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Implementing technology-based embedded assessment in the home and community life of individuals aging with disabilities: a participatory research and development study.

TitleImplementing technology-based embedded assessment in the home and community life of individuals aging with disabilities: a participatory research and development study.
Publication TypeJournal Article
AuthorsChen K-Y, Harniss M, Patel S, Johnson K
JournalDisabil Rehabil Assist Technol
Date Published2014 Mar

PURPOSE: The goal of the study was to investigate the accuracy, feasibility and acceptability of implementing an embedded assessment system in the homes of individuals aging with disabilities. METHOD: We developed and studied a location tracking system, UbiTrack, which can be used for both indoor and outdoor location sensing. The system was deployed in the homes of five participants with spinal cord injuries, muscular dystrophy, multiple sclerosis and late effects of polio. We collected sensor data throughout the deployment, conducted pre and post interviews and collected weekly diaries to measure ground truth. RESULTS: The system was deployed successfully although there were challenges related to system installation and calibration. System accuracy ranged from 62% to 87% depending upon room configuration and number of wireless access points installed. In general, participants reported that the system was easy to use, did not require significant effort on their part and did not interfere with their daily lives. CONCLUSIONS: Embedded assessment has great potential as a mechanism to gather ongoing information about the health of individuals aging with disabilities; however, there are significant challenges to its implementation in real-world settings with people with disabilities that will need to be resolved before it can be practically implemented. IMPLICATIONS FOR REHABILITATION: Technology-based embedded assessment has the potential to promote health for adults with disabilities and allow for aging in place. It may also reduce the difficulty, cost and intrusiveness of health measurement. Many new commercial and non-commercial products are available to support embedded assessment; however, most products have not been well-tested in real-world environments with individuals aging with disability. Community settings and diverse population of people with disabilities pose significant challenges to the implementation of embedded assessment systems.

Full Text

Using technology to gather health information in the home and community life of people aging with disabilities

What is this research about?

Technology is widely used by people to gather information about their health (heart rate), movements (number of steps walked), and physical activity (running miles and pace). Examples of some of these technologies include things that people can wear, such as a pedometer or an activity monitor like the FitBit. They can also be things that are placed in a house or a community like a motion sensor. Devices have been developed that measure movement, completion of tasks, activities of daily living (such as brushing teeth, getting out of bed), and other measures such as heart rate and pulse. When people have this information, they can use it to help make changes and improve their health. This information could be shared with their doctors and other health workers to start conversations about how to live healthier lives. Although many devices are available commercially, projects that look at how these technologies could be used by people with disabilities have mostly been set up in places like university campuses or research labs, so not much is known about the challenges involved in setting up and using these types of technologies in the real world. We wanted to learn more about how easy or hard it might be to set up a system in someone’s home or community.

What did the researchers do?

We installed a technology called UbiTrack in the homes of 5 people who were 45 years or older. Two of these people had a spinal cord injury, one had late effects of polio, one had muscular dystrophy, and one had multiple sclerosis. UbiTrack used a portable sensor and some other devices that were installed in the homes to record the movement of people inside and outside of their homes. Researchers and the people in the study could then review their movement history on a computer. Movement data gives information about activity level and how much someone travels outside of their home (that is, a measure of life space).

We asked people questions about how easy or hard the system was to use, whether they thought the information was useful and whether they would be willing to share the information. We also asked them to record their location every 30 minutes so we could compare it to the information collected by the technology to see how well it worked. Finally, we observed how people used the technology and the challenges they faced in its use.

What did the researchers find?

We found that the technology worked pretty well. It worked better in big houses than small ones because in small houses it sometimes became confused about which room a person was in. The people who were part of the study said that the technology was easy to use and that the information was useful, but they wanted us to work on technology that measured other kinds of things in addition to location. We noticed that there were some challenges in using it in the real world. Installing it took a long time. Some people had trouble remembering to turn the sensor on and off. Some people didn’t have enough electrical plugs or they had people in their house who unplugged it. There were also some concerns about privacy and what someone else might be able to do if they could see information about a person’s daily routines.

How can you use this research?

This research was mostly done to help researchers learn about trouble they might have if they used technology like this in a research study. But this research can help people with disabilities understand more about new technologies that are being developed and to make decisions about whether or not to use new technologies when they become available. It can also help people think about ways to balance the good and bad parts of using the technology. It may also help them think about ways to gather more information about their activity that could be shared with their doctor or other health worker—either with or without technology.

What you need to know:

  • Technology is being developed that can be used to gather information about things you do that make you more or less healthy.
  • Some of these technologies work pretty well and do not seem to be too much of a burden to use.
  • But the new technologies are not fool proof and work better in some situations than others.
  • There is still more work to be done to figure out what information to gather and who to share that information with in order to improve the health of people aging with disabilities.

Original Study: Chen, K., Harniss, M., Patel, S., & Johnson, K. (2014). Implementing technology-based embedded assessment in the home and community life of individuals aging with disabilities: A participatory research and development study. Disability and Rehabilitation: Assistive Technology, 9(2), 112-120.

About the researcher(s): Keyu Chen is a doctoral student in electrical engineering at the University of Washington with an emphasis on ubiquitous computing. He works in the UbiComp Lab led by Shwetak Patel. Mark Harniss is a Clinical Associate Professor in Rehabilitation Medicine with an emphasis on assistive technologies. He works in the Center for Technology and Disability Studies led by Kurt Johnson.

Key Words: embedded assessment, smart home technology

PubMed ID23802128