International Mobility Technology Research: A Delphi Study to Identify Challenges and Compensatory Strategies

ABSTRACT We sought to identify logistical and ethical challenges to performing wheelchair-related research in low- and middle-income countries and to generate a list of compensatory strategies to address these challenges. Thirteen individuals with experience in the field participated in an online Delphi study. The surveys asked participants to identify research challenges, suggest strategies to address the selected challenges, and critique each other's strategies. Participants identified challenges in the use of research techniques, compensation for participation that does not result coercion, oral and written translation materials, funding for research, collaboration with local professionals, and “respect for persons.” Effective international mobility research requires time, cultural sensitivity, collaboration, and careful planning. An understanding of these requirements can allow researchers to anticipate and compensate for common pitfalls of their work, thus making the research more productive and beneficial to subjects. Future research is required to verify the general effectiveness of compensatory strategies.

[1]  Tanja Stamm,et al.  Identification of relevant concepts of functioning in daily life in people with systemic lupus erythematosus: A patient Delphi exercise. , 2008, Arthritis and rheumatism.

[2]  恵子 紀国谷 国際生活機能分類(International Classification of Functioning, Disability and Health: ICF)にみた福祉・保健・医療の専門職協働における連携に関する貢献と課題 , 2007 .

[3]  Kathleen Puntillo,et al.  Ensuring Cross-Cultural Equivalence in Translation of Research Consents and Clinical Documents , 2009, Journal of transcultural nursing : official journal of the Transcultural Nursing Society.

[4]  Flora Hammond,et al.  Participant Recruitment and Retention in Rehabilitation Research , 2008, American journal of physical medicine & rehabilitation.

[5]  William Armstrong,et al.  Evaluation of CIR-Whirlwind Wheelchair and service provision in Afghanistan , 2007, Disability and rehabilitation.

[6]  Jonathan Lee Pearlman Research and Development of an Appropriate Electric Powered Wheelchair for India , 2007 .

[7]  Rory A Cooper,et al.  New design and development of a manual wheelchair for India , 2007, Disability and rehabilitation.

[8]  R. Devellis,et al.  Cross-Cultural Translation , 1994 .

[9]  Julianna Arva,et al.  RESNA Position on the Application of Wheelchair Standing Devices , 2009, Assistive technology : the official journal of RESNA.

[10]  N. Kass,et al.  Views of US researchers about informed consent in international collaborative research. , 2005, Social science & medicine.

[11]  Alarcos Cieza,et al.  Identification of Intervention Categories for Physical Therapy, Based on the International Classification of Functioning, Disability and Health: A Delphi Exercise , 2006, Physical Therapy.

[12]  Thomas R. Stewart,et al.  The Delphi technique and judgmental forecasting , 1987 .

[13]  Eun-Seok Cha,et al.  Translation of scales in cross-cultural research: issues and techniques. , 2007, Journal of advanced nursing.

[14]  Peter R. Giacobbi,et al.  Methodological challenges confronting researchers of wheeled mobility aids and other assistive technologies , 2007, Disability and rehabilitation. Assistive technology.

[15]  長瀬 修 わかりやすい障害者の権利条約 : 知的障害のある人の権利のために = Convention on the rights of persons with disabilities , 2009 .

[16]  Susan Jaglal,et al.  Identification of recruitment and retention strategies for rehabilitation professionals in Ontario, Canada: results from expert panels , 2008, BMC health services research.

[17]  James Burr,et al.  Making a Little go a Long Way , 1983 .

[18]  Julianna Arva,et al.  RESNA Position on the Application of Seat-Elevating Devices for Wheelchair Users , 2009, Assistive technology : the official journal of RESNA.

[19]  C. Powell The Delphi technique: myths and realities. , 2003, Journal of advanced nursing.

[20]  J. Betancourt,et al.  Language barriers to informed consent and confidentiality: the impact on women's health. , 2000, Journal of the American Medical Women's Association.

[21]  Tania D Strout,et al.  Development and implementation of an inductive model for evidence-based practice: A grassroots approach for building evidence-based practice capacity in staff nurses. , 2009, The Nursing clinics of North America.

