Implementation of welfare technology: a systematic review of barriers and facilitators

Abstract

Purpose: Although studies addressing barriers to and facilitators of implementation of welfare technology have been published, no systematic review synthesising evidence on such factors has been found. The purpose of this study was therefore to identify and synthesise existing primary research on facilitators and barriers that influence the implementation of welfare technology for older people, people with disabilities and informal caregivers. Materials and methods: A systematic search in 11 databases was performed using predefined inclusion and exclusion criteria to identify empirical studies that assess the implementation of welfare technology for older people, people with disabilities or informal caregivers. The search identified 33 publications with quantitative, qualitative and mixed method designs. The reported findings were thematically synthesised and conceptualised into themes. Results: Six themes of facilitators and barriers that influence the implementation of welfare technology emerged: capacity, attitudes and values, health, expectations, participation and identity and lifestyle. These were presented from five perspectives: older persons and persons with disabilities, informal caregivers, health and care personnel, organisation and infrastructure and technology. The findings may be used as a means to structure the planning and evaluation of implementation processes of welfare technologies for older persons and persons with disabilities and to understand the complexities of implementation. Conclusions: This knowledge generates deepened insights and structures to guide and evaluate the implementation processes of welfare technologies and engenders an understanding of the complexities of implementation. ä IMPLICATIONS FOR REHABILITATIONWhen planning for the implementation of welfare technology for older people and persons with disabilities, it is important to consider capacity, attitudes and values, health, expectations, participation, and identity and lifestyle. Using the result from the study facilitates deepened insights and structures for evaluation of implementation processes of welfare technologies and brings an understanding of the complexities of implementation. Welfare technology should be available, safe, usable and fit the user's daily lives. Implementable welfare technology should focus on needs, but also consider design and possible experienced stigma related to the identity of being a welfare technology user.

Understanding the possibilities and limitations of assistive technology in health and welfare services for people with intellectual disabilities, staff perspectives

“…There has recently been growing interest in utilising AT to improve the quality of life of people with disabilities and older people the balance of the population is shifting towards more senior citizens as the population of Scandinavian countries ages [5][6][7]. For example, AT is considered an innovative concept and policy area in Scandinavian countries [6].…”

Development Work in Swedish Eldercare: Resources for Trustworthy, Integrated Managerial Work During the COVID-19 Pandemic

“…Today's poor conditions for capability among old adults and the external pressure to develop eldercare due to ongoing demographic shifts points toward new ways of organizing as well as toward digitization and the implementation of welfare technology. Critical factors seen to affect the implementation of new technology are, besides capacity and aHealth literacy, as mentioned in section 1.2, attitudes and values in the eldercare workforce ( 13 ). The present study also identifies the diverse importance related to aim and focus of digitalized developments, i.e.…”

“…According to systems theory, the strengthening of resources necessary for capabilities needs to be informed by integrated perspectives that capture key conditions for development work and various resources at all system levels (29). This is supported by recent case studies in eldercare showing that resources for and perspectives on capability must be addressed at all organizational levels in order to support improvement and development work (13,24,30). A logic suggested to be more successful for public health and social service is to strengthen integrated values (31) in order to support the sustainable development of the capabilities of elders, employees, and eldercare organizations (32).…”

“…A systematic review of the barriers to and facilitators of welfare technology implementation in eldercare has identified the capacity of the old adults, employees, and eldercare organizations as a recurrent factor affecting implementation success ( 13 ). The work and leadership of first-line managers (FLMs) has been crucial for sustainable work by employees during the COVID-19 pandemic ( 3 , 14 ).…”

Measuring Self-Reported Access to Assistive Technology Using the WHO Rapid Assistive Technology Assessment (rATA) Questionnaire: Protocol for a Multi-Country Study

“…In 2018, the WHO Assistive Technology Access (ATA) team proposed the first draft rapid Assistive Technology Assessment (rATA) questionnaire to collect data on selfreported access to AT [6]. Self-reporting recognizes the principle that choice and consumer participation are crucial in successful AT implementation [7]. It is necessary to take consumer choice and preference into account as users' understanding of their need, uptake, use of, and benefit from AT are crucial for developing AT services for all in need.…”