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Siebelink NM, Gaasterland A, Gielissen M, van der Weegen S, Boon B, van der Poel A. Barriers and facilitators influencing implementation of care technology for people with intellectual disabilities: A cross-sectional study among care professionals. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2024; 37:e13262. [PMID: 38946655 DOI: 10.1111/jar.13262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 02/26/2024] [Accepted: 05/27/2024] [Indexed: 07/02/2024]
Abstract
BACKGROUND Implementation issues often hinder reaching the potential of care technology to improve daily lives of people with intellectual disabilities. We investigated barriers to and facilitators of implementing different technology modalities (app/social robot/sensor/domotics) in long-term care. METHOD Care professionals (N = 83) from 12 Dutch disability care organisations completed a customised measurement instrument for determinants of innovations (MIDI) questionnaire. RESULTS Out of 27 determinants, 20 were identified as facilitators and 16 as barriers. We highlight common barriers: few colleagues who work with the technology; no (awareness of) formal ratification of technology use; no arrangements regarding turnover of staff using the technology; unsettling organisational changes; technological defects and limited IT preconditions. CONCLUSIONS The results, which could be combined and compared across study sites, provide insight into which implementation determinants were already well addressed, and where there is ground to gain when implementing care technology in disability care organisations.
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Affiliation(s)
- Nienke M Siebelink
- Research & Advisory on Technology in Long-term Care, Academy Het Dorp, Arnhem, The Netherlands
| | | | - Marieke Gielissen
- Research & Advisory on Technology in Long-term Care, Academy Het Dorp, Arnhem, The Netherlands
- Center for Long-term Care for People with Disabilities, Siza, Arnhem, The Netherlands
| | - Sanne van der Weegen
- National Centre of Expertise for Long-term Care, Vilans, Utrecht, The Netherlands
| | - Brigitte Boon
- Research & Advisory on Technology in Long-term Care, Academy Het Dorp, Arnhem, The Netherlands
- Center for Long-term Care for People with Disabilities, Siza, Arnhem, The Netherlands
- Tranzo Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
| | - Agnes van der Poel
- Research & Advisory on Technology in Long-term Care, Academy Het Dorp, Arnhem, The Netherlands
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Mishra S, Laplante-Lévesque A, Barbareschi G, Witte LD, Abdi S, Spann A, Khasnabis C, Allen M. Assistive technology needs, access and coverage, and related barriers and facilitators in the WHO European region: a scoping review. Disabil Rehabil Assist Technol 2024; 19:474-485. [PMID: 35906719 DOI: 10.1080/17483107.2022.2099021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 07/03/2022] [Indexed: 10/16/2022]
Abstract
PURPOSE Globally, assistive technology (AT) is used by over 1 billion people, but the prevalence of needs and access to AT in specific countries or regions is largely unknown. This scoping review summarises the evidence available on the prevalence of needs, access and coverage of AT in the World Health Organisation European Region and the barriers and facilitators to its use. METHODS Relevant publications were identified using a combination of two strategies: 1) a systematic search for AT publications in five scientific literature databases; and 2) consultations with 76 of the Region's AT experts. RESULT The search strategies yielded 103 publications, 62 of them identified by the systematic search. The included publications were predominantly from six countries, and 18 countries were unrepresented. Information on AT use for specific functional impairments was present in 57 publications: AT for hearing impairment in 14 publications; vision in 12; mobility, 12; communication, 11; self-care, 6; and cognition, 2. AT needs for vision and hearing impairment were more likely to be met (1-87% and 5-90%, respectively) compared with communication and cognition impairments (10-60% and 58%, respectively). The barriers and facilitators to AT access described were linked to accessibility, affordability and acceptability. CONCLUSION Data on AT prevalence and coverage are limited in both quantity and quality. Agreed-upon definitions of functional impairment and assistive product categories and standards for data collection are needed to facilitate data comparisons and to build a more representative picture of AT needs and coverage.Implications for rehabilitationComprehensive and disaggregated data concerning the prevalence of needs and coverage of AT is needed to enable the development of responsive policies and actions.The literature available on the prevalence of needs and coverage of AT in the WHO European Region is primarily focussed on a small subset of countries and comparisons between studies are limited due to the use of different data collection strategies.Evidence concerning barriers and facilitators to AT access across countries is more consistent and can be organised across the key themes of accessibility, affordability and acceptability of AT.There is a need for consensus among multiple AT actors on standardised definitions for functional impairment and assistive product categories and standards for data collection to enable a more representative picture to be built of AT needs and coverage across the WHO European Region and globally.
