Skip to main content Accessibility help
×
Home

Enhancing Equitable Access to Assistive Technologies in Canada: Insights from Citizens and Stakeholders

  • Cristina A. Mattison (a1) (a2), Michael G. Wilson (a1) (a2) (a3), Rosalie H. Wang (a4) and Kerry Waddell (a1)

Abstract

The need for assistive technologies in Canada is increasing, but access is inconsistent and fragmented which can result in unmet needs. We aimed to identify citizens’ values and preferences for how to enhance equitable access to assistive technologies and to engage policymakers, stakeholders, and researchers in deliberations to spark action. In spring 2017, we convened three citizen panels and a stakeholder dialogue. Key panel findings were included in an evidence brief that informed dialogue participants. Thirty-seven citizens participated in panels and emphasized the need for access to reliable information, equitable access to assistive technologies regardless of ability to pay, and the need for collaboration. Twenty-two dialogue participants focused on the need for a guiding framework that supports fundamental change across the country. The proposed policy framework can enhance access to assistive technologies through enabling simplified policies and programs, along with fostering robust data collection and evaluation to support countrywide innovation and accountability.

Les besoins en technologies d’assistance augmentent au Canada, mais l’accès à ces technologies est inégal et fragmentaire, ce qui ferait en sorte que des besoins demeureraient non comblés. Cette étude visait à identifier les valeurs et préférences des citoyens concernant les moyens à utiliser pour favoriser un accès équitable aux technologies d’assistance. Elle visait également à impliquer les décideurs politiques, les parties prenantes et les chercheurs dans des discussions afin d’élaborer des actions dans ce domaine. Au printemps 2017, nous avons organisé trois panels de citoyens et un dialogue avec les parties prenantes. Les principales conclusions des panels ont été incluses dans une synthèse qui a été partagée avec les participants du dialogue. Trente-sept citoyens ont participé aux panels et ont souligné l’importance de l’accès à de l’information fiable, d’un accès équitable aux technologies d’assistance (et ce, quelle que soit la capacité de payer), et de la collaboration. Les vingt-deux participants au dialogue ont fait valoir la nécessité d’un cadre d’orientation pour appuyer l’évolution des pratiques dans l’ensemble au pays. Le cadre d’orientation proposé combinerait des politiques et programmes simplifiés incluant la collecte et l’évaluation de données robustes pour appuyer l’innovation et l’imputabilité à travers le pays.

Copyright

Corresponding author

La correspondance et les demandes de tirés-à-part doivent être adressées à : / Correspondence and requests for offprints should be sent to: Cristina A. Mattison, Ph.D. McMaster Health Forum McMaster University 1280 Main Street West, MML-417 Hamilton, ON L8S 4L6 (mattisc@mcmaster.ca)

Footnotes

Hide All

We would like to thank those involved with each of the projects presented in this article. These individuals are formally acknowledged in each of the documents that are available on the McMaster Health Forum website (https://www.mcmasterforum.org/). Funding for the citizen brief and the citizen panel, as well as the evidence brief and the stakeholder dialogue they were prepared to inform were funded by AGE-WELL NCE Inc. and McMaster University’s Labarge Optimal Aging Initiative.

