Understanding the use of digital technologies to provide disability services remotely during the COVID-19 pandemic; a multiple case study design.

BACKGROUND: Using digital technologies to provide services and supports remotely may improve efficiency and accessibility of healthcare, and support people with disabilities to live independently. This study aimed to explore the experience of using digital technologies to access and provide disability services and supports during the Covid-19 pandemic, from the perspective of people with disabilities, families and service providers. METHODS: Using a multiple case study design, we purposively sampled three cases based on service user characteristics and geographical reach of the service. We conducted semi-structured interviews with 40 service users and service providers. Topic guides and analysis were informed by the Consolidated Framework for Implementation Research (CFIR). Analysis followed a largely deductive approach, using the CFIR constructs as a coding framework. A summary memo was developed for each case. Influence and strength of each construct was rated to identify constructs that influenced implementation of digital technologies. Ratings were compared across services to identify facilitators and barriers to implementation. RESULTS: Service users and providers were positive about using digital technologies to access and provide disability services and supports remotely. Advantages over in-person delivery included reduced travel time, increased opportunity for peer support and peer learning, more choice and opportunity to participate in activities, and an enhanced sense of self while accessing services from the secure environment of their home. The urgency to identify new modes of service delivery to meet the needs of service users during Covid-19 was a strong facilitator but did not necessarily result in successful implementation. Other factors that were strong facilitators were the use of adaptations to enable service users to access the online service, service users' willingness to try the online service, service users' persistence when they encountered challenges, and the significant time and effort that service providers made to support service users to participate in the online service. Barriers to implementation included the complexity of accessing online platforms, poor design quality of online platforms, and organisations prioritising in-person delivery over online services. CONCLUSIONS: These findings may allow service providers to leverage facilitators that support implementation of online disability services and supports.

Using a systems thinking approach to understand teachers perceptions and use of assistive technology in the republic of Ireland.

PURPOSE: Assistive technology (AT) enables and promotes inclusion and participation, especially for persons with a disability, ageing populations, and those with non-communicable diseases. AT is essential for generating collaborative learning environments, inclusive of students with a range of specific needs and required supports. However, many teachers lack the training, resources, and skills to use AT in the class. This study uses a systems thinking approach to consider teachers AT needs in the Irish classroom. METHODS: Three hundred and five teachers completed an online survey, and 10 took part in semi-structured focus groups. The survey examined teachers experiences with AT, their training needs, and the context within which they need support. RESULTS: Teachers reported low levels of AT knowledge, skills, and confidence. Many described limited access to training and support for AT use. Results also reveal non-systems thinking, whereby there is no meaningful linking across the main strategic drivers of AT - policy, products, provision, and personnel, to support the people at the centre of the AT system - between these and the contextual factors that influence their effectiveness. CONCLUSION: An AT system which is easy to navigate, which has policies and provision that supports educators, and has expert personnel on hand to support teachers, is crucial if AT is to become embedded in Irish classrooms. This research shows that a comprehensive AT system in education should include policies, practices, personnel, and products that interact to support people to engage easily and successfully with AT in the classroom.IMPLICATIONS FOR REHABILITATIONDescribes current trends in how teachers are engaging with Assistive Technology.Describes the current trends in disabilities in Irish classroom and teachers requirements for support.Understand the system challenges facing teachers attempting to use Assistive Technology.Support the development of Assistive Technology training for teachers which are informed by teachers needs.Inform the development and improving policies and processes for common situations.

Assistive technology policy: a position paper from the first global research, innovation, and education on assistive technology (GREAT) summit.

Increased awareness, interest and use of assistive technology (AT) presents substantial opportunities for many citizens to become, or continue being, meaningful participants in society. However, there is a significant shortfall between the need for and provision of AT, and this is patterned by a range of social, demographic and structural factors. To seize the opportunity that assistive technology offers, regional, national and sub-national assistive technology policies are urgently required. This paper was developed for and through discussion at the Global Research, Innovation and Education on Assistive Technology (GREAT) Summit; organized under the auspices of the World Health Organization's Global Collaboration on Assistive Technology (GATE) program. It outlines some of the key principles that AT polices should address and recognizes that AT policy should be tailored to the realities of the contexts and resources available. AT policy should be developed as a part of the evolution of related policy across a number of different sectors and should have clear and direct links to AT as mediators and moderators for achieving the Sustainable Development Goals. The consultation process, development and implementation of policy should be fully inclusive of AT users, and their representative organizations, be across the lifespan, and imbued with a strong systems-thinking ethos. Six barriers are identified which funnel and diminish access to AT and are addressed systematically within this paper. We illustrate an example of good practice through a case study of AT services in Norway, and we note the challenges experienced in less well-resourced settings. A number of economic factors relating to AT and economic arguments for promoting AT use are also discussed. To address policy-development the importance of active citizenship and advocacy, the need to find mechanisms to scale up good community practices to a higher level, and the importance of political engagement for the policy process, are highlighted. Policy should be evidence-informed and allowed for evidence-making; however, it is important to account for other factors within the given context in order for policy to be practical, authentic and actionable. Implications for Rehabilitation The development of policy in the area of asssitive technology is important to provide an overarching vision and outline resourcing priorities. This paper identifies some of the key themes that should be addressed when developing or revising assistive technology policy. Each country should establish a National Assistive Technology policy and develop a theory of change for its implementation.

