and the ICF Framework

ABSTRACT Accommodation of the environment and technology is one of the key mediators of adjustment to disability and participation in community. In this article, accommodations are tested empirically as facilitators of return to work and participation, as defined by the International Classification of Disability, Function, and Health (ICF) and the Consortium for Assistive Technology Outcomes Research (CATOR). Both provide ideal models to examine this phenomenon with descriptive concepts and the relations between them. Nevertheless, there is a lack of predictive, empirically operational examinations of these models in order to serve the needs of assistive technology (AT) researchers and clinicians. The contribution of the current study is empirical examination of a framework to identify outcome measures for accommodation with AT. It confirms the major theoretical categories of outcomes: use, match to person/activity, effectiveness, participation, and well-being. Ninety adults with physical disabilities were evaluated in their natural workstations one year after adaptation of their computer workstation. Using the structural equation modeling (SEM) analysis method, findings confirmed the conceptual model, N = 90, χ2(30) = 33.47, p > .05, and the various outcome measures chosen for this study. Future research and clinical applications of the proposed model and the SEM examination are discussed.

Using Assistive Technology Outcomes Research to Inform Policy Related to the Employment of Individuals With Disabilities

We know that work is recognized as a central component of life for individuals with and without disabilities. It yields many physical and psychological benefits to the individual while simultaneously contributing numerous benefits to society. Lawmakers have enacted a plethora of laws designed to prevent discrimination, provide incentives for employers to hire individuals with disabilities, and facilitate job training/career preparation. Assistive technology figures prominently in disability employment law as a critical strategy for gaining access and supporting employment and upward mobility in the workplace. However, little systematic effort has been devoted to examining assistive technology use and outcomes as they relate to the employment of individuals with disabilities. The purpose of this article is to articulate a series of issues that permeate assistive technology outcome measurement in employment settings and subsequently affect the use of research knowledge for federal and state policy makers. For each issue, the authors pose three questions for critical analysis: Does the law compel the provision of assistive technology? Does outcome data play any part in the operation of the law? When it does, what kind of data would be useful to collect and where could it be found? Finally, the authors provide a brief glimpse of the current and future research efforts concerning the RSA-911 database. The recent database summaries exemplify the importance of such a national data collection system for informing federal policy, particularly concerning the contributions of assistive technology device use and services on improving the employment of individuals with disabilities.

Assessing the efficacy, effectiveness, and cost-effectiveness of assistive technology interventions for enhancing mobility

Purpose. The aim of this paper is to highlight the contributions that complementary efficacy, effectiveness, and cost-effectiveness studies can make to assessing the outcomes of assistive technology interventions for enhancing mobility.Method. The terms, ‘assistive technology outcomes research’ and ‘assistive technology interventions’, are defined. Several bases are examined for the shortage of outcomes research pertaining to mobility-related assistive technology interventions. Three presuppositions are described for the research strategy of interlocking studies being recommended. They are assigning priority to evaluating both recently developed assistive technologies and ones that have long been available, acknowledging the complexity of assistive technology as an intervention, and appreciating the trade-offs necessary for strengthening studies' internal and external validity. Some key study preparations are considered, including treatment theory, treatment specification, and the selection of outcome domains and measures. The essential features of efficacy, effectiveness, and cost-effectiveness studies are outlined, and their interdependence is stressed.Results and Conclusions. To assess the outcomes of assistive technology interventions for mobility in ways that are both methodologically sound and relevant to stakeholder needs, a research strategy is required involving mutually reinforcing efficacy, effectiveness, and cost-effectiveness studies. Collaborative arrangements and funding methods are discussed for fostering the needed research.

Conceptualization and measurement of assistive technology usability

Background. The concept of product usability has been discussed in several areas of product research and development. Usability, within the realm of assistive technology (AT) devices, determines how effectively and efficiently AT users with disabilities can function in different contexts and environments.Objectives. This article conceptualizes and proposes the significance of AT usability and its measurement in entirety from a human factors perspective. Conceptual models that characterize the interaction of the AT user, the AT device, the context and the involved activity is considered to be the hallmark of measurement of AT usability. On that basis, the article highlights the methodology and the initial progress of the development of an AT outcome tool, the Usability Scale for Assistive Technology (USAT), to measure self reported degree of AT usability.Methodology. In order to identify usability indicators for measurement, a qualitative study was conducted by exploring the experiences of AT users. Ten participants who used either wheeled mobility or computer based AT devices were interviewed with questions based on the theme of a usability framework.Results. The coded interview data generated more than 800 usability indicators specific to the two categories of AT devices. These indicators were mapped to a generic usability criteria list for construction of the USAT-Wheeled Mobility and the USAT-Computer Access.Implications. The USAT, when developed, is projected to be valid and useful for AT outcomes research as well as clinical practice. The use of the USAT will enable researchers and clinicians to comprehensively identify factors that underlie effectiveness and efficiency in AT device use and establish intervention protocols to optimize user-AT interaction.

Assistive technology outcomes research: challenges met and yet unmet.

This article highlights the special requirements, achievements, and yet unmet challenges of assessing the outcomes of assistive technology services. The current status of this research is considered from the standpoint of developmental stages that seem to characterize many areas of outcomes research. Those stages include exhortation, sober appraisal, infrastructure building, and "getting on with it." The status of measuring assistive technology outcomes is described, and efforts to develop new measures are critically reviewed. Three as yet unmet challenges are discussed that are faced alike by assistive technology outcomes research and by rehabilitation outcomes research in general. They are as follows: (1) operationalizing a multiple-stakeholder approach to outcomes research; (2) formulating adequate treatment theories; and (3) creating shared databases.