Assistive Technologies for Healthy living in Elders: Needs assessment by Ethnography

ATHENE
Project overview
1. PROJECT DESCRIPTION
1.1. Partners
• Queen Mary University of London (Centre for Health Sciences and Innovation Centre)
• University of Manchester
• Newham University Hospital Trust
• Policy Research Institute for Ageing and Ethnicity
• Graphnet Health
• Philips
• Tynetec
• Roke Manor
• Academic specialist consultants Guy Dewsbury and Mark Rouncefield
1.2. Project requirements
This study seeks to use ethnographic methods to illuminate the assisted living needs of older people in a socio-economically deprived and ethnically diverse area of London (Newham). The goal is to inform a new, person-focused methodology for designing assisted living technologies (ALTs). The absolute and relative numbers of frail, chronically sick and dependent older people are predicted to rise sharply in the next 20 years, and their ethnic mix will become much more diverse. Up to now, research into ALTs has largely been technology-focused (i.e. has sought to develop particular technologies and then promote their adoption). In contrast, this study is ‘technology-agnostic’ in the sense that we do not have a particular technology (or even class of technologies) in mind. Rather, we seek to produce a richer understanding of the complex and diverse living experiences and care needs of older people and to explore how industry, the NHS, social services and third sector can work with the older people themselves to produce ‘user-centred’ ALT designs to meet these needs.
1.3. Aims and objectives
Aim
To facilitate, through a series of enabling activities and interventions targeted at key stakeholders, the effective planning and implementation of assisted living technology (ALT) programmes for older people and to generate research insights from this work.
Strategic objectives
1. Build a rich picture of assisted living needs and preferences of older people from all ethnic groups, with significant but not exclusive focus on black and minority ethnic (BME) groups.
2. Identify key challenges faced by industry in designing and developing useful and useable ALTs for such groups.
3. Identify key challenges faced by health and social service providers and third-sector organisations for planning and delivering ALT programmes
4. Drawing on (1) and (2), devise capacity building programmes for industry and service providers in user-centred design methods for ALTs.
5. Drawing on (1) and (3), devise guidelines for planners and managers of ALT development projects and programmes.
Research questions
1. What needs of older people from different ethnic groups might be met by targeted introduction and use of ALTs?
2. What methods and tools are most effective for achieving user-centred design and development of ALTs for such groups?
3. What enabling activities are necessary at micro (i.e. individuals, families), meso (i.e. health and social service providers, ALT producers, community) and macro (i.e. health and social service policy makers, sector incentives) level to promote the design and successful uptake and use of ALTs, and how might these be supported?
1.4. Work breakdown
Operational objectives
1. Extend a preliminary literature review.
2. Establish a steering group with industry, NHS and third sector representation.
3. Work with the ALT industry and health and social care providers to analyse critical knowledge gaps in relation to assisted living in elders.
4. Informed by this analysis, undertake individual case studies of 30-50 older people with assisted living needs in a deprived, multi-ethnic London borough, using a data collection methodology based on ethnography and enhanced by tools such as cultural probes.
5. Feed emerging findings back to the steering group iteratively so as to produce an ongoing dialogue which informs further data collection.
6. Work with up to 10 ‘paradigm cases’ to develop ‘candidate’ ALT services, using these to pilot and refine user-centred design and development methodologies.
7. Draw lessons on how to involve older people from all ethnic groups in user-centred design.
8. Produce accessible summaries of findings and conclusions for policymakers, practitioners, academics, the ALT industry and service users.
9. Produce a set of enabling activities and resources for ALT adoption targeted to meet the needs of key stakeholders.
1.5. Work package description (distribution of roles)
Study design
Participatory action research / co-design informed by ethnography in the home and by partnerships with ALT and service providers. It will have two phases:
Phase 1 (1-12 months): Ethnographic studies of 30-50 cases to map the complex healthcare, social care and socio-cultural needs of older people and their carers from a range of ethnic groups using bilingual researchers and advocates as needed. Use these findings to inform a draft methodology for socio-technical co-design in ALT development.
Phase 2 (13-24 months): Work with up to 10 selected cases to bring together the older person, carers, NHS and social care organisations, third-sector organisations (including community and faith-based groups) and ALT providers to test and refine the draft methodology. Investigate how to embed the design and development of ALTs into organisational systems, processes and routines.
Work packages
1. Set-up. Recruit staff, establish steering group; finalise ethics approval; site-specific R&D paperwork; prepare information packs for participating organisations; prepare information packs for research participants; refine research methods, pilot data collection techniques; supplement preliminary literature review with additional references.
2. Ethnography. Recruit 30-50 cases; collect and analyse data; summarise findings.
3. Co-design. Recruit 5-10 cases; undertake cycles of data collection, design, analysis.
4. Dissemination. Assist participating organisations in documenting local lessons; write and present academic outputs (papers, conferences); co-produce guidance for different stakeholders including industry; website design and updates; industry training course on effective co-design with older users.