Technology and Environmental Supports in the Home and Community

Technology and environmental supports are ubiquitous across all areas of society. Technology use is a means to enhance occupational therapy interventions as well as a significant form of occupational engagement and social participation. Technology and environmental supports are a priority area across the lifespan in home, clinical, and community settings. Targeted technologies may include assistive technologies, information and communication technologies, artificial intelligence, mRehab applications, and 3D printing. Environmental supports may include universal design, home modifications, and reasonable accommodations. Systems of delivering and documenting technology need, use, and impact are also important areas of research focus within this priority. 

Technology and environmental supports is a priority area across the lifespan, in home, clinical, and community settings.  There is a substantial need of research to identify effective interventions and improved outcomes. 

• Designs for healthy communities are focusing on the characteristics of the built and natural environment that support physical activity and active living for people of all ages and abilities.¹ 

• Initiatives that emphasize health for all people are focusing on the social determinants of health or the “conditions in the environments in which people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks.” ² Development and evaluation of “innovative, effective, and affordable user-centric technologies”³ is needed to increase opportunities for people with disabilities to participate in school, work, home, and community environments.⁴ 

• Telehealth and health information communications technologies are providing new avenues to improve health care access and quality and meet the needs of medically underserved areas and populations. ^{5, 6} 

• Innovative outcome measures with strong psychometric properties that document the impact of assistive technologies on key occupational therapy outcomes, including function and participation.  

• Behavioral change and motivation strategies to promote technology use and adherence.³ 

Need and Relevance to Occupational Therapy 

Technology and environmental supports has been identified as 

• a critical area to target to promote health and participation for all people 

• an area in which evidence-based measures and interventions are needed 

• an area where application of the unique expertise of occupational therapy would be highly beneficial 

The occupational therapy lens provides a comprehensive understanding of the importance of the person-technology and person-environment fit to support performance of everyday activities and participation in home and community settings. This lens also bridges biomedical and sociocultural perspectives on the factors that support health and well-being.   

Current knowledge, research training, measures and interventions in the areas of technology and environment are inadequate for addressing participation and health issues.  AOTF is committed to the development of a scientific network and body of evidence to achieve effective and efficient advances in occupational therapy science for the areas of technology and environmental supports in school, home, clinical, and community settings. 

Opportunity to Affect Progress 

While there are  many occupational therapy scientists who are building knowledge related to technology and environmental supports,  there is not a coordinated network for occupational therapy research in this area, nor sufficient resources to train more occupational therapy researchers.  We believe a significant investment is needed to improve technology and environmental supports across the lifespan in order to achieve better outcomes and improve quality of life. 

1. Centers for Disease Control and Prevention. (2016). Healthy community design. Retrieved from 

http://www.cdc.gov/nceh/publications/factsheets/ImpactoftheBuiltEnvironmentonHealth.pdf 

2. Office of Disease Prevention and Health Promotion. (2016). Social determinants of health. Retrieved from 

http://www.healthypeople.gov/2020/topics-objectives/topic/social-determinants-health 

3. National Institutes of Health. (2021). National Institutes of Health (NIH) Research Plan for Rehabilitation. Retrieved from https://www.nichd.nih.gov/publications/product/505 

4. Disability.gov . (2016). Assistive and accessible communities. Retrieved from 

https://www.disability.gov/resource/disability-govs-guide-assistive-technology/ 

5. Health Resources and Services Administration. (2016). Telehealth. Retrieved from 

http://www.hrsa.gov/healthit/toolbox/ruralhealthittoolbox/telehealth/ 

6. U.S. Department of Health and Human Services. (2016). Health information technologies. Retrieved from 

http://www.hhs.gov/ocr/privacy/hipaa/understanding/special/healthit/ 

7. World Health Organization/UNICEF. (2022). Global Report on Assistive Technology. Retrieved from https://www.unicef.org/reports/global-report-assistive-technology