Background: Abandonment of adaptive equipment (AE) is a growing problem among the disabled population, particularly among those who rely on their devices to enhance independence by maximizing safety, promoting social inclusion, and increasing participation in daily activity and society (Howard et al., 2020). Abandonment of AE can often be linked to diminished client satisfaction with equipment as a consequence of a lack of fit between users, their assistive products, and users’ environment (Sugawara, 2018; Kraskowsky & Finlayson, 2001). Consideration of users’ individual experiences, including their desires, priorities, and opinions regarding their equipment, independence, and engagement in society, is necessary when prescribing and implementing AE to minimize the risk of discontinuation (Cruz and Emmel, 2016).

Objective: To identify, highlight, and explore the relationships between personal, environmental, and contextual factors unique to individuals who utilize adapted equipment to increase participation and engagement with daily activity to prevent abandonment of their devices.

ACOTE Area: Research (primary), Clinical (secondary)

Methods: A survey tool, the Adaptive Equipment Follow-up Protocol (AEFP), was created to assess and track users’ desires, priorities, and opinions about adaptive equipment to maximize functional use of equipment and decrease the prevalence of abandonment. 31 subjects were recruited through partnerships with local Metro-Atlanta outpatient neurorehabilitation clinics to be administered the survey in person using an online platform, Qualtrics. Results were analyzed to identify unique personal, environmental, and/or contextual factors related to functioning and disability using frequencies to identify trends within the data. In addition, relationships between responses were analyzed using qualitative analysis to identify common themes within the data based on device type and prevalence of continued use. Informal analysis via journal entries was used throughout the data collection process to support conclusions.

Results: Commonly identified factors contributing to the abandonment included: no longer needed, reliance on caregiver, uncomfortable, limited by physical condition, convenience of size/weight for transportation, limited accessibility of tools/features, poor aesthetic, environmental/architectural barriers, too complex, and stigma. Each factor identified within the study demonstrated a mismatch between functioning/disability and a combination of personal, environmental, and other contextual factors using the ICF. Upon analysis of responses based on device type and prevalence of continued use, responses in the “Mobility Devices” section yielded higher levels of variability compared to responses within the “Additional Adaptive Equipment” section. There was little variability present between trends and common responses for each question between the sections. However, results based on the prevalence of abandonment yielded trends and frequencies of responses that were inconsistent with each other, indicating that the prevalence of use may have a larger impact on feelings and attitudes towards devices versus device type.

Conclusions and Relevance: Responses were shown to be highly attributed to the unique interplay of functioning and disability with personal, environmental, and other contextual factors. Consideration of these factors and relationships between them can be used to help define and predict an individual’s attitudes and experience with adaptive equipment to effectively close the gap between what is known to influence the potential for abandonment of adaptive equipment. The AEFP survey can serve as a helpful tool for Occupational Therapists and other healthcare professionals to assess and track their patients’ overall experience with their adaptive equipment using a holistic, person-centered approach to identify and better understand these unique factors contributing to the perceived lack of usefulness of necessary adaptive equipment.