1
|
Simeoni R, Pirrera A, Meli P, Giansanti D. Promoting Universal Equitable Accessibility: An Overview on the Impact of Assistive Technology in the UN, UNICEF, and WHO Web Portals. Healthcare (Basel) 2023; 11:2904. [PMID: 37958048 PMCID: PMC10650659 DOI: 10.3390/healthcare11212904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 10/30/2023] [Accepted: 11/01/2023] [Indexed: 11/15/2023] Open
Abstract
The number of people with disabilities and frailties who need support and assistance is increasing. Assistive technologies (ATs) are increasingly playing a central role in supporting people with disabilities and frailties. The study investigated the impact of the ATs on the websites of the UN, UNICEF, and WHO in terms of proposed activities and actions. The methodology proposed was based on two points of view: (1) A formal process to directly select elements in the institutional webs of the UN, UNICEF, and WHO. (2) A formal process for a complementary literature narrative review based on an umbrella review of Pubmed and Scopus. A standard checklist and a qualification process were applied. The outcome reported 35 documents from the direct search on the web and 19 systematic reviews for the complimentary literature overview. The direct search returned documents related to initiatives focused on the following: The tailoring of the ATs to a person based on international guidelines and specific monitoring initiatives of the AT introduction/access based on surveys both at the population and system/government level with the publication of the data/metadata in an observatory. Dissemination initiatives of both the culture of ATs (e.g., catalog, guidelines, reports, congresses) and of recommendations. The literature overview contributed more specifically to the use and effectiveness of categories of ATs. Both direct research and the literature overview have shown a consistent growth in interest in ATs. The initiatives of the UN, UNICEF, and WHO have been consistent with the institutional role and aimed at improving the diffusion of ATs through capillary monitoring, which is not free from obstacles, and a diffusion of the culture and rational use of ATs. The narrative review shows also the important role of research in monitoring the development, use, and effectiveness of devices, strategies, and support of international institutional initiatives. Important initiatives have been launched internationally on AT in terms of monitoring, dissemination, and improvement in access. However, it is necessary to consider and face the obstacles that limit these initiatives.
Collapse
Affiliation(s)
- Rossella Simeoni
- Facoltà di Medicina e Chirurgia, Università Cattolica del Sacro Cuore, Largo Francesco Vito, 1, 00168 Roma, Italy
| | - Antonia Pirrera
- Centro Nazionale TISP, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Roma, Italy
| | - Paola Meli
- Centro Nazionale TISP, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Roma, Italy
| | - Daniele Giansanti
- Centro Nazionale TISP, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Roma, Italy
| |
Collapse
|
2
|
Bell D, Prain M, Layton N. Assistive technology for people with deafblindness in Southern Africa: a Delphi study exploring dimensions of impact. Disabil Rehabil Assist Technol 2023; 18:30-43. [PMID: 34812099 DOI: 10.1080/17483107.2021.1994031] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
PURPOSE Assistive technology (AT) is a highly effective intervention to address the capability gap for people living with deafblindness. The My AT Outcomes Framework (MyATOF) is a novel Australian framework founded upon AT process principles and outcomes research. It guides stakeholders to articulate AT use according to 6 dimensions. MyATOF was developed as a data collection and knowledge translation tool. The use case of AT by people with deafblindness in Southern Africa was investigated in this study to determine the applicability of MyATOF dimensions to (a) people with deafblindness and (b) low- and middle-income countries. MATERIALS AND METHODS Two online surveys, using the Delphi methodology, were undertaken with key stakeholders including people with deafblindness, family members, researchers, service providers, educators and advocates. An expert panel of 17 completed Phase 1, with 14 completing Phase 2. The WHO 5 Ps AT systems thinking model was used in data analysis. RESULTS Respondents affirmed the validity of the dimensions of MyATOF for people with deafblindness in four Southern African countries. In-country barriers and constraints were identified as significantly impacting the capacity of AT users with deafblindness, to realize positive outcomes. CONCLUSIONS The MyATOF dimensions show promise in their use with persons with deafblindness in Southern Africa, though further research is needed.IMPLICATIONS FOR REHABILITATIONThe impact of assistive technology and related supports can be evaluated across a number of dimensions including human rights, costs incurred and saved, consumer experience, and service delivery satisfaction.These dimensions of impact resonate across the two continents investigated to date, with contextual factors being considered.Variables influencing access to assistive technology across contexts can be understood through the WHO GATE five P's systems thinking model.Few tools place data capture and outcomes measurement in the hands of assistive technology users, but indications are that this is of value to consumers.