Footnotes

References

Hide All
Abelson, J., & Gauvin, F. P. (2006). Assessing the impacts of public participation: Concepts, evidence and policy implications. Ottawa, ON: Canadian Policy Research Networks.
Abelson, J., Montesanti, S., Li, K., Gauvin, F. P., & Martin, E. (2010). Effective strategies for interactive public engagement in the development of healthcare policies and programs. Ottawa, ON: Canadian Health Services Research Foundation.
Alberta Health. (2016). Alberta aids to daily living. Retrieved from https://www.alberta.ca/alberta-aids-to-daily-living.aspx
Beyeler, N., York De La Cruz, A., & Montagu, D. (2013). The impact of clinical social franchising on health services in low- and middle-income countries: A systematic review. PLoS One, 8(4), e60669. https://doi.org/10.1371/journal.pone.0060669
Boyko, J. A., Lavis, J. N., Abelson, J., Dobbins, M., & Carter, N. (2012). Deliberative dialogues as a mechanism for knowledge translation and exchange in health systems decision-making. Social Science & Medicine, 75(11), 19381945. doi: 10.1016/j.socscimed.2012.06.016
Canadian Institute for Health Information. (2011). Health care in Canada, 2011. A focus on seniors and aging. Retrieved from https://secure.cihi.ca/free_products/HCIC_2011_seniors_report_en.pdf
Cancelliere, C., Donovan, J., Stochkendahl, M. J., Biscardi, M., Ammendolia, C., Myburgh, C., & Cassidy, J. D. (2016). Factors affecting return to work after injury or illness: Best evidence synthesis of systematic reviews. Chiropractic & Manual Therapies, 24(1), 32. doi: 10.1186/s12998-016-0113-z
Center for Technology and Aging. (2014). The new era of connected aging: A framework for understanding technologies that support older adults aging-in-place. Retrieved from http://healthliteracycentre.eu/wp-content/uploads/2015/11/ConnectedAgingFramework.pdf
Cromwell, I., Peacock, S. J., & Mitton, C. (2015). ‘Real-world’ health care priority setting using explicit decision criteria: A systematic review of the literature. BMC Health Service and Research, 15, 164. https://doi.org/10.1186/s12913-015-0814-3
Denburg, A., Wilson, M. G., Johnson, S., Kutluk, T., Torode, J., & Gupta, S. (2017). Advancing the development of national childhood cancer care strategies in Latin America. Journal of Cancer Policy, 12, 715. https://doi.org/10.1016/j.jcpo.2016.12.005
Dugas, M., Shorten, A., Dube, E., Wassef, M., Bujold, E., & Chaillet, N. (2012). Decision aid tools to support women’s decision making in pregnancy and birth: A systematic review and meta-analysis. Social Science & Medicine, 74(12), 19681978. doi: 10.1016/j.socscimed.2012.01.041
Durand, M. A., Carpenter, L., Dolan, H., Bravo, P., Mann, M., Bunn, F., & Elwyn, G. (2014). Do interventions designed to support shared decision-making reduce health inequalities? A system review and meta-analysis. PLoS One, 9(4), e94670. doi: 10.1371/journal.pone.0094670
Freeman, J. D., Kadiyala, S., Bell, J. F., & Martin, D. P. (2008). The causal effect of health insurance on utilization and outcomes in adults: A systematic review of US studies. Medical Care, 46(10), 10231032. doi: 10.1097/MLR.0b013e318185c913
Gastil, J., & Richards, R. (2013). Making direct democracy deliberative through random assemblies. Politics & Society, 41(2), 253281. https://doi.org/10.1177/0032329213483109
Gauvin, F. P., Abelson, J., Giacomini, M., Eyles, J., & Lavis, J. N. (2010). “It all depends”: Conceptualizing public involvement in the context of health technology assessment agencies. Social Science & Medicine, 70(10), 15181526. doi: 10.1016/j.socscimed.2010.01.036
Gemmill, M. C., Thomson, S., & Mossialos, E. (2008). What impact do prescription drug charges have on efficiency and equity? Evidence from high-income countries. International Journal of Equity in Health, 7, 12. https://doi.org/10.1186/1475-9276-7-12
Government of Canada. (2011). Status or remote/off-grid communities in Canada. Retrieved from https://www.nrcan.gc.ca/sites/www.nrcan.gc.ca/files/canmetenergy/files/pubs/2013-118_en.pdf