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Affiliation(s)
- Satish Mishra
- World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | | | | | - Luc De Witte
- Centre for Assistive Technology and Connected Healthcare, University of Sheffield, Sheffield, United Kingdom
| | - Sarah Abdi
- Centre for Assistive Technology and Connected Healthcare, University of Sheffield, Sheffield, United Kingdom
| | - Alice Spann
- Centre for Assistive Technology and Connected Healthcare, University of Sheffield, Sheffield, United Kingdom
| | | | - Michael Allen
- United States Agency for International Development, Washington, DC, United States of America
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Friedman C. Assistive technology for people with intellectual and developmental disabilities in the United States in Home- and Community-Based Services. Disabil Rehabil Assist Technol 2023:1-8. [PMID: 37862062 DOI: 10.1080/17483107.2023.2272849] [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: 06/08/2023] [Accepted: 10/13/2023] [Indexed: 10/21/2023]
Abstract
PURPOSE Unmet needs for assistive technology (AT) contribute to health and quality of life disparities among people with intellectual and developmental disabilities (IDD) [1-4]. The biggest barrier people with IDD face accessing technology is affordability and a lack of funding [1,3-6]. The purpose of this study was to examine how AT were provided to people with IDD in Medicaid Home- and Community-Based Services (HCBS) in the United States, the largest funding source for Long-Term Services and Supports for people with IDD. MATERIALS AND METHODS We analysed Medicaid HCBS 1915(c) waivers for people with IDD from across the USA in fiscal year (FY) 2021 using content analysis and descriptive statistics. RESULTS AND CONCLUSIONS In FY2021, 31 states and the District of Columbia provided AT (stand-alone and combined services) through 68 waivers for people with IDD to improve functioning, communication, independence, and community integration. In total, $63.3 million was projected for the AT services for 23,753 people with IDD. Average spending per person on AT services was $2,663. We found significant variability in terms of how states allocated AT to people with IDD in their HCBS programs. Not only were less than 3% of people with IDD with HCBS projected to receive assistive technology services, there was also large variance across services and states. Assistive technology promotes the health, safety, quality of life, independence, and community integration of people with IDD - they align with the very aims of HCBS, and thus, should be expanded.
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Affiliation(s)
- Carli Friedman
- CQL | The Council on Quality and Leadership, Towson, MD, USA
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Boot FH, Kahonde C, Dinsmore J, MacLachlan M. Perspectives on access and usage of assistive technology by people with intellectual disabilities in the Western Cape province of South Africa: Where to from here? Afr J Disabil 2021; 10:767. [PMID: 33824859 PMCID: PMC8007997 DOI: 10.4102/ajod.v10i0.767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 11/26/2020] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Whilst assistive technology (AT) can play an important role to improve quality of life, health inequity regarding access to appropriate AT for people with intellectual disabilities (ID) is still very much present especially in low resource countries. OBJECTIVES This study focused on exploring factors that influence access to and continued use of AT by people with ID in the Western Cape province of South Africa and to suggest potential implications of these findings and actions required to promote access to AT. METHOD A qualitative approach was used to explore the experiences of people with ID and providers of AT. Face-to-face interviews with 20 adults with mild to profound ID, and 17 providers of AT were conducted and the data were analysed thematically. RESULTS People with ID within the study setting faced many challenges when trying to access AT and for those who managed to acquire AT, its continued usage was influenced by both personal characteristics of the user and environmental factors. Important factors that influence AT access and use for people with ID found in this study were (1) attitudes from the community, (2) knowledge and awareness to identify AT need and (3) AT training and instructions to support the user and care network. CONCLUSION With the perspectives of both the providers and users of AT, this study identified priority factors, which could be addressed to improve AT access and use for people with ID in the Western Cape province.
