Evaluating Access and Mobility within a New Model of Supported Housing for People with Neurotrauma: A Pilot Study

The experience of using home automation by individuals with disability

PURPOSE

People with disability often require long-term support within the home. Advances in technology have made home automation more readily available to support people living with disability. However, few studies describe the perspectives of people using home automation. The aim of this study was to explore the experience of individuals living with long term serious disability using home automation.

MATERIALS AND METHODS

A phenomenological approach was adopted. In-depth, semi-structured interviews were conducted. Data were analysed using an inductive approach to identify themes.

RESULTS

Two overarching categories of themes were identified: 'benefits' and 'challenges'. Benefits captured the outcomes experienced by people living with disability using home automation and the impact upon their lives. Participants described several challenges with using home automation such as self-advocating to receive home automation, long waiting periods in the assessment and installation process, frustrations when home automation did not work, and the challenges experienced from being without home automation.

CONCLUSION

This research identified the benefits and challenges of home automation experienced by people with long term serious disability. The findings can be used to understand the importance of home automation and the impact it has upon the lives of people living with disability.

A scoping review to explore the health, social and economic outcomes of home automation for people with disability

PURPOSE

People with disability often require long-term care. Long-term care is changing with the availability and advances in cost and function of technologies, such as home automation. Home automation has the potential to reduce paid carer hours and can potentially offer many benefits to people with a disability. The aim of this scoping review is to identify the health, social and economic outcomes experienced by people living with a disability who use home automation.

MATERIALS AND METHODS

Two electronic databases were searched by title and abstract to identify international literature that describes home automation experiences from the perspectives of people with disability. A thematic approach was taken to synthesise the data to identify the key outcomes from home automation.

RESULTS

The review identified 11 studies reporting home automation outcomes for people living with a disability. Seven outcomes were associated with home automation: independence, autonomy, participation in daily activities, social and community connectedness, safety, mental health, and paid care and informal care.

CONCLUSION

Advances in technology and changes in funding to support people living with a disability have made access to home automation more readily available. Overall, the study findings showed that there is a range of potential benefits of home automation experienced by individuals living with a disability.

Geographic intelligence to investigate community participation: a scoping review

PURPOSE

To understand the applicability and unique contributions of global positioning system (GPS) and geographic information system (GIS) technologies to investigate individuals' participation in the community.

METHODS

A scoping review was conducted to summarize studies that employed GPS and/or GIS to assess community participation. Systematic literature searches were performed using nine electronic databases, up to April 2022. Two independent reviewers screened studies for eligibility and extracted data from the selected studies.

RESULTS

The searches retrieved 628 articles, of which 36 met the inclusion criteria. In 31 studies, a GPS unit or GPS-enabled device monitored the community mobility of individuals with different health conditions. Tracking periods varied from five hours to 30 consecutive days. The spatiotemporal parameters obtained from satellite-based data provided information about individuals' presence in the community. Most studies combined GPS with other measuring tools (self-report diaries/questionnaires, qualitative interviews) to capture a broader description of community participation.

CONCLUSIONS

GPS and GIS are viable approaches for advancing research as they provide unique information about community participation not easily captured by other methods. The combination of available methods comprehensively address the physical and social dimensions of this construct.IMPLICATIONS FOR REHABILITATIONGlobal positioning system (GPS) and geographic information system (GIS) technology allows direct and real-time quantification of patterns of individuals' community mobility.The geographic area where individuals participate in daily living activities complements information from self-report diaries/questionnaires.Combining GPS technology with self-report diaries/questionnaires allows a broader description of individuals' community participation, addressing respectively both its physical and social dimensions.Knowledge of individuals' access to and involvement in community locations/situations may help therapists design interventions to improve community participation.

Measuring what matters: a descriptive participatory case evaluation of a tool for measuring outcomes of assistive technology after acquired brain injury

Acquired Brain Injury (ABI) can lead to the need to plan for housing, assistive technology and support to meet a person's goals. Recent Australian policy reforms have brought about opportunities for person-centred approaches to assistive technology (AT) product selection, and the opportunity for users of supports such as assistive technology and environmental adaptations to describe and measure their own outcomes. My AT Outcomes Framework (MyATOF) is an Australian tool designed for use by AT users and their support networks to articulate supports, outcomes, costs, and service delivery experiences. This article aims (i) report on use of MyATOF in a case study of ABI and AT-enabled housing and (ii) critically evaluate MyATOF tools and administration for this use case from the perspectives of the MyATOF author, an occupational therapist, and a lived experience expert with an ABI. An iterative development and test design was used to adapt the MyATOF administration procedures and conduct a case report evaluation. Results support the relevance of MyATOF conceptual domains, and detailed data about outcomes made possible by an AT-enabled home was captured. Recommendations are made to further refine the questions for ease of use by persons with ABI including simplifying the costing tool and enabling staggered administration. This case report suggests MyATOF can 'measure what matters' for ABI and AT-enabled housing and is worthy of further evaluation.