Government of Canada. (2014). Convention on the rights of persons with disabilities. First report of Canada. Retrieved from https://www.canada.ca/content/dam/pch/documents/services/canada-united-nations-system/reports-united-nations-treaties/conv_relative_handicap-conv_rights_disabilities-eng.pdf
Guindo, L. A., Wagner, M., Baltussen, R., Rindress, D., van Til, J., Kind, P., & Goetghebeur, M. M. (2012). From efficacy to equity: Literature review of decision criteria for resource allocation and healthcare decisionmaking. Cost Effectiveness and Resource Allocation, 10(1), 9. doi: 10.1186/1478-7547-10-9
Hoefsmit, N., Houkes, I., & Nijhuis, F. J. N. (2012). Intervention characteristics that facilitate return to work after sickness absence: A systematic literature review. Journal of Occupational Rehabilitation, 22(4), 462477. doi: 10.1007/s10926-012-9359-z
Huber, J., & Mielck, A. (2010). Morbidität und Gesundheitsversorgung bei GKV- und PKV-Versicherten [Morbidity and healthcare differences between insured in the statutory (“GKV”) and private health insurance (“PKV”) in Germany]. Review of empirical studies. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz, 53(9), 925938. doi: 10.1007/s00103-010-1119-7
Islam, T., Dahlui, M., Majid, H. A., Nahar, A. M., Mohd Taib, N. A., & Su, T. T. (2014). Factors associated with return to work of breast cancer survivors: A systematic review. BMC Public Health, 14(Suppl. 3), S8. doi: 10.1186/1471-2458-14-S3-S8
Jones, K., Forder, J., Caiels, J., Welch, E., Glendinning, C., & Windle, K. (2013). Personalization in the health care system: Do personal health budgets have an impact on outcomes and cost? Journal of Health Services Research & Policy, 18(Suppl. 2), 5967. doi: 10.1177/1355819613503152
Lee, J. L., Fischer, M. A., Shrank, W. H., Polinski, J. M., & Choudhry, N. K. (2012). A systematic review of reference pricing: Implications for US prescription drug spending. American Journal of Managed Care, 18(11), e429437.
Legare, F., Turcotte, S., Stacey, D., Ratte, S., Kryworuchko, J., & Graham, I. D. (2012). Patients’ perceptions of sharing in decisions: A systematic review of interventions to enhance shared decision making in routine clinical practice. Patient, 5(1), 119. doi: 10.2165/11592180-000000000-00000
Luiza, V. L., Chaves, L. A., Silva, R. M., Emmerick, I. C., Chaves, G. C., Fonseca de Araujo, S. C., … Oxman, A. D. (2015). Pharmaceutical policies: Effects of cap and co-payment on rational use of medicines. The Cochrane Database of Systematic Reviews, (5), Cd007017. doi: 10.1002/14651858.CD007017.pub2
MacEachen, E., Clarke, J., Franche, R.-L., & Irvin, E. (2006). Systematic review of the qualitative literature on return to work after injury. Scandinavian Journal of Work and Environmental Health, 32(4), 257269.
Malloy-Weir, L. J., Charles, C., Gafni, A., & Entwistle, V. A. (2015). Empirical relationships between health literacy and treatment decision making: A scoping review of the literature. Patient Education and Counselling, 98(3), 296309. doi: 10.1016/j.pec.2014.11.004
Manderson, B., McMurray, J., Piraino, E., & Stolee, P. (2012). Navigation roles support chronically ill older adults through healthcare transitions: A systematic review of the literature. Health & Social Care in the Community, 20(2), 113127. doi: 10.1111/j.1365-2524.2011.01032.x
Mattison, C. A., & Lavis, J. N. (2016). Delivery arrangements 2: Workforce. In Lavis, J. N. (Ed.), Ontario’s health system: Key insights for engaged citizens, professionals and policymakers (pp. 175207). Hamilton, ON: McMaster Health Forum.
Mattison, C. A., Waddell, K., Wang, R. H., & Wilson, M. G. (2017). Citizen brief: Enhancing equitable access to assistive technologies for older adults in Canada. Hamilton, ON: McMaster Health Forum.
Mattison, C. A., Waddell, K., & Wilson, M. G. (2017). Panel summary: Enhancing equitable access to assistive technologies in Canada. Hamilton, ON: McMaster Health Forum.
