Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations.
The Mobility Assistance for People with Cognitive Disabilities (MAPCD) program, including the WayFinder 3 assistive smartphone navigation app and training program, addresses barriers to community mobility and provides supports to both individuals with cognitive deficits and their caregivers. We describe the MAPCD program and examine strategies that facilitated the adoption of the WayFinder 3 app designed to optimize independent community mobility.
Primary Author and Speaker: Sarah E. Anderson
Additional Authors and Speakers: Lisa Juckett
Contributing Authors: Carmen DiGiovine, Sandra A. Metzler, Ashley Stojkov, Bethany Frick, Kaetlyn E. Culter, and Elizabeth Mance
PURPOSE: Over 560,000 individuals with disabilities never leave their homes due to transportation difficulties resulting from a variety of environmental and societal barriers leading to a lack of safe and effective community mobility. Supporting accessible public transportation for individuals with cognitive disabilities is critical for promoting health, well-being, and employment opportunities within the community. The purpose of this presentation is to describe the strategies used to support the implementation of an assistive smartphone navigation app, WayFinder 3, in a community-based setting to optimize independent travel among individuals with cognitive deficits.
DESIGN: The Mobility Assistance for People with Cognitive Disabilities (MAPCD) study used a mixed-methods approach to implement the WayFinder 3 app in a community setting over a one-year period. Participants were recruited through word of mouth and community stakeholder outreach. Participants eligible to participate were adults with cognitive disabilities residing in the community (travelers), and their caregivers or community supporters (travel partners).
METHOD: The MAPCD study consisted of two primary phases: 1) training on the WayFinder 3 ecosystem and 2) WayFinder 3 implementation. In Phase 1, participants were introduced to the WayFinder 3 ecosystem which included the WayFinder 3 assistive smartphone navigation app, an online portal where individualized routes and prompts can be created, and a tracking system where user travel can be monitored in real-time. Participants received interactive training over the course of four sessions through educational modules. In Phase 2, travelers were provided with a smartphone and the WayFinder 3 app to use in their daily lives for up to a year. To examine the extent to which WayFinder 3 had been adopted by participants, usage data were collected and monitored through the web-based WayFinder 3 system. Focus group data underscored the barriers and facilitators that influenced WayFinder 3 adoption by individuals with disabilities. Quantitative WayFinder 3 data were analyzed with descriptive statistics and qualitative data were analyzed through directed content analysis informed by the Consolidated Framework for Implementation Research.
RESULTS: A total of 36 individuals were recruited into the MAPCD study. In the WayFinder 3 implementation phase, eight travelers used WayFinder to initiate a total of 100 trips, and the average number of trips per traveler was 12.5 trips (SD = 11.5 trips). Of those eight participants, three used WayFinder 3 on five or more occasions. Preliminary findings from focus group data indicated four themes related to WayFinder 3 adoption: 1) difficulty accessing related trainings, 2) perceived complexity of app and trainings, 3) efforts to individualize app and trainings, and 4) social considerations pertaining to use of the app within the community.
CONCLUSION: While preliminary data suggest that the adoption of the WayFinder app among most participants was relatively low, possibly due to usability issues and access to other needed resources, the assistive features of the app may have facilitated its frequent use among a subset of travelers. There are several complex factors to consider when implementing assistive technology with individuals with disabilities in the community. The MAPCD study identified these factors, illuminating opportunities for improvement during the next phase of WayFinder 3 implementation.
IMPACT STATEMENT: Community mobility is an IADL essential to positive quality of life and is vital to the access of services. While a technology may be desirable, it is vital to assess the factors that influence implementation to improve outcomes and usefulness across stakeholders.
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