Establishing the measurement properties of the Residential Environment Impact Scale (Version 4.0)

BACKGROUND

Developed as an environment assessment informed by the Model of Human Occupation, the Residential Environment Impact Survey considered the physical, social and activity features of the environment, evaluating the impact of the environment on resident's quality of life. Clinicians reported that the Residential Environment Impact Survey was a useful tool; however, it had not been structured to be a measurement tool and did not have established psychometric properties.

AIMS/OBJECTIVES

This study examines the psychometric properties of the restructured Residential Environment Impact Scale Version 4.0 (REIS), which measures the level of environment support provided to residents.

MATERIAL AND METHODS

The REIS was completed across residential sites for people with complex mental health needs. A many facets Rasch analysis was conducted to establish the reliability and validity of the REIS.

RESULTS

The REIS demonstrated reasonable psychometric properties, with items demonstrating internal scale validity and scale items following an expected pattern of increasingly challenging environment support.

CONCLUSIONS AND SIGNIFICANCE

Initial evidence suggests that the REIS provides a valid and reliable measure of environment support, providing a detailed assessment of how physical, social and activity elements of the environment support or inhibit participation and can be applied across a range of living environments.

Housing and Support for People with Disability: Perspectives of Motor Accident, Disability and Injury Insurers across Australia and New Zealand

Housing is a critical enabler of a dignified life, civic participation and the achievement of human rights. Providing appropriate housing for people who experience neurotrauma as a result of road or workplace injury, with both the assistive technology and human support required, continues however to be a policy and practice challenge. Australian and New Zealand motor accident, disability and injury insurers have high and enduring liability in this area, and their under-researched perspectives are needed to strengthen the evidence base for policy and practice development. This qualitative study utilised focus group methodology with representatives from government injury and disability insurers across Australia and New Zealand (n = 8). The study aimed to identify (a) issues and trends; (b) factors for decision making; and (c) service impacts relating to housing and support for people with disability and high daily support needs. Thematic analysis generated results across four key areas: influences on the decision to fund housing and/or support; identifying 'good' housing solutions; evaluating cost-benefit of housing and support investments; and developing future investment in housing and support. Findings such as those regarding decision-making, and investment, attest to the value of capturing the perspectives of this key group of stakeholders to assist to envision better housing and support for people with disability.

Smart home and communication technology for people with disability: a scoping review

PURPOSE

The links between disability, activity limitation and participation restriction are well established. Recent and continued advancement of technology, particularly smart home and communication technologies, presents new ways in which some of the limitations and restrictions experienced by people with disabilities can be overcome. The aim of this scoping review was to explore the impact of smart home and communication technology on the outcomes of people with disabilities and complex needs.

METHOD

This review involved systematic searching of four databases, hand searches and data extraction. Eligibility criteria included [1] participant outcomes of [2] technology used within the home [3] among adults with a disability and complex needs.

RESULTS

Of the 2400 studies identified, 21 met our inclusion criteria. Studies were characterized by significant diversity in relation to disability and type of technology. Overall, technology appeared to improve independence, participation and quality of life among people with a disability and complex needs. Despite this, ethical considerations were raised given the vulnerability of this population, including potential risks through social participation and privacy concerns of using monitoring technology.

CONCLUSIONS

Smart home and communication technology can improve outcomes for people living with disabilities and complex needs. However, a number of factors impact the successful implementation of technology, including personalization, flexibility and ongoing support to the person with a disability and their close others. Future research should utilize high-quality study designs and established measures of important outcomes for this group.IMPLICATIONS FOR REHABILITATIONThere is a broad range of smart home and communication technology devices and systems available that may support the independence and participation of people with disabilities and complex needs; however, high-quality evidence documenting the impact of technology is lacking.Soft-technology supports, including assessment, training and evaluation of technology implementation, may play just as important a role in shaping outcomes as the technology itself.Systematic research is required to ensure there is quality evidence to inform investment in both technologies, and the soft-technology supports that promote its successful use.