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Affiliation(s)
- Fleur H Boot
- Department of Primary and Community Care, Faculty of Medicine, Radboud University Medical Centre, Nijmegen, The Netherlands
- Assisting Living and Learning (ALL) Institute, Department of Psychology, Maynooth University, Maynooth, Ireland
| | - Callista Kahonde
- Centre for Disability and Rehabilitation Studies, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - John Dinsmore
- Centre for Practice and Healthcare Innovation, School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Malcolm MacLachlan
- Assisting Living and Learning (ALL) Institute, Department of Psychology, Maynooth University, Maynooth, Ireland
- Centre for Disability and Rehabilitation Studies, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- Olomouc University Social Health Institute (OUSHI), Palacky University, Olomouc, Czech Republic
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Lancioni GE, Singh NN, O’Reilly MF, Sigafoos J, Alberti G, Campodonico F, Acquaviva G, Chiariello V, Desideri L. Persons with intellectual and multiple disabilities activate via non-verbal responses a smartphone's Google Assistant to access preferred stimulation. INTERNATIONAL JOURNAL OF DEVELOPMENTAL DISABILITIES 2020; 68:518-527. [PMID: 35937160 PMCID: PMC9351553 DOI: 10.1080/20473869.2020.1827213] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 08/18/2020] [Accepted: 09/13/2020] [Indexed: 06/15/2023]
Abstract
OBJECTIVES The present study evaluated a new smartphone-based program to help 12 participants with intellectual disability plus visual and motor impairments to self-regulate their stimulation input (thus avoiding their dependence on staff) through simple non-verbal responses. METHOD Nonconcurrent multiple baseline designs across participants were used to assess the effects of the program. The technology used for the program involved a Samsung J4 Plus smartphone with Android 9.0 operating system, two voice recording devices, smart-plugs, and a mini speaker. The smartphone was provided with a Google account and Internet connection, which allowed the participants to access Google Assistant and Google Play Music. The participants could make requests for two different types of stimulation (e.g. songs and familiar voices or noises) by activating via hand pressure the two voice recording devices. The verbal request messages emitted by the devices were recognized by the Google Assistant, which led the smartphone to deliver the related stimulation. RESULTS During the baseline sessions (without the support of the voice recording devices), the participants failed to access any stimulation. During the intervention and post-intervention phases (with the support of the voice recording devices), all participants managed to access the types of stimulation available independently. The mean frequency of responses (i.e. activations of both voice recording devices) per session ranged between about 8 and 14. CONCLUSION The new smartphone-based program can be viewed as a useful resource to enable individuals like the participants of this study to access preferred stimulation independently.
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Affiliation(s)
- Giulio E. Lancioni
- Department of Neuroscience and Sense Organs, University of Bari, Bari, Italy
| | - Nirbhay N. Singh
- Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Mark F. O’Reilly
- Department of Special Education, University of Texas at Austin, Austin, TX, USA
| | - Jeff Sigafoos
- School of Education, Victoria University of Wellington, Wellington, New Zealand
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Gómez LE, Monsalve A, Morán ML, Alcedo MÁ, Lombardi M, Schalock RL. Measurable Indicators of CRPD for People with Intellectual and Developmental Disabilities within the Quality of Life Framework. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E5123. [PMID: 32679924 PMCID: PMC7400318 DOI: 10.3390/ijerph17145123] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 07/02/2020] [Accepted: 07/10/2020] [Indexed: 11/17/2022]
Abstract
This article proposes the quality of life (QOL) construct as a framework from which to develop useful indicators to operationalize, measure, and implement the Articles of the Convention on the Rights of Persons with Disabilities (CRPD). A systematic review of the scientific literature on people with intellectual and developmental disabilities (IDD) was carried out, with the aim of identifying personal outcomes that can be translated into specific and measurable items for each of the CRPD Articles aligned to the eight QOL domains. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, the systematic review was conducted across the Web of Science Core Collection, Current Contents Connect (CCC), MEDLINE, KCI-Korean Journal Database, Russian Science Citation Index and SciELO Citation Index, for articles published between 2008 and 2020. A total of 65 articles focusing on people with IDD were selected. The results were grouped into four broad categories: conceptual frameworks used to monitor the CRPD; instruments used to assess the rights set out in the CRPD; recommendations on the use of inclusive research; and indicators or personal outcomes associated with specific rights contained in the CRPD.
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Affiliation(s)
- Laura E. Gómez
- Department of Psychology, Universidad de Oviedo, 33003 Oviedo, Spain; (A.M.); (M.L.M.); (M.Á.A.)
| | - Asunción Monsalve
- Department of Psychology, Universidad de Oviedo, 33003 Oviedo, Spain; (A.M.); (M.L.M.); (M.Á.A.)
| | - Mª Lucía Morán
- Department of Psychology, Universidad de Oviedo, 33003 Oviedo, Spain; (A.M.); (M.L.M.); (M.Á.A.)
| | - Mª Ángeles Alcedo
- Department of Psychology, Universidad de Oviedo, 33003 Oviedo, Spain; (A.M.); (M.L.M.); (M.Á.A.)
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