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There is limited evidence on the strategies, resources, and tools shown to improve winter mobility and community participation. This paper describes a multifaceted approach taken to develop an mHealth application that provides information, resources, and strategies to facilitate winter mobility for mobility device users, service providers, community organisations, and researchers. The study was conducted in three phases: (1) A scoping review of peer-reviewed and grey literature was completed to identify literature that reported on tools, strategies, resources, and recommendations used to promote winter mobility; (2) Online asynchronous focus groups were conducted to identify the type of content that mobility device users wanted to include in the web-based application; and (3) A prototype mHealth application was developed based on the findings from the previous phases. Using a rapid prototyping process that included stakeholder review through an online survey, four cycles of application design and development were undertaken. The scoping review identified 23 peer-reviewed studies and limited grey literature on winter mobility strategies, resources and recommendations. Twenty-four participants from across Canada engaged in one of five focus groups. Focus group analysis led to the development of the content categories for the mHealth application. The initial prototype application developed was reviewed by; 27 mobility device users, 16 health care providers, and seven consumer organisation representatives identified areas of strength and further refinement in regard to application design. The approach used in this study provided a method to develop an application based on the ideas, needs, and interests of a variety of stakeholders. Once fully developed, the application has the potential to fill the gaps related to the lack of a unified collection of winter mobility strategies and resources, and open the dialogue on methods to improve winter participation among mobility device users. Despite winter conditions being a common challenge among mobility device users, there is an absence of an organised approach towards helping individuals manage their winter mobility needs. As the development and usage of mHealth applications continues to increase, it is valuable to use methods of designing applications based on the ideas, needs, and interests of a variety of stakeholders. Development of a framework for collating information on winter mobility strategies and resources is the first step towards launching an mHealth application. [ABSTRACT FROM AUTHOR]

Appropriate wheelchair provision is necessary for addressing participation barriers experienced by individuals with mobility impairments. Health care professionals involved in the wheelchair service provision process require a specific set of skills and knowledge to enable wheelchair use that meets individual posture, mobility and daily living requirements. However, inconsistencies exist in academic programmes globally about providing comprehensive education and training programmes. The planned scoping review aims to review and synthesize the global literature on wheelchair service provision education for healthcare professional students, healthcare personnel and educators offered by universities, organizations and industries. This scoping review will be guided by the Joanna Briggs Institute (JBI) methodological framework. Comprehensive literature searches will be conducted on various global electronic databases on health to seek out how wheelchair service provision education is organized, integrated, implemented and evaluated. Two independent reviewers will perform eligibility decisions and key data extractions. Data from selected studies will be extracted and analysed using conventional content analysis. Information related to wheelchair service provision education including curriculum development, content, teaching methods, evaluation and models of integration will be synthesized. The planned scoping review will be the first to examine all aspects of wheelchair service provision education across professionals, settings and countries. We anticipate that results will inform the content of a Wheelchair Educators' Package, and if appropriate, a follow-up systematic review. An article reporting the results of the scoping review will be submitted for publication to a scientific journal. A comprehensive examination of wheelchair service provision education could help develop strategies to address the unmet need for wheelchair services globally. Findings for this review will facilitate the planning and development of an evidence-based education package that could bridge the existing knowledge gaps related to safe and effective wheelchair service provision among health professionals involved. This review will also inform the potential barriers and enablers for effective integration and implementation of wheelchair service provision education worldwide. [ABSTRACT FROM AUTHOR]

This review aimed to collate and summarize available research literature about wheelchair service provision education available to healthcare professional students, healthcare personnel and educators across low- to high-resourced settings. The Joanna Briggs Institute methodological steps for scoping reviews were followed. Included studies were mainly sourced from Medline, Embase, CINAHL, Scopus, Academic Search Complete and ProQuest. Independent title, abstract and full-text screening with defined inclusion and exclusion criteria was performed. All screening and extraction were performed independently by two authors. A thematic approach was used to synthesize results. Data extracted from included studies were charted according to a template that we created. The study quality was also appraised. A total of 25 articles were included (11, 36% from high-income settings) with 12 (48%) observational studies and 13 (52%) experimental studies. The literature addressed three main topics: (1) assessing wheelchair service provision knowledge, (2) implementing training interventions using in-person, online and/or hybrid learning approaches and (3) describing current wheelchair service provision education globally. The most frequently reported training programs used were the Wheelchair Skills Program and the World Health Organization Wheelchair Service Training Package – Basic Level. Limited information has been published about the integration of wheelchair content into the curricula of professional rehabilitation programs. Efforts to build international partnerships, improve the quality and currency of training programs and build resources that can assist educators in the integration of wheelchair-related content into professional rehabilitation programs should be prioritized. This is the first review that examined and synthesized the current state of wheelchair service provision education for rehabilitation students and personnel across low- to high-income countries. Findings from this review indicate that there is limited information about the integration of wheelchair-related content into professional rehabilitation programs. Efforts to build international partnerships, standardize wheelchair service provision content and evaluation and integrate training into professional rehabilitation programs worldwide should be prioritized. [ABSTRACT FROM AUTHOR]

