Flik: design tool on adaptation process for non-designers in a rehabilitation setting

Adaptation is a key practice in rehabilitation that assists the client’s recovery following a disease or injury. Lack of design skills and problem solutions has turned the process into a fuzzy front, especially for entry level therapists. Furthermore, the low adaptation tool rate usage has listed several contributing factors, which includes non-compliance, uncomfortable designs, low aesthetic values, scant personal acceptance, inadequate instructions, and training. However, the design thinking concept has seen an increase with the adoption of interdisciplinary studies in recent years. From the aspect of innovation, the concept seems difficult to implement without close supervision from design experts. That said, a proper design process shall be introduced to therapists for better adaptive tools in the future. The purpose of this study is to assist in the adaptation process for occupational therapy as a self-assisting tool through the design process. This method is a convergence of OT and design practice into a design-health system, which resulted in the development of FLIK (Functionled Innovation Kit), that supports non-designers (therapists) while performing adaptation activities, albeit not possessing formal design knowledge. Overall, this study investigates the opportunity of an interdisciplinary collaboration between design and health sectors; as well as to enhance work practices which is imperative for more effective services and recoveries in future

Seeking information about assistive technology: Exploring current practices, challenges, and the need for smarter systems

Ninety percent of the 1.2 billion people who need assistive technology (AT) do not have access. Information seeking practices directly impact the ability of AT producers, procurers, and providers (AT professionals) to match a user's needs with appropriate AT, yet the AT marketplace is interdisciplinary and fragmented, complicating information seeking. We explored common limitations experienced by AT professionals when searching information to develop solutions for a diversity of users with multi-faceted needs. Through Template Analysis of 22 expert interviews, we find current search engines do not yield the necessary information, or appropriately tailor search results, impacting individuals’ awareness of products and subsequently their availability and the overall effectiveness of AT provision. We present value-based design implications to improve functionality of future AT-information seeking platforms, through incorporating smarter systems to support decision-making and need-matching whilst ensuring ethical standards for disability fairness remain

Value beyond function: Analyzing the perception of wheelchair innovations in Kenya

Innovations in the field of assistive technology are usually evaluated based on practical considerations related to their ability to perform certain functions. However, social and emotional aspects play a huge role in how people with disabilities interact with assistive products and services. Over a five months period, we tested an innovative wheelchair service provision model that leverages 3D printing and Computer Aided Design to provide bespoke wheelchairs in Kenya. The study involved eight expert wheelchair users and five healthcare professionals who routinely provide wheelchair services in their community. Results from the study show that both users and providers attributed great value to both the novel service delivery model and the wheelchairs produced as part of the study. The reasons for their appreciation went far beyond the practical considerations and were rooted in the fact that the service delivery model and the wheelchairs promoted core values of agency, empowerment and self-expression

The Global Care Ecosystems of 3D Printed Assistive Devices

The popularity of 3D printed assistive technology has led to the emergence of new ecosystems of care, where multiple stakeholders (makers, clinicians, and recipients with disabilities) work toward creating new upper limb prosthetic devices. However, despite the increasing growth, we currently know little about the differences between these care ecosystems. Medical regulations and the prevailing culture have greatly impacted how ecosystems are structured and stakeholders work together, including whether clinicians and makers collaborate. To better understand these care ecosystems, we interviewed a range of stakeholders from multiple countries, including Brazil, Chile, Costa Rica, France, India, Mexico, and the U.S. Our broad analysis allowed us to uncover different working examples of how multiple stakeholders collaborate within these care ecosystems and the main challenges they face. Through our study, we were able to uncover that the ecosystems with multi-stakeholder collaborations exist (something prior work had not seen), and these ecosystems showed increased success and impact. We also identified some of the key follow-up practices to reduce device abandonment. Of particular importance are to have ecosystems put in place follow up practices that integrate formal agreements and compensations for participation (which do not need to be just monetary). We identified that these features helped to ensure multi-stakeholder involvement and ecosystem sustainability. We finished the paper with socio-technical recommendations to create vibrant care ecosystems that include multiple stakeholders in the production of 3D printed assistive devices

e-NABLE: DIY-AT Production in a Multi-Stakeholder System

The e-NABLE community is a distributed collaborative volunteer effort to make upper-limb assistive technology devices available to end users. e-NABLE represents a do-it-yourself (DIY) approach to traditional prosthetic care. In order to learn about the attitudes and challenges of stakeholders working in and around e-NABLE, we conducted interviews with 12 volunteers in the e-NABLE movement and 3 clinicians. We found that volunteers derive a rich set of benefits from this form of altruistic activity; that both volunteers and clinicians recognize that end users benefit from aesthetic customization and personal choice in device selection; and that volunteers and clinicians bring separate, but potentially complementary, skills to bear on the processes of device provision. Based on these findings, we outline potential ways for volunteers and clinicians to optimize their talents and knowledge around the end goal of increased positive patient outcomes

Emotionally-driven prostheses: exploring the effects on users’ lives and societies’ attitudes in the UK and Greece

