Development and feasibility of an automated call monitoring intervention for older wheelchair users: the MOvIT project

Abstract

BackgroundRecent advances in wheeled mobility technology are multiplying opportunities for community integration and improved quality of life. The mobility needs of older wheelchair users are particularly complex due to a constellation of chronic conditions and comorbidities that may compromise optimal use of the device. The purpose of the Mobility Outcomes via Information Technologies (MOvIT) project is to examine the feasibility of automated calls for the systematic monitoring for adverse outcomes associated with wheelchair use.MethodsA two-phase mixed methods approach was used. Phase I involved user-centered development and face validation of a monitoring questionnaire with end-users (seven wheelchair users and five healthcare providers). Phase II tested the feasibility of monitoring outcomes using automated calls to administer the MOvIT questionnaire 1 and 3 months after wheelchair delivery with a prospective cohort of older adults (50–84 years of age). When problems were identified, the computer monitoring system notified a clinical coordinator who followed up with respondents requiring interventions. Feasibility data were extracted from the web database and from individual interviews covering perceived ease of use, usefulness and intention to use the MOvIT questionnaire in the future.ResultsThe MOvIT monitoring questionnaire developed in phase I tracks nine potential wheelchair-related adverse outcomes considered important for end-users: 1) non-use of wheelchair, 2) pain, 3) skin condition, 4) positioning, 5) wheelchair incidents, 6) psychosocial issues, 7) restricted wheelchair participation, 8) limited wheelchair skills and knowledge, and 9) technical problems. In phase II, 92 individuals who received a wheelchair were eligible, 71 out of 92 accepted (77 %) and 65 out of 71 (92 %) completed the 3-month follow-up. In the sample of 65 participants, a wheelchair-related adverse outcome was confirmed by a rehabilitation professional for 58.5 %, and at least one recommendation was given to 66.2 % during the 3-month monitoring period. A majority of participants found the intervention useful (82.8 %) and said they intended to use the MOvIT monitoring questionnaire in the future (81.5 %). Participants made suggestions to make the calls more adaptive to various ability profiles.ConclusionsAutomated calls tailored for individuals with mobility limitations and associated comorbidities are a promising approach to reach clients who need post-rehabilitation support.

What’s behind the Dashboard? Intervention Mapping of a Mobility Outcomes Monitoring System for Rehabilitation

“…Following the analysis of TRIAGE notes and material and based on the logic model, we linked each component to target behaviors, associated determinants of change and expected outcomes in the format of three detailed tables. Each component was also matched with its original ranking from the needs assessment and its supporting evidence from the systematic review [ 16 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 , 87 , 88 , 89 , 90 , 91 , 92 , 9...…”

“…Because of geographic barriers and time constraints, these training programs are not necessarily accessible for all AT users and their caregivers. Through the Internet, it would be possible to overcome these obstacles while also providing means of remote monitoring for clinicians when potential issues arise [ 16 , 17 ].…”

Supporting Healthy Aging through the Scale-Up, Spread, and Sustainability of Assistive Technology Implementation: A Rapid Realist Review of Participatory Co-Design for Assistive Technology with Older Adults

“…A common theme in the literature was the underlying aim of participatory co-design to engage older adults and their informal carers in order to respect their rights, autonomy and agency, and allow them to participate as fully as possible in guiding the design of the AT and their implementation. Sometimes the emphasis is on the somewhat nebulous concept of “empowerment” as a stand-alone outcome; at other times, the engagement process seems to be seen as the precondition (or “context” in realist terms) for successful knowledge integration (Auger et al, 2011). Furthermore, there are great advantages claimed for PCD methodologies beyond usability, such as its valuable contribution for “scalable services to be developed, deployed, tested, and evaluated with the end users, quickly and effectively prior to large scale implementation” (Ward et al, 2015, p. 14).…”

Montreal Accord on Patient-Reported Outcomes (PROs) use series – Paper 4: patient-reported outcomes can inform clinical decision making in chronic care

“…The Wheelchair Outcome Measure (WhOM) incorporates participation goals in specific activities in- or outside the home. One study used automated calls to periodically assess satisfaction with participation and identify problems [19]. When pre-determined thresholds were exceeded, a rehabilitation specialist was alerted to direct patients to appropriate services; adherence to clinical recommendations also increased 79%.…”