Collapse
Affiliation(s)
- Diane Bell
- Faculty of Business and Management Sciences, Cape Peninsula University of Technology, Cape Town, South Africa.,Business School, University of Stellenbosch, Bellville, South Africa
| | - Meredith Prain
- Centre of Excellence - Deafblind, Able Australia, Melbourne, Australia
| | - Natasha Layton
- Rehabilitation, Ageing and Independent Living Research Centre, Monash University, Melbourne, Australia
| |
Collapse
|
3
|
Jaiswal A, Aldersey H, Wittich W, Mirza M, Finlayson M. Factors that influence the participation of individuals with deafblindness: A qualitative study with rehabilitation service providers in India. BRITISH JOURNAL OF VISUAL IMPAIRMENT 2022. [DOI: 10.1177/0264619620941886] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Evidence to inform rehabilitation service delivery for individuals with deafblindness, especially in the Indian context, is inadequate. Rehabilitation professionals often find it challenging to design rehabilitation interventions that promote participation for those with deafblindness. Therefore, our purpose was to understand the contextual factors that influence the participation of individuals with deafblindness in India from the perspectives of those who are involved in providing rehabilitation services to them. Using the International Classification of Functioning, Disability, and Health (ICF) as a framework, we conducted two focus group discussions with 16 rehabilitation service providers in India. We used a content analysis approach to examine the data. Rehabilitation service providers perceived participation barriers to be linked primarily to the social environment. Specifically, participants identified four major factors acting as barriers, including (a) lack of awareness about deafblindness; (b) negative attitudes and stigma associated with disability; (c) lack of access to resources such as assistive technology and interpreter support; and (d) communication challenges associated with severe impairments. Facilitators include accessibility of the built environment for multisensory impairments, affordable technology, provision of an interpreter and personal support worker, and training on deafblindness for professionals. The participation of individuals with deafblindness could be enhanced by identifying and removing environmental barriers and improving knowledge about deafblindness among rehabilitation professionals for proper identification, assessment, and access to rehabilitation services.
Collapse
|
4
|
Shopping When You Are Deafblind: A Pre-Technology Test of New Methods for Face-to-Face Communication—Deafblindness and Face-to-Face Communication. SOCIETIES 2021. [DOI: 10.3390/soc11040131] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This article presents the first-year results of a project that aimed to explore the feasibility of using a braille display and a smartphone in society to improve face-to-face communication for a person living with deafblindness, using a simulated communication situation. An applied experimental development design was implemented, followed by a pre-test in the community. Two clinicians and an engineer conducted communication tests with three communication partners with normal vision in a shopping mall. A blind clinician acting as deafblind bought an iPhone case and asked for the location of two stores. Communication partners did not report any difficulties, understood the exchanges, and were proud to have helped a person living with deafblindness. No communication breakdowns or keyboard input incidents occurred. Speech turns were not optimal but can be improved. Clinicians proposed a sequence of three training modules: (1) prior knowledge (basic operations for iPhone, software, and braille display), (2) methods for preparing a face-to-face discussion, and (3) processes during a face-to-face discussion. Results demonstrate the feasibility of using a tactile technological solution coupled with a smartphone to interact with unknown interlocutors. Technology trials form the groundwork for a 9-month case study, involving two individuals with deafblindness.
Collapse
|
5
|
Rodríguez J, Díaz MV, Collazos O, García-Crespo Á. GoCC4All a pervasive technology to provide access to TV to the deafblind community. Assist Technol 2021; 34:383-391. [PMID: 33200974 DOI: 10.1080/10400435.2020.1829176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
Considering the importance of communication and independence for the deafblind community, this work presents findings of the use of technology to address the lack of information due to communication challenges among the deafblind community. Over time, many investigations have been carried out regarding this matter, but very few providing solution, which is why this study emerged, looking to making all the information broadcasted through television accessible for this community. The work team designed a technology (GoCC4All) to address the needs of the deafblind community. GoCC4All provides access to captions available on TV through braille displays and mobile devices. Our research process and results outline the path for creating, adapting, and adopting new technologies for people with disabilities who have the right to access the information just as their peers without disabilities. The information in this paper is based on two surveys, an initial beta testing (BT) and a final survey among a group of 14 users (UT) who tested the GoCC4All application. Our findings support the positive impact of the iterative creation of assistive technology based on users' experience and users' recommendations to better serve the needs of the deafblind community.
