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The impact of assistive technology in India: Surveys, a wheelchair skills test, and a research methods Delphi

Jefferds, Alexandra Nicole (2009) The impact of assistive technology in India: Surveys, a wheelchair skills test, and a research methods Delphi. Master's Thesis, University of Pittsburgh. (Unpublished)

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Current assistive technology (AT) provision efforts in less-resourced environments rely on heuristic methods to monitor and improve service provision, instead of evidence-based practice (EBP) which has become standard in well-resourced regions. To introduce EBP methods, and evaluate the impact of technology on the lives of people with disabilities, we collaborated with clinicians at the Indian Spinal Injuries Centre (ISIC). Two studies were conducted using ISIC quality assurance data collected with our assistance. Based on our experience at ISIC, a third study was performed to investigate the challenges to international AT research, and develop strategies to overcome these challenges.The first study was conducted with individuals receiving new AT from ISIC. The data consisted of a baseline PART survey and 6-month and 12-month follow-ups taken with a majority (92%) outpatient population. Thirteen clients completed all three questionnaires. Results showed trends toward increased community participation and life satisfaction over the 12-month period. ISIC is planning to expand its implementation of the PART survey, perhaps online.The second study was conducted with individuals (69% inpatient) who received new wheelchairs from ISIC. The Wheelchair Skills Test and QUEST were administered before and after personal wheelchair provision. Seven clients completed a full set of pre- and post-tests. Trends toward increased skill completion rates, increased skill attempt rates, and slightly increased safety scores were found. QUEST scores increased in the post-test, bringing scores close to values reported in literature.The third study, conducted using a three-round Delphi method online, involved the participation of 13 experts in AT and rehabilitation research with experience working in low- and middle-income countries. During the first questionnaire round, participants were asked to identify domains of research that they considered the most challenging. In the second round, they were asked to rank and categorize the challenges as being either ethical or logistical, and also to suggest strategies to address them. In the final round, participants were asked to critique each strategy on its efficacy. Topics discussed included local collaboration, appropriate tools and techniques, translation, retention, compensation, and funding. Verifying the efficacy of suggested strategies could be the subject of future research.


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Item Type: University of Pittsburgh ETD
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Jefferds, Alexandra
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairPearlman, Jon Ljlp46@pitt.eduJLP46
Committee MemberSeelman, Katherinekds31@pitt.eduKDS31
Committee MemberCooper, Rory Arcooper@pitt.eduRCOOPER
Date: 10 September 2009
Date Type: Completion
Defense Date: 29 June 2009
Approval Date: 10 September 2009
Submission Date: 22 July 2009
Access Restriction: 5 year -- Restrict access to University of Pittsburgh for a period of 5 years.
Institution: University of Pittsburgh
Schools and Programs: School of Health and Rehabilitation Sciences > Health and Rehabilitation Sciences
Degree: MS - Master of Science
Thesis Type: Master's Thesis
Refereed: Yes
Uncontrolled Keywords: assistive technology; barriers; challenges; CHART; Delphi; Delphi method; developing countries; disabled persons; evidence-based practice; international; less-resourced countries; mobility; obstacles; PART; participation; people with disabilities; provision; QUEST; rehabilitation; satisfaction; self-help devices; third world countries; translations; wheelchair skills; wheelchair skills test; wheelchairs
Other ID:, etd-07222009-144003
Date Deposited: 10 Nov 2011 19:52
Last Modified: 15 Nov 2016 13:46


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