Mattison, C. A., Wilson, M. G., Wang, R. H., & Waddell, K. (2017). Evidence brief: Enhancing equitable access to assistive technologies in Canada. Hamilton, ON: McMaster Health Forum.
McMaster Health Forum. (2019). Overview of the McMaster Health Forum’s approach to convening citizen panels. Retrieved from https://www.mcmasterforum.org/spark-action/citizen-panels
Meng, Q., Yuan, B., Jia, L., Wang, J., Yu, B., Gao, J., & Garner, P. (2011). Expanding health insurance coverage in vulnerable groups: A systematic review of options. Health Policy and Planning, 26(2), 93104. doi: 10.1093/heapol/czq038
Ministry of Health and Long-Term Care. (2016). Policies and procedures manual for the assistive devices program. Retrieved from http://www.health.gov.on.ca/en/pro/programs/adp/policies_procedures_manuals/docs/pp_adp_manual.pdf
Mitton, C., Smith, N., Peacock, S., Evoy, B., & Abelson, J. (2009). Public participation in health care priority setting: A scoping review. Health Policy, 91(3), 219228. doi: 10.1016/j.healthpol.2009.01.005
Nachtnebel, M., O’Mahony, A., Pillai, N., & Hort, K. (2015). Effectively engaging the private sector through vouchers and contracting – A case for analysing health governance and context. Social Science & Medicine, 145, 193200. doi: 10.1016/j.socscimed.2015.05.021
Ndegwa, S. (2011). Initiatives for healthy aging in Canada: Environmental Scan (17). Retrieved from https://www.cadth.ca/media/pdf/Initiatives_on_Healthy_Aging_in_Canada_es-17_e.pdf
Nunan, M., & Duke, T. (2011). Effectiveness of pharmacy interventions in improving availability of essential medicines at the primary healthcare level. Tropical Medicine & International Health, 16(5), 647658. doi: 10.1111/j.1365-3156.2011.02748.x
OECD. (2005). Evaluating public participation in policy making. Paris, FRA: OECD Publishing.
Posner, M. (2011, April 29). The new citizens’ panels: A powerful antidote to cynicism. The Globe and Mail. Retrieved from https://www.theglobeandmail.com/news/politics/the-new-citizens-panels-a-powerful-antidote-to-cynicism/article578195/
Public Health Agency of Canada. (2010). The health and well-being of Canadian seniors. Ottawa, ON: Author.
Salmi, L. R., Barsanti, S., Bourgueil, Y., Daponte, A., Piznal, E., & Menival, S. (2015). Interventions addressing health inequalities in European regions: The AIR project. Health Promotion International, 32(3), 430441. https://doi.org/10.1093/heapro/dav101
Sarrami-Foroushani, P., Travaglia, J., Debono, D., & Braithwaite, J. (2014). Implementing strategies in consumer and community engagement in health care: Results of a large-scale, scoping meta-review. BMC Health Service and Research, 14, 402. https://doi.org/10.1186/1472-6963-14-402
Schreiber, D., Wang, R. H., Durocher, E., & Wilson, M. G. (2017). Access to assistive technology in Canada: A jurisdictional scan of programs. Retrieved from https://www.researchgate.net/publication/319143618_Access_to_Assistive_Technology_in_Canada_A_Jurisdictional_Scan_of_Programs
Senate of Canada. (2009). Canada’s aging population: Seizing the opportunity. Special senate committee on aging final report. Ottawa, ON: Author.
Shommu, N. S., Ahmed, S., Rumana, N., Barron, G. R., McBrien, K. A., & Turin, T. C. (2016). What is the scope of improving immigrant and ethnic minority healthcare using community navigators: A systematic scoping review. International Journal of Equity in Health, 15, 6. doi: 10.1186/s12939-016-0298-8
Sinnott, S. J., Buckley, C., O’Riordan, D., Bradley, C., & Whelton, H. (2013). The effect of copayments for prescriptions on adherence to prescription medicines in publicly insured populations: A systematic review and meta-analysis. PLoS One, 8(5), e64914. doi: 10.1371/journal.pone.0064914
Skinner, E. H., Foster, M., Mitchell, G., Haynes, M., O’Flaherty, M., & Haines, T. P. (2014). Effect of health insurance on the utilisation of allied health services by people with chronic disease: A systematic review and meta-analysis. Australian Journal of Primary Health, 20(1), 919. doi: 10.1071/PY13092