[22]  Patricia S. Jones,et al.  Cultural differences in responses to a Likert scale. , 2002, Research in nursing & health.

[23]  Åse Brandt Translation, cross-cultural adaptation, and content validation of the QUEST , 2006 .

[24]  M. Puhan,et al.  Recruitment barriers in a randomized controlled trial from the physicians' perspective – A postal survey , 2009, BMC Medical Research Methodology.

[25]  David A Paz,et al.  Cross-cultural dynamics in rural Peru. , 2006, Military medicine.

[26]  Jenny Kim,et al.  Seating/wheelchair technology in the developing world: need for a closer look , 1999 .

[27]  J. Jutai,et al.  Development of a scale to measure the psychosocial impact of assistive devices: lessons learned and the road ahead , 2002, Disability and rehabilitation.

[28]  U. P. Wyss,et al.  Evaluating a new mobility device: feedback from women with disabilities in India , 2000, Disability and rehabilitation.

[29]  F. Godlee,et al.  Can we achieve health information for all by 2015? , 2004, The Lancet.

[30]  T L Packer,et al.  The mobility needs of women with physical disabilities in India: a functional perspective. , 1998, Disability and rehabilitation.

[31]  K. Bozic,et al.  Using observational data for decision analysis and economic analysis. , 2009, The Journal of bone and joint surgery. American volume.

[32]  L. Hunt,et al.  Are Good Intentions Good Enough?: Informed Consent Without Trained Interpreters , 2007, Journal of General Internal Medicine.

[33]  Jennifer B Unger,et al.  Translation of Health Programs for American Indians in the United States , 2008, Evaluation & the health professions.

[34]  Yi-Fang Lee,et al.  Methodological and conceptual issues confronting a cross-country Delphi study of educational program evaluation. , 2008, Evaluation and program planning.

[35]  Ann Dozier,et al.  Ethical Review Issues in Collaborative Research between US and Low Middle Income Country Partners: A Case Example , 2008, Bioethics.

[36]  Derick T Wade,et al.  Barriers to rehabilitation research, and overcoming them , 2003, Clinical rehabilitation.

[37]  B. S. Hoppestad,et al.  Essential elements for assessment of persons with severe neurological impairments for computer access utilizing assistive technology devices: A Delphi study , 2006, Disability and rehabilitation. Assistive technology.

[38]  C. Simon,et al.  Interpreter Accuracy and Informed Consent Among Spanish-speaking Families with Cancer , 2006, Journal of health communication.

[39]  M M Prabhaka,et al.  A Follow-Up Program In India For Patients With Spinal Cord Injury: Paraplegia Safari , 2004, The journal of spinal cord medicine.

[40]  Rosemarie Cooper,et al.  RESNA Position on the Application of Tilt, Recline, and Elevating Legrests for Wheelchairs , 2009, Assistive technology : the official journal of RESNA.

[41]  D G Beaumont,et al.  The interaction between general practitioners and occupational health professionals in relation to rehabilitation for work: a Delphi study. , 2003, Occupational medicine.

[42]  Rubén Nieto,et al.  Predictive factors of chronic pain and disability in whiplash: A Delphi poll , 2008, European journal of pain.

[43]  R. Jacobs,et al.  Cultural adaptation in translational research: Field experiences , 2005, Journal of Urban Health.

[44]  Robert Weech-Maldonado,et al.  Survey Response Style and Differential Use of CAHPS Rating Scales by Hispanics , 2008, Medical care.

[45]  Alison Mann,et al.  Lessons learned: research with rural Mexican-American women. , 2005, Nursing outlook.

[46]  Silke Schmidt,et al.  Current issues in cross-cultural quality of life instrument development. , 2003, Archives of physical medicine and rehabilitation.

[47]  Anthony F Jorm,et al.  Self-help strategies that are helpful for sub-threshold depression: a Delphi consensus study. , 2009, Journal of affective disorders.

[48]  D. Kewman,et al.  Advancing disability policy: Opportunities and obstacles. , 2001 .