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

从历史上看，生活在资源匮乏地区的肢体丧失患者可能会通过修改捐赠的辅助设备或使用现有材料设计和制造自己的设备来改善他们的行动能力。然而，最近，高资源地区的工业和专业学校已经开始推动专门为生活在低资源环境中的人们设计辅助设备。在为这个新市场设计时，工程师和设备制造商经常通过使用更便宜的材料和简化产品设计来修改标准原型，使最终产品更容易制造、使用和维修。但是，当涉及到辅助设备时，预期的接受者看重的不仅仅是简单和成本。他们使用辅助技术来帮助他们发展新的社会关系，从事有偿工作，发挥照顾者的作用，并解决残疾对其身份的负面影响。该项目旨在了解高收入地区的工程师在为资源匮乏地区的受术者制造假肢时如何开发出新的设计。然后，它询问低资源地区的人们如何接受、拒绝或改变辅助设备，以更好地满足他们对自我效能、改善经济前景和社会关系的需求。这项研究的更广泛影响包括推进关于文化和社会关系如何影响生活在低收入地区的人们使用技术解决残疾问题的方式的学术研究。它还将通过培训当地研究助理进行混合方法社会科学研究、揭示资源分配途径以及向组织宣传残疾人适应和利用资源的发现来促进能力建设。这个混合方法的项目将定性和定量数据收集与实地调查相结合，以了解高资源地区的设计师如何为低资源地区的用户设计最好的假肢。首先，在一个资源丰富的地区，一个生物工程小组在资源匮乏的儿童骨科医院分发3D打印机，为儿童打印假肢。通过半结构化访谈和向肢体丧失患者、其家庭成员和卫生保健提供者分发定量调查，从资源匮乏地区获得数据，对这些观察结果进行补充。因此，该项目加强了对生活在高资源地区的工程师和假肢专家在为生活在低资源地区的接受者开发设备时对最终用户需求的假设的理解，以及低资源地区的人们如何接受、拒绝或改变辅助设备以更好地满足他们的需求。总而言之，项目成果有助于为资源匮乏地区生产更有效的假肢。本研究通过研究辅助装置形式的技术创新的不公平分配如何影响高资源和低资源环境中的个人和社区如何看待“正常”和“残疾”身体，导航卫生系统和重组社会关系来推进科学和技术研究。该奖项反映了美国国家科学基金会的法定使命，并通过使用基金会的知识价值和更广泛的影响审查标准进行评估，被认为值得支持。

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.