Social Development, . (2017). Persons with disabilities. Retrieved from http://www2.gnb.ca/content/gnb/en/departments/social_development/persons_disabilities.html
Stacey, D., Legare, F., Col, N. F., Bennett, C. L., Barry, M. J., Eden, K. B., … Wu, J. H. (2014). Decision aids for people facing health treatment or screening decisions. Cochrane Database of Systematic Reviews, (1), Cd001431. doi: 10.1002/14651858.CD001431.pub4
Statistics Canada. (2014a). Table 44-10-0001-01 – Population providing care to a family member or friend with a long-term illness, disability or aging needs, by sex and age group. Retrieved from http://www5.statcan.gc.ca/cansim/a26?lang=eng&retrLang=eng&id=1140001&pattern=aging&tabMode=dataTable&srchLan=-1&p1=1&p2=-1
Statistics Canada. (2014b). Table 13-10-0343-01 – Prevalence of disability for adults. Retrieved from http://www5.statcan.gc.ca/cansim/a26?lang=eng&retrLang=eng&id=1150001&pattern=disability&tabMode=dataTable&srchLan=-1&p1=1&p2=-1
Statistics Canada. (2015). A profile of persons with disabilities among Canadians aged 15 years or older, 2012. Retrieved from http://www.statcan.gc.ca/pub/89-654-x/89-654-x2015001-eng.htm
Statistics Canada. (2016). Table 17-10-0005-01 – Population estimates on July 1st, by age and sex. Retrieved from http://www.statcan.gc.ca/tables-tableaux/sum-som/l01/cst01/demo02a-eng.htm
Statistics Canada. (2017a). Age and sex highlight tables, 2016 Census. Population by broad age groups and sex, 2016 counts for both sexes, Canada, provinces and territories, 2016 Census – 100% data. Retrieved from http://www12.statcan.gc.ca/census-recensement/2016/dp-pd/hlt-fst/as/Table.cfm?Lang=E&T=11
Statistics Canada. (2017b). Age and sex, and type of dwelling data: Key results from the 2016 Census. Retrieved from http://www.statcan.gc.ca/daily-quotidien/170503/dq170503a-eng.htm
United Nations. (2017). Convention on the rights of persons with disabilities. Concluding observations on the initial report of Canada. Retrieved from https://tbinternet.ohchr.org/_layouts/treatybodyexternal/Download.aspx?symbolno=CRPD%2fC%2fCAN%2fCO%2f1&Lang=en
United Nations. (2006). Convention on the rights of persons with disabilities (CRPD). Retrieved from https://www.un.org/development/desa/disabilities/convention-on-the-rights-of-persons-with-disabilities.html
United Nations Treaty Collection. (2019). Chapter IV human rights, 15.a. Optional protocol to the convention on the rights of persons with disabilities. Retrieved from https://treaties.un.org/Pages/ViewDetails.aspx?src=TREATY&mtdsg_no=IV-15-a&chapter=4&clang=_en
Waddell, K., Wilson, M. G., & Mattison, C. A. (2017). Dialogue summary: Enhancing equitable access to assistive technologies in Canada. Hamilton, ON: McMaster Health Forum.
Walsh, T., Barr, P., Thompson, R., Ozanne, E., O’Neill, C., & Elwyn, G. (2014). Undetermined impact of patient decision support interventions on healthcare costs and savings: Systematic review. British Medical Journal, 138, 188.
World Health Organization. (2016a). Priority assistive products list: Improving access to assistive technology for everyone, everywhere. Geneva, CHE: Author.
World Health Organization. (2016b). Priority assistive products list. Retrieved from http://www.who.int/phi/implementation/assistive_technology/global_survey-apl/en/
World Health Organization. (2017). Priority assistive products list (APL). Retrieved from http://www.who.int/phi/implementation/assistive_technology/global_survey-apl/en/
Wilson, M., Lavis, J., Moat, K., & Guta, A. (2016). Evidence brief: Strengthening care for people with chronic diseases in Ontario. Hamilton, ON: McMaster Health Forum.

Keywords

Enhancing Equitable Access to Assistive Technologies in Canada: Insights from Citizens and Stakeholders

  • Cristina A. Mattison (a1) (a2), Michael G. Wilson (a1) (a2) (a3), Rosalie H. Wang (a4) and Kerry Waddell (a1)

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed