Fall prevention self-assessments via mobile 3D visualisation technologies: Community dwelling older adults’ perceptions of opportunities and challenges

Abstract

Background: In 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) which provides enhanced measurement and assessment guidance to patients via the use of 3D visualisation technologies. Objective: The purpose of this study is 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. Methods: Thirty-three community-dwelling older adults participated in interactive sessions with a bespoke 3D-MAP application utilising the retrospective think-aloud protocol, and semi-structured 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 semi-structured focus group data. Results: The 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 = .000) of the application. Four high-level themes emerged from think-aloud and focus groups discussions: (i) Perceived Usefulness (PU), (ii) Perceived Ease of Use (PEOU), (iii) Application Use (AU) and (iv) Self-assessment (SA). The application was seen as a useful tool to enhance visualisation 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. Conclusions: Participants 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 and accuracy and reliability of measurements that are recorded using the application and to compared it with 2D measurement guidance leaflets.