Development of a Smart Home Modification Program: A Delphi Survey of Multidisciplinary Health Care Experts

Abstract

Abstract Importance: There is a critical gap between the potential of smart home technologies to enhance the lives of people with physical disabilities (PwPD) and their limited use because of complex interfaces, high costs, technical issues, and insufficient institutional support. Objective: To bridge this gap and ensure that PwPD can fully benefit from smart home advancements to improve their daily living and quality of life by developing a smart home modification program. Design: A Delphi survey involving three rounds was conducted with experts in disability and smart home technologies. Setting: Online survey. Participants: Thirty multidisciplinary health care experts. Outcomes and Measures: Experts rated the level of relevance in smart home modification with each survey. Consensus was set at ≥75%, content validity (CVR) was ≥.33, and convergence was ≤.5. Results: The first Delphi result selected 26 items, and the second included 59 items after adjusting for values that fell below a CVR of .33. In the third Delphi survey, 59 items were selected. The final Delphi study had an average CVR of .96 and a coefficient of variation of .10. The last survey’s consensus point was .92, indicating a high level of agreement among participants. Conclusions and Relevance: On the basis of expert consensus, the study provides a validated framework for smart home modifications to aid PwPD. Plain-Language Summary: This research highlights the role of smart home adaptations to promote responsible, independent living for people with physical disabilities. There is a critical gap between the potential of smart home technologies to improve the lives of people with physical disabilities and their limited use because of complex interfaces, high costs, technical issues, and insufficient institutional support. The study authors developed a smart home modification program with the goal of closing this gap and to ensure that people with physical disabilities can fully benefit from smart home advancements to improve their daily living and quality of life. Based on expert ratings, the study findings provide a validated framework that occupational therapists can use to recommend smart home modifications to help people with physical disabilities. The framework can also be used by occupational therapists to identify people who may need more extensive environmental modifications and interventions.