Experts Views on the Use of Mobile Devices to Support Patients with Mild Learning Disabilities During Clinical Consultations

Due to several factors including time and budget constraints, General Practitioners (GPs) are often under-trained on the communication needs of patients with learning disabilities (LDs). As such, they may find it difficult to extract accurate information from these patients. Digital technologies have the potential to alleviate communication barriers, yet their use in this context remains vastly unexplored. Hence, we conducted 2 focus groups with 12 experts in LDs to investigate how tablet applications may be used to promote the information exchange process between GPs and patients with mild LDs. The experts identified an initial set of design criteria for the future implementation of these technologies and were enthusiastic about the potential impact they may have on primary care. In addition, they also discussed a potential model for extracting medical information from this population, which focused on breaking the overall consultation down into smaller, less cognitively challenging segments

Design requirements for a digital aid to support adults with mild learning disabilities during clinical consultations: a qualitative study with experts

Background: Adults with mild learning disabilities (MLDs) face a plethora of obstacles when accessing effective health care. Central to many of these barriers is communication, with medical practitioners often remaining untrained on how to interact with patients who have learning disabilities (LDs). To date, research on how to promote this communication has largely centered on the development of low-tech aids. Objective: The objective of this study was to assess the feasibility of utilizing tablet technologies to promote communication between general practitioners and patients with MLDs. We achieved this by identifying a set of design requirements from experts in LDs. Methods: A set of design guidelines was formed during a 2-phase process. Phase 1 involved conducting a series of requirements-gathering interviews with 10 experts in LDs-the protocol of which emerged from the results of a separate scoping review. The interviews were subjected to a framework analysis to discern the key requirements discussed by the experts, and these were embedded within a technology probe. In phase 2, this probe was presented to a subset (n=4) of the experts during a round of usability studies, and the feedback received was used to update the requirements identified in phase 1. Results: An initial set of design requirements has been produced that may assist in the development of clinical Alternative and Augmentative Communication technologies for adults with MLDs. Factors that must be considered range from the health, physical and cognitive needs of stakeholders, to the more individual needs of users. Conclusions: The experts involved in the study were optimistic about the proposed app. They believe that such technologies can help to alleviate time constraints and promote communication by presenting information in a form understood by both practitioners and patients

Lessons from Expert Focus Groups on how to Better Support Adults with Mild Intellectual Disabilities to Engage in Co-Design

Co-design techniques generally rely upon higher-order cognitive skills, such as abstraction and creativity, meaning they may be inaccessible to people with intellectual disabilities (ID). Consequently, investigators must adjust the methods employed throughout their studies to ensure the complex needs of people with ID are appropriately catered to. Yet, there are a lack of guidelines to support researchers in this process, with previous literature often neglecting to discuss the decisions made during the development of their study protocols. We propose a new procedure to overcome this lack of support, by utilizing the knowledge of “experts” in ID to design a more accessible workshop for the target population. 12 experts across two focus groups were successful in identifying accessibility barriers throughout a set of typical early co-design activities. Recommendations to overcome these barriers are discussed along with lessons on how to better support people with ID to engage in co-design

Alternative and Augmentative Communication Technologies for Supporting Adults With Mild Intellectual Disabilities During Clinical Consultations:Scoping Review

Background: People with intellectual disabilities (IDs) face significant communication barriers when accessing health care services; they find it difficult to identify and describe conditions clearly enough to support practitioners in making an accurate diagnosis. In addition, medical professionals generally have little knowledge and understanding of the needs of people with ID, which may result in the use of consultation techniques that do not cater to their patients' skills. Objective: This review aims to identify and synthesize the literature on alternative and augmentative communication technologies that are used to support adults with mild ID during the exchange of information with medical practitioners. Methods: We performed a scoping review of studies published in English that describe the technologies that are used to promote communication with patients with mild ID during medical consultations. The databases searched were PubMed, ACM Digital Library, and Google Scholar. A qualitative framework-based approach was used to synthesize the data and discern key recurring themes across the identified literature. Results: Of the 1557 articles screened, 15 (0.96%) met our inclusion criteria. The bulk of the communication aids used focused on low-tech solutions, including patient passports, note-based prompts, Talking Mats, health diaries, and easy-read information sheets. Their influence on current practice ranged from advancing medical professionals' knowledge of the health and communication needs of people with ID to increasing interagency collaboration, patient advocacy skills, and health promotion activities. The major barriers to the implementation of low-tech aids were a lack of portability and increased maintenance efforts. Only 3 studies explored the use of mobile apps to promote communication. Their findings indicated that high-tech solutions offer greater customization with regard to the accessibility and health care needs of people with ID. Conclusions: Alternative and augmentative communication technologies have the potential to increase the quality of care provided to patients with mild ID; however, little work has been carried out in this area. Greater emphasis must be placed on (high-tech) two-way communication aids that empower patients to become involved in decisions regarding their care. Quantitative evaluation methods should be used to discern the true benefits of such aids, and researchers should describe their study protocols in depth to promote replication and generalizability

Mobile support for adults with mild learning disabilities during clinical consultations

Some of the factors that explain poor health outcomes for people with learning disabilities (LDs) include multi-morbidity and underdiagnosed health conditions. Previous studies have suggested that this population face significant communication barriers when interacting with health professionals and this is a major contributing factor to such diagnosis complications. Consequently, such health barriers are often preventable. However, there is a surprising lack of research-based technologies available that intend to promote this communication. We aim to address this gap by investigating the potential of using mobile technologies to support adults with mild LDs during clinical consultations. To achieve this, we interviewed a number of domain experts including government advisors, academics, support workers and General Practitioners. We then developed a technology probe to inform the information extracted and subsequently created a set of design guidelines for the development of Augmentative and Communicative technologies that target the clinical needs of adults with mild LDs

Evaluating the usability of a tablet application to support adults with mild intellectual disabilities during primary care consultations

Patients with mild intellectual disabilities (ID) face significant communication barriers when attending primary care consultations. Yet there is a lack of two-way communication aids available to support them in conveying medical symptoms to General Practitioners (GPs). Based on a multi-stakeholder co-design process including GPs, domain experts, people with mild ID and carers, our previous work developed prototype technology to support people with mild ID in GP consultations. This paper discusses the findings of a usability study performed on the resulting prototype. Five experts in ID/usability, four caregivers, and five GPs participated in cognitive and post-task walkthroughs. They found that the application has the potential to increase communication, reduce time constraints, and overcome diagnostic overshadowing. Nevertheless, the participants also identified accessibility barriers relating to: medical imagery; the abstract nature of certain conditions; the use of adaptive questionnaires; and the overloading of information. Potential solutions to overcome these barriers were also discussed

Future bathroom: A study of user-centred design principles affecting usability, safety and satisfaction in bathrooms for people living with disabilities

Research and development work relating to assistive technology 2010-11 (Department of Health) Presented to Parliament pursuant to Section 22 of the Chronically Sick and Disabled Persons Act 197