The literature shows that research into the aesthetic aspects of prostheses is limited. Although there are suggestions that prostheses with high levels of emotionally-driven design may improve users’ well-being, they are based only on theoretical findings. Therefore, in this thesis the effects of emotionally-driven prostheses on users’ lives and society’s attitudes were explored, with respect to culture and more specifically, the theories of individualism/ collectivism. In order to investigate the effects of culture, the research was conducted in two countries with different cultures; the UK (individualistic) and Greece (collectivistic). The thesis began with a literature review across three core areas: user, product and environment, and revealed the importance of investigating an additional area; that of prosthetists. The research employed a qualitative approach and consisted of four studies. Study I was an online questionnaire to explore users’ preferences towards prostheses, with respect to their culture. Study II consisted of semi-structured interviews and informational probes to comprehend the role of prostheses on users’ lives, with respect to prosthetic appearance. In Study III, the aim was to investigate prosthetists’ attitudes towards the needs of prosthetic users by conducting semi-structured interviews. Finally, Study IV was an online questionnaire to explore non-users’ attitudes towards the design of prostheses. The research showed that the use of prostheses for the completion of users’ body was not an adequate factor to improve their well-being, and a shift on users’ desires towards emotionally-driven prostheses has occurred. From the variables that were tested, sex, age, cause and area of limb-loss may affect people’s attitudes towards the design of prostheses. Furthermore, the results showed that prostheses with high emotionally-driven design evoked emotions, in both users and non-users, with higher levels of pleasantness and arousal than the emotions that were elicited by the prostheses of lower emotionally-driven designs and thus, they may trigger a greater behavioural reaction. This suggested that emotionally-driven prostheses may eliminate users’ stigmatisation by increasing their self-confidence and altering society’s attitudes. However, attention needs to be paid in collectivistic countries, as emotionally-driven prostheses may enhance users’ stigmatisation.</div

Warm Solutions: Medical Making & Collaborative Infrastructure for Care

Making, as an activity and culture, enables people to participate in technological innovation at non-traditional sites. In healthcare settings, medical makers undertake activities as a part of routine, professional care practice. Their collaborative process occurs at the intersection of centralized healthcare systems and decentralized maker technologies with reflexive opportunities for human-centered design. In my research, I propose a critical view of medical making as an opportunity to reposition the power to participate in design within traditional healthcare practice. I develop my thesis from multiple efforts in a wide ecosystem of medical makers across private and public practice, STEM institutions, academic research labs, and non-profit groups. I apply Science and Technology Studies (STS) and HCI theories to analyze stakeholder efforts in relation to long-term patient-centered care infrastructure. Embedded in practice, infrastructure becomes visible in relation to its use. In my dissertation, I develop an understanding of how stakeholders in healthcare settings and networks influence care infrastructure with maker technologies. I do this by foregrounding the norms, values, and expertise related to stakeholder participation across three sections. First, I re-locate the site where physician-led making begins from labs to the bedside – as safe, reliable, small-scale prototypes. Second, I re-frame the importance of medical making, with lessons from the COVID-19 pandemic, when grassroot- and institutional makers repaired temporary manufacturing breakdowns by creating reliable medical supplies. Third, I re-center the role of point-of-care medical makers, highlighting present-day nurse contributions as makers and contrasting their historically undocumented contributions in routine care. My research work culminates in a discussion of the human infrastructure, in addition to information systems, required to design environments for innovation based on the case study of medical making. For HCI researchers, this work first diversifies design values of novelty to include healthcare values of safety, reliability, and verifiability in collaborative systems, and second, extrapolates lessons from medical making to build fair, equitable, and sustainable infrastructure for collaboration between experts and non-experts. From these value-driven insights, I hope my work further contributes practical, methodological, and ethical implications for multiple stakeholders including policymakers and researchers.Ph.D

A PHENOMENOLOGICAL LOOK AT THE LIFE HACKING-ENABLED PRACTICES OF INDIVIDUALS WITH MOBILITY AND DEXTERITY IMPAIRMENTS

Human-computer interaction and assistive technology research and practice are replete with examples of mostly non-disabled individuals trying to empower individuals with disabilities through the design and provision of accessible products. This study asks one overarching question: what can these communities learn from the self-driven embodied experiences of individuals with disabilities who address accessibility, impairment, and everyday life concerns for themselves? The goal of this dissertation is to examine the underexplored adaptation, modification, and design-like activities of individuals with mobility and dexterity impairments as well as the implications of these activities for researchers, designers, and individuals with disabilities. This phenomenological study examined the embodied everyday life practices of 16 individuals with mobility and dexterity impairments as well as well as their efforts to transform disabling practices into enabling ones. Using sensitizing constructs from contemporary social practice theory approaches as described by Andreas Reckwitz and Theodore Schatzki as well Bruno Latour’s articulation of actor-network theory, this interpretive qualitative research study uncovers different ways participants were dis/enabled and dis/empowered in their daily life practices. Findings point to issues most HCI researchers and professional designers rarely consider in their efforts to study access issues and develop accessible technology, including the impact of the embodied perspectives of mostly non-disabled researchers and designers on the everyday life practices of individuals who live with impairments