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BackgroundAlternative and innovative strategies such as mHealth and eLearning are becoming a necessity for delivery of rehabilitation services. For example, older adults who require a wheelchair receive little, if any, training for proficiency with mobility skills. This substantive service gap is due in part to restricted availability of clinicians and challenges for consumers to attend appointments. A research team of occupational therapists and computer scientists engaged clinicians, consumers, and care providers using a participatory action design approach. A tablet-based application, Enhancing Participation In the Community by improving Wheelchair Skills (EPIC Wheels), was developed to enable in-chair home training, online expert trainer monitoring, and trainee-trainer communication via secure voice messaging. ObjectivePrior to undertaking a randomized controlled trial (RCT), a pilot study was conducted to determine the acceptability and feasibility of administering an mHealth wheelchair skills training program safely and effectively with two participants of different skill levels. The findings were used to determine whether further enhancements to the program were indicated. MethodsThe program included two in-person sessions with an expert trainer and four weeks of independent home training. The EPIC Wheels application included video instruction and demonstration, self-paced training activities, and interactive training games. Participants were provided with a 10-inch Android tablet, mounting apparatus, and mobile Wi-Fi device. Frequency and duration of tablet interactions were monitored and uploaded daily to an online trainer interface. Participants completed a structured evaluation survey and provided feedback post-study. The trainer provided feedback on the training protocol and trainer interface. ResultsBoth participants perceived the program to be comprehensive, useful, and easily navigated. The trainer indicated usage data was comprehensive and informative for monitoring participant progress and adherence. The application performed equally well with multiple devices. Some initial issues with log-in requests were resolved via tablet-specific settings. Inconsistent Internet connectivity, resulting in delayed data upload and voice messaging, was specific to individual Wi-Fi devices and resolved by standardizing configuration. Based on the pilot results, the software was updated to make content download more robust. Additional features were also incorporated such as check marks for completed content, a more consumer-friendly aesthetic, and achievement awards. The trainer web interface was updated to improve usability and provides both a numerical and visual summary of participant data. ConclusionsThe EPIC Wheels pilot study provided useful feedback on the feasibility of a tablet-based home program for wheelchair skills training among older adults, justifying advancement to evaluation in an RCT. The program may be expanded for use with other rehabilitation interventions and populations, particularly for those living in rural or remote locations. Future development will consider integration of built-in tablet sensors to provide performance feedback and enable interactive training activities. Trial RegistrationClinicalTrials.gov NCT01644292; https://clinicaltrials.gov/ct2/show/NCT01644292 (Archived by WebCite at http://www.webcitation.org/6XyvYyTUf).

Objective: To identify the knowledge, products, and strategies for individuals with mobility-related disabilities used to address challenging winter conditions., Data Sources: AgeLine, OVID, Scopus, and CIHAHL were searched for studies that met the inclusion criteria, from inception to April 2018. Sources for gray literature, or information outside commercial publishing, included ProQUEST, government websites, and manufacturers, vendors, and consumer organization websites., Source Selection: Population of people with limited or reduced mobility or mobility device users involved in winter-related environmental conditions; aim was to increase activity, participation, or safety., Data Extraction: Two reviewers independently applied the inclusion criteria to select eligible sources. Two reviewers independently extracted the data from each source., Data Synthesis: Twenty-three published peer-reviewed papers were located. Study populations were predominantly those who used wheelchairs (mixed wheelchair type, n=7; power, n=4; manual, n=2), canes (n=3), or specialized winter footwear (n=2). The primary focus of these papers was determined to be tool or device (n=10), recommendations (n=9), strategy (n=2), or resource (n=2). Civic policy documents were variable in citizen responsibility for snow clearing. Limited winter-related supports were identified on consumer organization websites. Although some winter-specific products exist, very few studies have examined the effectiveness of any of these products., Conclusions: Despite the common experience of challenging winter conditions, a paucity of winter-specific research and innovation relevant for individuals who use mobility devices exists. Researchers, consumers, and industry need to partner to develop novel tools, strategies, resources, and evidence-based recommendations., (© 2019 The Authors.)