Development of a Web-Based Monitoring System for Power Tilt-in-Space Wheelchairs: Formative Evaluation

Abstract

BackgroundIn order to prevent pressure ulcers, wheelchair users are advised to regularly change position to redistribute or eliminate pressure between the buttocks region and the seat of the wheelchair. A power tilt-in-space wheelchair (allowing simultaneous pivoting of the seat and the backrest of the wheelchair toward the back or front) meets many clinical purposes, including pressure management, increased postural control, and pain management. However, there is a significant gap between the use of tilt as recommended by clinicians and its actual usage. A Web-based electronic health (eHealth) intervention, including a goal setting, monitoring, reminder, and feedback system of the use of power tilt-in-space wheelchairs was developed. The intervention incorporates behavior change principles to promote optimal use of tilt and to improve clinical postprocurement follow-up.ObjectiveThis study aimed to conduct a formative evaluation of the intervention prototype to pinpoint the functionalities needed by end users, namely, power wheelchair users and clinicians.MethodsOn the basis of an evaluation framework for Web-based eHealth interventions, semistructured interviews were conducted with power wheelchair users and clinicians. A content analysis was performed with a mix of emerging and a priori concepts.ResultsA total of 5 users of power tilt-in-space wheelchairs and 5 clinicians who had experience in the field of mobility aids aged 23 to 55 years were recruited. Participants found the Web interface and the physical components easy to use. They also appreciated the reminder feature that encourages the use of the tilt-in-space and the customization of performance goals. Participants requested improvements to the visual design and learnability of the Web interface, the customization of reminders, feedback about specific tilt parameters, and the bidirectionality of the interaction between the user and the clinician. They thought the current version of the intervention prototype could promote optimal use of the tilt and improve clinical postprocurement follow-up.ConclusionsOn the basis of the needs identified by power wheelchair users and clinicians regarding the prototype of a power tilt-in-space wheelchair monitoring system, 3 main directions were defined for future development of the intervention. Further research with new wheelchair users, manual tilt-in-space wheelchairs, various age groups, and family caregivers is recommended to continue the formative evaluation of the prototype.

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

“…The sensor-based monitoring system collects data on the use of power wheelchairs, specifically tracking tilt angle and time spent in the wheelchair (time seated and time tilted). If pre-determined behavior targets are not met, a sound or vibration notification is issued to the AT user as a reminder [ 21 ]. The sensor-based monitoring system is also connected to the clinicians’ intervention system.…”

“…While our initial work embraced AT for various limitations (mobility, vision, communication, …), through the intervention mapping approach we refined the target population to users of mobility aids only: manual and power wheelchairs, wheeled bases, scooters, rollator walkers, walkers and quadripod canes. As such, the Internet-based intervention aimed to address abovementioned gaps by providing non-emergency remote monitoring, support, and training resources to facilitate behavior change in older adult AT users and their caregivers, and to mitigate negative outcomes that can be associated with mobility AT use [ 18 , 19 , 20 , 21 ]. With MOvIT+™, remote monitoring is done via self-report questionnaires completed by the AT user or caregiver through customized data collection methods (online, SMS or interactive voice-response system), clinician report (clinical portal) and internet of things (sensors attached to a device post-delivery).…”

Rehabilitation Supported by Technology: Protocol for an International Cocreation and User Experience Study

“…The objective is to test the teledance intervention, including a series of video vignettes adapted for stroke rehabilitation and follow-up modalities with users (asynchronous and synchronous). To do so, the intervention will be subject to a formative evaluation by the users to identify and resolve problems that may influence their experience [ 61 ] and to explore its potential impacts. By testing the intervention within an intensive functional rehabilitation setting, the objective is to identify the characteristics of users to whom such an intervention can be applied, evaluate its usability and safety, and explore its potential impacts.…”

Development and evaluation of an eHealth self-management intervention for patients with chronic kidney disease in China: protocol for a mixed-method hybrid type 2 trial

“…To this end, we will use the 'think aloud' method [48], in which patients and care providers can speak aloud any words in their mind as they read through parts of the intervention plan. The think-aloud research method has been demonstrated to provide valid data on participant thinking and was successfully used in other intervention development studies [49,50]. Based on the results obtained, further modifications will be made, resulting in a pre-tested version of the intervention plan ready for implementation in practice.…”