What attributes of digital devices are important to clinicians in rehabilitation? A cross-cultural best-worst scaling study

Background

Digital interventions are becoming increasingly popular in rehabilitation. Understanding of device features which impact clinician adoption and satisfaction is limited. Research in the field should be conducted across diverse settings to ensure digital interventions do not exacerbate healthcare inequities.

Objective

This study aimed to understand rehabilitation clinicians’ preferences regarding device attributes and included a cross-cultural comparison.

Materials and Methods

Choice experiment methodology (best-worst scaling) was used to survey rehabilitation clinicians across Australia and Brazil. Participants completed 10 best-worst questions, choosing the most and least important device attributes from subsets of 31 attributes in a partially balanced block design. Results were analysed using multinomial models by country and latent class. Attribute preference scores (PS) were scaled to 0–100 (least to most important).

Results

A total of 122 clinicians from Brazil and 104 clinicians from Australia completed the survey. Most respondents were physiotherapists (83%) working with neurological populations (51%) in the private/self-employed sector (51%) who had experience using rehabilitation devices (87%). Despite preference heterogeneity across country and work sector (public/not-for-profit versus private/self-employed/other), clinicians consistently prioritised patient outcomes (PS 100.0, 95%CI: 86.2–100.0), patient engagement (PS 93.9, 95%CI: 80.6–94.2), usability (PS 81.3, 95%CI: 68.8–82.5), research evidence (PS 80.4, 95%CI: 68.1–81.7) and risk (PS 75.7, 95%CI: 63.8–77.3). In Australia, clinicians favoured device attributes which facilitate increased therapy dosage (PS 79.2, 95%CI: 62.6–81.1) and encourage patient independent practice (PS 66.8, 95%CI: 52.0–69.2). In Brazil, clinicians preferred attributes enabling device use for providing clinical data (PS 67.6, 95%CI: 51.8–70.9) and conducting clinical assessments (PS 65.6, 95%CI: 50.2–68.8).

Conclusion

Clinicians prioritise patients’ needs and practical application over technical aspects of digital rehabilitation devices. Contextual factors shape clinician preferences rather than individual clinician characteristics. Future device design and research should consider preferences and influences, involving diverse stakeholders to account for context-driven variations across cultures and healthcare settings.