Evaluating the Use of Smart Home Technology by People With Brain Impairment: Protocol for a Single-Case Experimental Design

Background

Smart home technologies are emerging as a useful component of support delivery for people with brain impairment. To promote their successful uptake and sustained use, focus on technology support services, including training, is required.

Objective

The objective of this paper is to present a systematic smart home technology training approach for people with brain impairment. In addition, the paper outlines a multiple-baseline, single-case experimental design methodology to evaluate training effectiveness.

Methods

Adult participants experiencing acquired brain impairment who can provide consent to participate and who live in housing where smart home technology is available will be recruited. Target behaviors will be identified in consultation with each participant based on his or her personal goals for technology use. Target behaviors may include participant knowledge of the number and type of technology functions available, frequency of smart home technology use, and number of function types used. Usage data will be gathered via log-on smart home technology servers. A smart technology digital training package will also be developed and left on a nominated device (smartphone, tablet) with each participant to use during the trial and posttrial, as desired. Measures of the target behavior will be taken throughout the baseline, intervention, and postintervention phases to provide the evidence of impact of the training on the target behaviors and ascertain whether utilization rates are sustained over time. In addition, trial results will be analyzed using structured visual analysis, supplemented with statistical analysis appropriate to single-case methodology.

Results

While ascertaining the effectiveness of this training protocol, study results will offer new insights into technology-related training approaches for people with brain impairment. Preliminary data collection has been commenced at one supported housing site, with further scoping work continuing to recruit participants from additional sites.

Conclusions

Evaluation evidence will assist in planning for the smart technology set-up as well as training and support services necessary to accompany the provision of new devices and systems.

International Registered Report Identifier (IRRID)

RR1-10.2196/10451

Electronic assistive technology use in Australian shared supported accommodation: rates and user characteristics

Electronic assistive technologies (EATs) are fast becoming considered an essential component of everyday life. To date, there has been little research on the use of EAT by people living in shared supported accommodation (SSA), one of the major community-based housing options for people with disability (PwD) in Australia. This study aimed to (1) audit current EAT use by PwD living in SSA, (2) describe the impact of Internet access on EAT use, and (3) examine potential relationships between individual characteristics and EAT use. A customized survey administered with 32 house managers, representing 52 SSAs, gathered data on the EAT use of 254 people. Only 45.7% of residents used EAT, and devices available to the mainstream market were most frequently used. Access to home-based Internet was not a predictor of the number of devices in use. Disability type (congenital or acquired) was found to be significantly correlated with the number of devices in use, however, associations across a number of variables suggest complex mediational interactions. These findings provide an insight into the EAT use trends of PwD living in SSA, indicating that further work needs to be done to support the uptake and continued use of EAT by PwD Implications for Rehabilitation Further work needs to be done to promote the uptake and use of electronic assistive technology (EAT) by people with disability (PwD). Personal characteristics and experiences need to be considered in the prescription of EAT to PwD, as these may explain variations in use between individuals.

Electronic assistive technology used by people with acquired brain injury in shared supported accommodation: Implications for occupational therapy

Introduction

People with severe acquired brain injury often require lifetime support, sometimes received from paid workers if living in shared supported accommodation. Electronic assistive technology may offer a less intrusive method of support that can enable autonomous participation and deliver cost savings. However, research on rates, barriers, and facilitators of electronic assistive technology uptake is lacking. This study aimed to identify electronic assistive technology types used by people with acquired brain injury living in shared supported accommodation, assess user satisfaction and psychosocial impact of electronic assistive technology, detail the impact of technology use on respondents’ participation and support needs, and describe barriers and/or facilitators to electronic assistive technology uptake and ongoing use.

Method

Participants were identified electronic assistive technology users with acquired brain injury living in shared supported accommodation in Australia ( N = 22). Mixed methods data were collected using semi-structured interviews and published measures of support need, electronic assistive technology satisfaction, and psychosocial impact.

Results

Participants reported satisfaction with the devices they used, and positive psychosocial outcomes. Areas impacted by electronic assistive technology, key facilitators and barriers to electronic assistive technology use, and implications for occupational therapists working to deliver electronic assistive technology solutions were identified.

Conclusion

Electronic assistive technology use by this group can positively influence both everyday functioning and participation. Skilled prescription and ongoing support services are necessary to maximise uptake and use.