Collapse
Affiliation(s)
- Juanita Rodríguez
- Department of Education, University of Puerto Rico, Rio Piedras, Puerto Rico
| | - María V Díaz
- Department of Philology, Communication and Documentation, University of Alcalá De Henares, Madrid, Spain
| | - Olga Collazos
- Technology Innovation Department, Dicapta Foundation, Winter Springs, FL, USA
| | - Ángel García-Crespo
- Computer Sciences Department, Universidad Carlos III De Madrid, Leganes, Spain
| |
Collapse
|
6
|
Ran M, Banes D, Scherer MJ. Basic principles for the development of an AI-based tool for assistive technology decision making. Disabil Rehabil Assist Technol 2020; 17:778-781. [PMID: 33275457 DOI: 10.1080/17483107.2020.1817163] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
INTRODUCTION The impact of assistive technology use on the lives of people with disabilities has long been demonstrated in the literature. Despite the need for assistive technologies, and a wealth of innovative, afford-able, and accessible products, a low rate of assistive technology uptake is globally maintained. One of the reasons for this gap is related to data and knowledge formation and management. Low access to information and a lack of assessment services is evident. Fragmentation of data, inconsistency in assessment methodology and heterogeneity in the competence of assistive technology professionals, has led to a growing interest in the opportunities that data sciences, including AI, hold for the future of the assistive technology sector, as a supportive and constructive mechanism in any decision-making process. OBJECTIVES In this short paper, we seek to describe some of the principles that such an AI-based recommendation system should be built upon, using the Atvisor platform as a case study. Atvisor.ai is an AI-based digital platform that supports assistive technology assessments and the decision-making process. RECOMMENDATIONS Our recommendations represent the aggregated insights from two pilots held in Israel, testing the platform in multiple environments and with different stakeholders. These recommendations include ensuring the continuum of care and providing a full user journey, incorporating shared decision making and self-assessment features, providing data personalisation and a holistic approach, building a market network infrastructure and designing the tool within a wider service delivery model design. Assessment and decision-making processes, crucial to optimal uptake, cab be leveraged by technology to become more accessible and personalised.IMPLICATIONS FOR REHABILITATIONProvides principles for the development of an AI-based recommendation system for assistive technology decision making.Promotes the use of artificial intelligence to support users and professionals in the assistive technology decision making process.Personalization of data regarding assistive technology, according to functional, holistic and client centered profiles of users, ensures optimal match and better use of assistive technology.Self-assessment and professional assessment components are important for enabling multiple access points to the assistive technology decision making process, based on the preferences and needs of users.
Collapse
Affiliation(s)
| | - David Banes
- David Banes Access and Inclusion Services, United Kingdom
| | - Marcia J Scherer
- Institute for Matching Person & Technology, Inc, Webster, NY, USA
| |
Collapse
|
7
|
Cantin S, de Abreu Cybis W, Durocher N. Setup by a person with deafblindness of a face-to-face communication assistive technology based on generally available applications. Disabil Rehabil Assist Technol 2020; 17:16-22. [PMID: 32315219 DOI: 10.1080/17483107.2020.1751315] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Purpose: This article describes and analyses the journey with technology of a woman with deafblindness, from her first experiences with communication assistive devices (CADs) until the setup of her homemade CAD. More specifically, it describes the homemade CAD setup, reports on her journey with technology until the setup, and examines the setup process and its outcomes in terms of user innovation and changes in life domains.Materials and Methods: This is a case study report derived from a previous assessment study. It was documented on the basis of meetings, operation sessions, literature searches, clinicians' memories as well as observations, impressions, stories and interviews from previous field visits. Analyses were performed based on von Hippel's description of the user innovation process and the Activities and Participation domains of the International Classification of Functioning, Disability and Health (ICF). The participant in this case study was a female client of a deafblindness rehabilitation program in the Montreal region, living with type 1 Usher syndrome.Results and Conclusions: The homemade CAD setup was based on an electronic braille notetaker connected to an iPhone via Bluetooth. The software included the iOS operating system, the VoiceOver screen reader and a text editing application, all running on the iPhone. The examination of the participant's journey found the presence of the four characteristics of the user innovator proposed by von Hippel. It appears that the participant's life has been positively impacted by the use of her homemade CAD on the nine "Activities and Participation" domains of the ICF.Implications for RehabilitationA CAD may make it easier to achieve some rehabilitation goals with respect to social participation.A person with deafblindness who becomes more autonomous with communications requires less support from rehabilitation professionals.An iPhone-based CAD provides access to a normalizing life and results in better self-esteem, among other things.Lead users facilitate future professional interventions in the field by providing positive experiences and successes that make the general public aware of the situation of persons using special technologies.
