Aging, Disability and Technology (ADT): Understanding and Advancing Canadian Policies to Enhance Access to Assistive Technologies

Regions: Inuvialuit Settlement Region, Gwich'in Settlement Area, Sahtu Settlement Area, Dehcho Region, North Slave Region, South Slave Region

Tags: social sciences, aging, disability, technology

Principal Investigator: Wang, Rosalie (1)
Licence Number: 16192
Organization: University of Toronto
Licenced Year(s): 2017
Issued: Dec 07, 2017
Project Team: Rosalie Wang (Co-Principal Investigator, University of Toronto), Michael Wilson (Co-Principal Investigator, McMaster University), Jerome Bickenbach (Co-Investigator, University of Lucerne and Schweizer Paraplegiker-Forschung), Evelyne Durocher (Post-doctoral fellow and primary contact, University of Toronto)

Objective(s): To study how assistive technologies are accessed by Canadians to identify funding and service gaps; and to explore the ethical, social, and policy issues around assistive technology access and technology adoption.

Project Description: The focus of the Aging, Disability, and Technology (ADT) project is the ethical concern of equity in the availability and adoption of new technology -- the issue of fairness of access and distribution. ADT addresses the need for the implementation of the human rights of persons with technology needs in Canada, including people who are aging well, and people who are acquiring disability as they age and aging with a disability such as older adults with cognitive impairments. The project includes the following research objectives:
1) to study how assistive technologies are accessed by Canadians to identify funding and service gaps; and,
2) to explore the ethical, social, and policy issues around assistive technology access and technology adoption ADT will engage policymakers and stakeholders to facilitate policy development and implementation in the context of aging, disability and technology. The outcomes will be an approach to better align policies and services with ethical perspectives and the societal values of Canadians and to improve technology access through policy implementation.

The ADT project will engage policymakers, stakeholders, and researchers in key informant interviews to provide qualitative data on how assistive technologies are currently accessed and procured in Canada.
The ADT project will apply qualitative descriptive research methodology to guide the key informant interviews. A jurisdictional scan of policies and a scoping review on ethical implications of technology access are currently underway within the ADT project. The team will utilize the findings from the jurisdictional policy scan and scoping review to develop the sampling frame and refine interview questions. Specifically, the findings from the jurisdiction policy scan will be served as a key input into identifying the aging, disability and technology key informants, representing policymakers and stakeholders from across Canada.

The sampling approach will be an iterative process which includes: 1) identifying the 2-3 most relevant government ministries in each Canadian province/territory and document the assistant deputy minister(s) and directors within them; 2) identifying the relevant stakeholders including civil society; consumer groups; technology developers; professional and other experts based on the Jurisdictional Policy Scan; 3) selecting a purposive sample of policymakers, stakeholders and researchers to interview; and, 4) conducting interviews with additional leaders of important stakeholder organizations based on those identified during key informant interviews. The researcher will follow this chain of contacts in order to identify and accumulate the sampling frame.

The one-on-one key informant interviews will be conducted, either in person or by telephone by the post-doctoral fellow. The in-person interviews may take place in the participant’s work organization, and will be scheduled at a time agreeable to the participant.

The participants will be recruited using purposive sampling approaches. A sample of approximately 26 to 39 key informants is projected. The aim is to have approximately 1-3 representing policymakers or stakeholders for the ten provinces and three territories within Canada. The researchers recognize that the number of interviews may change once the study is underway depending on how participants create new lines of inquiry through data saturation. Study participants will be recruited using the following inclusion criteria: Individuals who are 18 years of age or older who are able to provide their informed consent; and are able to communicate in English/French. The research team will build a sample frame of relevant policymakers and stakeholders who have expert knowledge about how assistive technologies are accessed or procured in Canada, as well as insights into the ethical issues around assistive technology adoption, services, and policies.

Eligible policymaker participants must be individuals who represent the relevant government ministries in one of the Canadian provinces/territories at the national, provincial, or municipal levels. Eligible policymakers must possess a policy portfolio that includes aging with a health system focus and/or assistive technology. Eligible stakeholders must be individuals who represent the field of aging, disability and technology, including non-profit organization, private insurance company, technology industry, aging industry, advocacy group, consumer group and support group. The research team will include a mixture of national stakeholders, those representing academic; direct service providers; manufacturers and distributors; family and informal caregivers; heath care practitioners and formal caregivers; aging seniors with diagnosis-specific illnesses or disabilities in community-living, home care, long-term care, hospital and primary care.

The researcher will collect qualitative data about the policymakers and stakeholders’ perceptions on current policies and processes for technology access, procurement, and ethical and social values related to aging, disability and technology, and feedback on policy approaches and solutions. The study participants will be asked questions related to how assistive technologies are currently adopted, accessed or procured in Canada. Interviews will be approximately one hour in duration with the aim of exploring participants’ perceptions on policy, service and funding gaps, extent and sources of unmet needs, enablers and barrier to technology access for different consumers, ethical and social issues relevant to inform policy for equitable access and proposed solutions. Examples of interview questions include: a) How are AT currently accessed?; b) What do you see as the key issues related to AT access, procurement and regulations?; c) What do you see as the key ethical issues related to AT access, procurement and technology adoption?; d) What do see as the priorities for what needs to be done to address the issues?; e) Who are the important stakeholders in your province?
An interview guide will be used to facilitate the interview process. A preliminary guide is included in this application. With the consent of participants, the interviews will be digitally recorded. The interview text will be transcribed verbatim into a word-processing file for data analysis.

Qualitative content analysis will be used to analyze interview data, and the analysis phase will be characterized by the simultaneous collection and analysis of interview data whereby both mutually shape each other. The interview questions will be kept open to additional modifications as themes are identified during the data analysis. The findings from the interviews may potentially be used to develop a survey for subsequent stages of the project in the future, and the survey may be circulated online to a broad sample of Canadian policymakers, stakeholders, researchers, citizens, government agencies and non-profit organizations.

The research is focused in issues of inequity in relation to access to assistive technology as part of health and social services in Canada. There are many factors contributing to inequitable access, including a lack of programs, services and funding for rural and remote areas and for particular populations depending on the province/territory/geographical area. The northern areas of Canada tend to be more remote, rural and isolated. These areas would not only provide important insights in terms of access to assistive technology, but would hopefully also benefit from the findings of the study and the recommendations about how barriers to access can be overcome in order to enable equitable access to such services for all Canadians including those within the Northwest Territories. Among many others, the benefits of equitable access to assistive technology include that assistive technology can contribute to increased participation in daily life activities, increased mobility in the home as well as in the community and increased participation in work, leisure and community opportunities, all of which contribute to quality of life. Additionally, use of assistive technologies has been shown to decrease use of health and social services. Promoting equitable access to assistive technology to individuals in remote and rural areas as are found in the Northwest Territories will contribute to improving individuals' quality of life, increasing community participation and decreasing health and social care costs.

Each participant will be offered the option of receiving a summary of the research upon completion. The ADT team will present at national conferences and meetings (including the AGE-WELL and Canadian Association on Gerontology conferences), as well as disseminating the findings through journal publications and AGE-WELL website at Furthermore, information about journal publications, and related AGE-WELL website material will be sent to the Department of Health and Social Services for their records.

The fieldwork for this study will be conducted from December 7, 2017 to December 31, 2017.