Blind rehabilitation programs teach iPhone and iPad use to improve independence in Veterans with low vision or blindness
Abstract: While many individuals affected by blindness or low vision utilize accessibility applications on iPhone and iPad devices, few receive professional training on application use. Determining the impact of a smartphone and tablet-based curriculum at a Blind Rehabilitation Center (BRC) on functionality and independence can help patients and physicians understand the value of these training programs. Between January 2015 and December 2019, a pre–post initiative evaluated patient functionality and independence scores before and after exposure to a technology educational curriculum at the West Palm Beach Veteran Affairs BRC. A total of 337 patients with impaired vision or complete blindness participated in a 1-month, 35-hr iPhone and iPad learning course. This course was led by technology instructors trained in working with patients with low vision or blindness. The level of function and independence was determined before and after the educational curriculum using a modified Functional Independence Measurement (FIM) Scale from 1 to 7, with 1 indicating no independent functionality and 7 indicating complete independence. After completion of the course, patients were stratified by age, gender, ethnicity, and eye-related diagnosis. All demographic groups noted an increase in FIM score, with average improvement of 3.75 points. A factorial analysis of variance (ANOVA) revealed that younger age groups displayed a statistically significant improvement in FIM score compared to older groups with an F ratio of F(3, 295) = 4.503, p = .004. Eye diagnosis did not have an impact on FIM score change. These results suggest any patient may benefit from professional training in the use of iPhone and iPad applications with younger patients showing greater rates of initial improvement. The authors recommend increased utilization of smartphone and tablet training programs at BRCs by all individuals with low vision or blindness.
Abstract:Military families face many unique challenges, including frequent separations, demanding work hours, and relocations. The HealthySteps (HS) program may offset these challenges utilizing the expertise of a nonclinical child development specialist called a HS specialist who offers enhanced well-child visits (WCVs), support between visits, and connections to community resources. Our study sought to identify the impact of the military HS pilot program on the timeliness of WCVs, immunizations, routine behavioural and developmental screenings, and referrals to community resources within the first 15 months of life (MOL). We retrospectively reviewed charts of 26 HS-enrolled and 26 randomly selected age-matched non-HS–enrolled children from age 2 to 15 MOL. Demographic variables obtained include child’s gender, child’s birth order, mother’s age, active duty parent’s rank classification, and active duty parent’s gender. We examined five outcomes measures aligning with the American Academy of Pediatrics health supervision, immunization, and screening recommendations and National Committee for Quality Assurance Healthcare Effectiveness Data and Information Set measures: (1) completed six or more WCVs in the first 15 MOL, (2) completed developmental screening at the 9-month WCV, (3) up to date on vaccinations at 15 MOL, (4) completed three or more postpartum depression (PPD) screens in the first 6 MOL, and (5) the total number of documented referrals to community resources within the first 15 MOL. Chi-square analysis and independent t-tests were used to compare the groups. There was no statistical significance (P > .05) between the HS-enrolled and control groups for all five demographic variables. A significantly higher percentage of children in the HS-enrolled group received PPD screening compared to the control group (96% vs. 73.1%, P = .021). The HS-enrolled group had a higher mean number of community resource referrals at 15 MOL of 2.46 (SD = 1.14) vs. the control group with a mean of 0.19 (SD = 0.49). None of the other outcomes showed a statistically significant difference between groups. The results of this study indicate the positive impacts of the military HS program on referrals to community resources and PPD screening, reflecting the HS specialist focus on the family unit. Limitations of this study include the small population size and limited demographic information resulting from the retrospective nature of the study and pilot status of the HS program. Larger prospective studies are needed to clarify the true impact of the HS program in the military health system.