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Using technology for self care

March 2010

FAST are currently working with Assist UK on a project to support people to choose and use technology for self care. We are focusing on developing learning materials that will support older people to make choices about how to choose and use assistive technology to maximise health, care and well-being.The project is due to run to March 2011.

A report on the first and second year's activity can be downloaded here.

Summary of the report on Years 1&2 activity

In April 2008, the Foundation for Assistive Technology (FAST), Assist UK and Age Concern began a three year Department of Health S64 funded project ‘Using Technology for Self Care’. The aim of the project is to produce learning approaches to support disabled adults and older people to actively seek technology and be confident to use it to manage their self care. This report outlines the work undertaken during years one and two, sets out the business plans developed during year two and presents a plan for year three based on the knowledge and understanding achieved to date.

Background

There are currently no assistive technology education or confidence building programmes focused on disabled or older people. The project aims to address this gap developing a package of training, tools and resources designed to enable older and disabled people to become aware of and feel confident to employ technology to maintain their health and maximize their independence. The philosophy shaping the development of the course is one of empowerment and recognition of existing expertise. The theoretical framework will be informed by the Trusted Assessor competence framework and current good practice in self-management.

The development of a viable business model for ‘Using Technology for Self Care’ involved investigating existing assistive technology courses, self-care programmes and IT confidence building courses. All the relevant courses were assessed to discover whether they either provided useful models for the delivery of’ Using Technology’, or to discover whether they might in themselves prove to be vehicles for the dissemination of the ‘Using Technology’ course, through the integration or addition of new material into their existing content.

Analysis of market and delivery options:

a) Course structure and delivery: our conclusion is that FASTcan not afford to develop a training programme for tutors specifically for the course. However we do not want to set a prescribed script, something that reduces training requirement, as we felt this was antithetical to the aim of a self-care programme and that there was also little ‘agreed’ good practice that would underpin such a script. The obvious solution to this dilemma is to work in partnership with voluntary sector organisations and local faith and community groups that already provide training and confidence building programmes for their members. This led to a decision to present the course as a set of group discussions either led by a regular group ‘tutor’ or led by one of the members, and not to assume there was a ‘tutor’ available.

This then led to a requirement to make the course materials coherent enough to enable confident delivery by untrained tutors while retaining consistent key messages. The course would have to be self-explanatory and straightforward so that group leaders could pick the course up ‘off the shelf’ and, with limited guidance, feel able to deliver it with confidence. It also made sense to present the material in ‘modular’ format so that it was sufficiently malleable to be easily integrated (either in its entirety or as elements) into a variety of other programmes and appeal to a wide-range of audiences.

b) Quality control: We adopted a working assumption that voluntary sector organisations and local faith and community groups have experience of setting up discussion groups and confidence building events in such a way as to manage the quality of the experience for individual participants. We would have to assume that the course material would need to support group leaders who lacked familiarity with assistive technology devices, concepts and resources and address some of the common misconceptions about technology.

Using this approach we recognised that we would need to maintain the quality of the courses in partnership with participating groups and their group leaders. We recognised the need to develop a method to get easy feed back from groups that could be used to amend the material and make new versions available for easy download.

c) Market and costs: Our working assumption is that materials will be made available online but other means of accessing them may be required. Working through some of the large umbrella organisations is one route to alert potential partner groups but further work will be needed to understand how to penetrate the information networks for other voluntary sector, faith and community groups. A strong brand and positioning will be required so work will be carried out within Year Three to develop a recognisable and appealing product.

Development and piloting of course materials

The course materials were piloted with focus groups of older and disabled people during years one and two. Learning from the focus groups indicated that it would be possible to develop a course that was sufficiently generic to appeal to a broad audience of older people who are, on the whole, largely unaware of the breadth of equipment that is available to support independence. There is further work to be carried to make such a course relevant to an audience of disabled people who have gained experience and expertise in choosing equipment.

Some elements of the course are relatively unproblematic, specifically relating to awareness raising, signposting to resources and suppliers and to the range of ways to acquire equipment, even given the complexities of a shift towards personal budgets and prescriptions for equipment. More problematic is the use of a generic decision-support approach based on the ICF. It may be challenging to convey the value of a conceptual tool for use by individuals faced with very concrete problems in terms of achieving independent living. Also problematic is the need to motivate individuals to buy equipment when this is the best solution for them when much existing equipment is not designed to appeal to a private purchase customer.

Alongside development of the course content was an in-depth review of the business models used by self care and customer-focused AT education courses and the potential audiences, distribution partners and markets. This review looked at the options for formatting the course to be scripted or self-directed learning, to be tutor led or led by a group facilitator and the implications for income generation, quality control and branding, dissemination and sustainability of the course.

The conclusion is that the most effective means of disseminating the learning materials is through working in partnership with independent third sector organisations who aim to support their members to live independently. Several third sector organisations already deliver a range of recreational and educational courses in-house using their own facilitators. Building on, or being assimilated into, an existing programme would not only ensure the course’s continued quality, but it would also facilitate widespread dissemination without a disproportionate investment by FAST. Rather than FAST having to market the course directly to individuals, we would only need to enlist the support of like-minded third sector organisations who would then take on the responsibility of promoting it and delivering it to their members.

This ‘piggy-backing model’ of distribution, whereby FAST makes course material freely available to all and relies on other organisations for its propagation, could be sustainable if it meets the needs of the organisations involved and the course participants. However, it still poses the challenges that dissemination of the course is dependent on its appeal to third sector organisations that often operate on small budgets and with few staff. The process by which 3rd sector organisations can pick up and use the course material must involve minimal investment in time and training and must be directly and immediately relevant to their members and formatted in a way that fits into the interactions between 3rd sector organisations and their members, e.g. at day centres, local group meetings, etc.

This further supports the creation of a modular course. A product packaged into a number of discrete modules, each focusing on a different aspect of AT in self care, would enable organisations to use the material as they see fit – integrating whole modules or elements from modules into their existing programmes, or delivering the whole course as a stand-alone package.