Collapse
Affiliation(s)
- Sylvie Cantin
- CRIR - Institut Nazareth et Louis-Braille, Longueuil, QC, Canada
| | | | - Nicole Durocher
- CRIR - Institut Nazareth et Louis-Braille, Longueuil, QC, Canada
| |
Collapse
|
8
|
The Audibility of Low Vision Devices with Speech Output Used by Older Adults with Dual Sensory Impairment. Optom Vis Sci 2020; 96:345-353. [PMID: 31046017 PMCID: PMC6493671 DOI: 10.1097/opx.0000000000001374] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
SIGNIFICANCE The successful uptake, integration, and use of vision rehabilitation devices with speech output depend to a large part on their audibility. However, individuals with combined vision and hearing impairments are at a disadvantage when using devices that do not consider multiple impairments. PURPOSE Sensory rehabilitation for individuals with combined vision and hearing impairment often relies on the use of assistive technology devices that use speech outputs (e.g., talking clock), but in individuals with dual impairment, their use is likely compromised by a concurrent hearing loss. The goal of this study was to evaluate the audibility of these devices in a population of individuals with acquired dual sensory impairment. METHODS We measured the ability to correctly repeat speech output presented by three assistive technology devices (talking watch, calculator, scanner) and confidence levels in response accuracy in 24 participants with visual impairment only and in 22 individuals with dual sensory loss. Stimuli were presented at three volumes that were repeated one or four times. Participants were placed at a fixed distance of 74 cm from the sound source. RESULTS The pattern of results was similar across the different devices, whereby an interaction of volume and repetition indicated that participants' accuracy to repeat a phrase and their confidence in their response improved with increasing volume, but more so at higher numbers of repetition (P < .05; ω, from 0.005 to 0.298). Participants with dual sensory loss generally had lower accuracy and confidence. CONCLUSIONS Scores and confidence levels being very low across devices and users suggest that even participants with normal hearing for their age experienced a certain level of difficulty understanding speech output, confirming the need for better assistive technology device design.
Collapse
|
9
|
Song Y, van der Cammen TJM. Electronic assistive technology for community-dwelling solo-living older adults: A systematic review. Maturitas 2019; 125:50-56. [PMID: 31133218 DOI: 10.1016/j.maturitas.2019.04.211] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 04/05/2019] [Accepted: 04/10/2019] [Indexed: 10/27/2022]
Abstract
The proportion of older adults who live alone in single households is growing continuously. In the care of these solo-living older adults, electronic assistive technology (EAT) can play an important role. The objective of this review is to investigate the effects of EAT on the wellbeing of community-dwelling older adults living alone in single households. A systematic review of English articles was conducted based on PMC, Scopus, Web of Science and the Cochrane database. Additional studies were identified from the references. In total, 16 studies were identified, six of them with follow-up. There is evidence that EAT can improve the physical and mental wellbeing of older adults. There was little evidence that EAT can improve social wellbeing. We conclude that more personalized designs and interventions, and more user engagement could be embedded in the design of EAT for solo-living community-dwelling older adults and that more evidence is needed regarding the effects of those interventions.
Collapse
Affiliation(s)
- Yu Song
- Faculty of Industrial Design Engineering Delft University of Technology, Delft, the Netherlands.
| | - Tischa J M van der Cammen
- Faculty of Industrial Design Engineering Delft University of Technology, Delft, the Netherlands; Section of Geriatric Medicine, Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands
| |
Collapse
|
10
|
Jaiswal A, Aldersey HM, Wittich W, Mirza M, Finlayson M. Meaning and experiences of participation: a phenomenological study with persons with deafblindness in India. Disabil Rehabil 2019; 42:2580-2592. [PMID: 30686125 DOI: 10.1080/09638288.2018.1564943] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Purpose: Deafblindness, also known as dual sensory loss, creates a distinct condition more disabling than either deafness or blindness alone. The participation experiences of persons with deafblindness have not been understood well. This phenomenological study aims to understand the meanings of participation for persons with deafblindness and identify the domains of life that are important to them.Methods: We used the International Classification of Functioning, Disability and Health as a guiding framework. Sixteen adults with deafblindness were interviewed between March and May 2017 in India using a qualitative interview guide.Results: Findings suggest participation as a dynamic, individualized construct that is not just an end outcome. Rather, it is a means to achieve other goals important to the participants such as gaining respect, autonomy, independence, support and relationships, to fulfill aspirations and responsibilities, and to feel included and recognized in society. Life domains that they deemed important for participation were communication and access to information, mobility, relationships, education and productivity, and recreation and leisure.Conclusions: In order to enhance societal participation of people with deafblindness, a significant change in the focus of rehabilitation services is required which involves professionals viewing participation as both a means and an end outcome while designing interventions.
Collapse
Affiliation(s)
- Atul Jaiswal
- School of Rehabilitation Therapy, Queen's University, Kingston, Canada
| | | | - Walter Wittich
- School of Optometry, University of Montreal, Montreal, Canada
| | - Mansha Mirza
- Department of Occupational Therapy, University of Illinois at Chicago, Chicago, IL, USA
| | - Marcia Finlayson
- School of Rehabilitation Therapy, Queen's University, Kingston, Canada
| |
Collapse
|