Using videoed workshops in interdisciplinary research with people who have disabilities.

BACKGROUND: Internationally, interdisciplinary research is advocated in healthcare. Such research receives great respect, particularly from funding bodies, which expect innovations in healthcare to emerge from a whole team rather than a single discipline. However, little guidance exists about the process and structures for such research. AIM: To explore and explain the use of videoed workshops and mixed-media artefacts to collect data, and explore the benefits and challenges for interdisciplinary healthcare research. DATA: sources Videoed workshops were used to ascertain the preferences of eight people who have disabilities concerning assistive technology. These workshops are used to demonstrate the method's benefits and related challenges for interdisciplinary healthcare research. DISCUSSION: This method of collecting data has important potential benefits for healthcare research. Future research in healthcare must not only be interdisciplinary, it should also involve a range of research designs that are adaptive and responsive to service users' needs and use innovative methods of collecting data. CONCLUSION: The use of video and photography in interdisciplinary research for healthcare technology is an exciting possibility, but it poses ethical and practical considerations. IMPLICATIONS FOR RESEARCH: Videos and photography area a useful aid in interdisciplinary research and can be a valuable means of non-verbal data collection, especially with participants affected by disabilities, and can support research methods, such as the use of questionnaires.

Introducing an AT Passport: A Key to Managing Transitions Across the Lifespan.

The service delivery of Assistive Technology for access to information and communications technology is frequently fragmented and inconsistent as evidenced by experience in the US and much of Europe (AAATE 2012). AT users can experience hiatuses in their access to appropriate assistive technologies as they transition from home to education, to employment and in the community. An AT Passport can provide a record of Assistive Technology requirement and use across the lifespan.

Interdisciplinary doctorial supervision: lessons for nurse education and practice.

BACKGROUND: This paper concerns a reflection on one interdisciplinary doctorate supervision project. It outlines key elements for success within this supervisory context. AIM: The aim of this paper is to present a reflection on interdisciplinary doctorate supervision project experience and examine these experiences in light of literature on the topic. METHODS: Reflection was carried out using Rolfe et al. (2010) framework for reflexivity. FINDINGS: The supervised engineering project aimed to develop, demonstrate and evaluate a new framework for the design of customisable assistive technology (AT) which involved professionals working with AT and users with disabilities. As this research occurs in between disciplines, it required an innovative and interdisciplinary approach, with an ultimate merger between health sciences and design engineering disciplines and external liaison with adults with disabilities and a disability service provider. CONCLUSION: Interdisciplinary research is popular contemporarily and addresses societal needs. In the case outlined, clear understandings were developed, in addition to clear territorial boundaries that helped guide the novel research. Steps to success in interdisciplinary research supervision include selecting the appropriate interdisciplinary team; ensuring open communication; establishing and agreeing boundaries of the research and supervision; keeping an open mind; tolerance of lack of expertise in some areas; regular meetings and communication; keeping the student focused and agreeing publication plans in advance.

Crucial design issues for special access technology; a Delphi study.

PURPOSE: To develop and demonstrate a method to involve professional users of assistive technology (AT) in the development process of customisable products. Employing the ideas of user participation and mass customisation, this research addresses the need for reduced product costs and optimised product flexibility. METHOD: An adaptable six-question Delphi study was developed to establish consensus among AT professionals on design issues relating to a specified AT domain requiring innovation. The study is demonstrated for the special access technology (SAT) domain. A modified morphological matrix structures the application of the study results to the product design process. RESULTS: Fourteen professionals from the Republic of Ireland and the UK participated. Consensus was reached on prevalent parts of SAT that malfunction, primary reasons for SAT malfunction, characteristics of clients associated with SAT selection, client needs regarding SAT use and training, desirable traits of SAT and clinicians' frustrations with SAT. CONCLUSION: The study revealed a range of problems related to SAT, highlighting the complexities of successful SAT adoption. The questions led to differentiated insights and enabled design solution conceptualisation from various perspectives. The approach was found to help facilitate efficient generation and application of professional users' knowledge during the design process of customisable AT.