Doctoral Dissertation Research: Social and Cultural Drivers of Assistive Device Design and Re-Design for People Living in Low-Resource Settings

University Of North Carolina At Chapel Hill, Chapel Hill NC

Investigators

Abstract

Historically, people who have suffered limb-loss and live in low-resource regions might improve their mobility by modifying donated assistive devices or by designing and building their own devices using found materials. Recently, however, there has been a drive on the part of industry and professional schools in high-resource regions to design assistive devices specifically for people living in low-resource settings. In designing for this new market, engineers and device makers frequently modify standard prototypes by using cheaper materials and simplifying product design to make the final product easier to build, use, and repair. But the intended recipients value more than simplicity and cost when it comes to assistive devices. They use assistive technology to help them develop new social relationships, engage in paid work, function as care-givers, and address the negative impact of disability on their identities. This project seeks to understand how engineers from high-income regions develop new kinds of designs when they build prosthetic legs intended for recipients in low-resource settings. It then asks how people in in low-resource regions accept, reject, or alter assistive devices to better meet their needs for self-efficacy, improved economic prospects, and social relationships. Broader impacts of this research include advancing scholarship about how culture and social relationships influence the ways people living in low-income regions use technology to address disability. It will also promote capacity building by training local research assistants in mixed-methods social science research, uncovering pathways of resource distribution, and publicizing findings about resource adaptation and use to organizations by and for persons with disabilities. This mixed-methods project blends qualitative and quantitative data collection and fieldwork to understand how designers in high-resource regions can best design prosthetics for users in low-resource regions. It begins with participant observation in a high-resource region with a bioengineering group that distributes 3D printers capable of printing prosthetic limbs for children at a pediatric orthopedic hospital in low-resource settings. These observations are then complimented with data from the low-resource region captured by administering semi-structured interviews and distributing quantitative surveys to those who have sustained limb-loss, their family members, and health care providers. The project thus enhances understanding of the assumptions that engineers and prosthetists living in high-resource regions make about the needs of their end-users as they develop devices intended for recipients living in low-resource regions, and how people in low-resource settings accept, reject, or alter assistive devices to better meet their needs. Taken together, project results can help enable the production of more effective prosthetics for low-resource regions. This research advances Science and Technology Studies by studying how the inequitable distribution of technological innovations in the form of assistive devices influences how individuals and communities in high and low-resource settings perceive "normal" and "disabled" bodies, navigate health systems, and reorganize social relationships. This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.