Fall Prevention Self-Assessments Via Mobile 3D Visualization Technologies: Community Dwelling Older Adults’ Perceptions of Opportunities and Challenges

Abstract

BackgroundIn the field of occupational therapy, the assistive equipment provision process (AEPP) is a prominent preventive strategy used to promote independent living and to identify and alleviate fall risk factors via the provision of assistive equipment within the home environment. Current practice involves the use of paper-based forms that include 2D measurement guidance diagrams that aim to communicate the precise points and dimensions that must be measured in order to make AEPP assessments. There are, however, issues such as “poor fit” of equipment due to inaccurate measurements taken and recorded, resulting in more than 50% of equipment installed within the home being abandoned by patients. This paper presents a novel 3D measurement aid prototype (3D-MAP) that provides enhanced measurement and assessment guidance to patients via the use of 3D visualization technologies.ObjectiveThe purpose of this study was to explore the perceptions of older adults with regard to the barriers and opportunities of using the 3D-MAP application as a tool that enables patient self-delivery of the AEPP.MethodsThirty-three community-dwelling older adults participated in interactive sessions with a bespoke 3D-MAP application utilizing the retrospective think-aloud protocol and semistructured focus group discussions. The system usability scale (SUS) questionnaire was used to evaluate the application’s usability. Thematic template analysis was carried out on the SUS item discussions, think-aloud, and semistructured focus group data.ResultsThe quantitative SUS results revealed that the application may be described as having “marginal-high” and “good” levels of usability, along with strong agreement with items relating to the usability (P=.004) and learnability (P<.001) of the application. Four high-level themes emerged from think-aloud and focus groups discussions: (1) perceived usefulness (PU), (2) perceived ease of use (PEOU), (3) application use (AU) and (4) self-assessment (SA). The application was seen as a useful tool to enhance visualization of measurement guidance and also to promote independent living, ownership of care, and potentially reduce waiting times. Several design and functionality recommendations emerged from the study, such as a need to manipulate the view and position of the 3D furniture models, and a need for clearer visual prompts and alternative keyboard interface for measurement entry.ConclusionsParticipants perceived the 3D-MAP application as a useful tool that has the potential to make significant improvements to the AEPP, not only in terms of accuracy of measurement, but also by potentially enabling older adult patients to carry out the data collection element of the AEPP themselves. Further research is needed to further adapt the 3D-MAP application in line with the study outcomes and to establish its clinical utility with regards to effectiveness, efficiency, accuracy, and reliability of measurements that are recorded using the application and to compare it with 2D measurement guidance leaflets.

Information and communication technology use within occupational therapy home assessments: A scoping review

“…Following review of 67 full-text papers, 14 studies met the inclusion criteria. These 14 studies were reported in 16 articles as presented in Table 1 (Atwal et al, 2013 andMoney et al, 2011 described the same study, as did Hamm et al, 2017a and2017b). Figure 1 shows the PRISMA chart summarising the search and study selection process.…”

“…The 3D-MAP program is a mobile application that draws on three-dimensional visualisation technology and aims to facilitate services users to record measurements within the home as part of the assistive equipment provision process (Hamm et al, 2017a(Hamm et al, , 2017b). Hamm and colleagues conducted surveys and focus groups with healthy adults (aged over 50 years) (Hamm et al, 2017a) and Evaluate the feasibility of using an interactive 3D home visualisation software as a tool to aid occupational therapists in carrying out pre-discharge home visits and explore the attitudes of occupational therapists toward technology in general Most therapists were not using technology with clients within their practice but recognised the need to do so Potential benefits of software for discharge planning identified: reduce cost when transporting client difficult, when the home is some distance away and when the client cannot take part in the visit Concern that software would be used to replace home visits Atwal et al (2014), UK Qualitative: think-aloud data captured while using technology and subsequent semi-structured interviews with occupational therapists Female: 57%; age, mean (SD): not reported; N ¼ 7 Occupational therapists within the UK health sector familiar with using desktop computers and typical applications…”

Identifying Key Components of Paper-Based and Technology-Based Home Assessment Tools Using a Narrative Literature Review

“…This review found a developing interest toward assessing patient-environment fit in the technology-based home assessment tools (Hamm et al, 2017(Hamm et al, , 2019Hoffmann & Russell, 2008). However, the consideration of patient fit was only limited to measuring popliteal height in one tool, and in another, video observations of resident's movement around the house.…”

“…Yet, some tools require participants to measure popliteal height (the height from underside of feet to underside of knee) and furniture dimensions. Two assessments that required such tasks were conducted by professionals with assistance from the older adults (Hoffmann & Russell, 2008;Spiliotopoulou et al, 2018) and one was used by the individual alone (Hamm et al, 2017).…”

Exploration of Fall-Evaluation Scores Using Clinical Tools with the Short-Form Berg Balance Scale and Timed Up and Go and Motion Detection Sensors

“…For those who actually perform the data analysis tasks, many ambiguous areas remain, such as the crossover among older people between fallers and non-fallers, as well as the different classification cut points. Therefore, a perception of the feasibility, acceptability, and availability of new tools and techniques in clinical practice [29,30] via data visualization is essential. This perception is far more critical than the usage of community services in obtaining an initial judgment of subhealth.…”