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HESTIA: Home Evaluation with a Strategic Triangulating Integrative Approach (A Home Evaluation App)
Hestia Logo

Project Proposal

The Hestia Project, funded by the National Institute of Disability, Independent Living, and Rehabilitation Research (NIDILRR), is developing a smart mobile app that will provide a more comprehensive, consistent and efficient approach completing home evaluations. HESTIA will provide an in-depth multi-faceted assessment to identify problems in the home environment that impede a person's ability to successfully live at home and as independently as possible. Our hope is that a more efficient and comprehensive home evaluation will enable more people with disabilities to remain live at home safely.

The Goal: Accurate Practitioner Home Evaluations Increase Client Independence

Practitioner measuring doorframe distance using iPad camera in order to determine accessibility of doorway.

Demand for Hestia

The foundation of a home modification is the home evaluation, which begins with a comprehensive examination of the physical structure of the home, the homeowner's capacities, as well as desired level of performance and culminates in recommendations aimed at enhancing the homeowner's safety when engaged in daily activities. Home evaluations may be completed by licensed occupational therapists, physical therapists, or certified aging-in-place specialists (CAPS) and are implemented with the help of a team that may include an architect, contractor, and/or social worker.

Hestia App Description

Person, Environment, and Occupation model represented by three puzzle pieces forming a circle, one with “P”, one with “O”, and one with “E”.

HESTIA will include three data collection modules that reflect Person, Environment, and Occupation (Activity) and an integrated Report Module. After accounting for the basic home information such as the number of bedrooms, the presence of a garage, or how many stairs are required to enter, the evaluator will collect several specific measurements of the physical environment related to accessibility (e.g. the width of doorways, heights of cabinets, etc.). The Report Module integrates data collected in the 3 modules into a summary report.

Data Collection diagram depicting 3 iPads, one with the Person Module, one with the Environment Module, and the third with the Occupation or Activity Module, integrating their data into a summary report on the client’s functional performance.

HESTIA will facilitate fast communication across the home evaluation team (including the rehabilitation personnel, home remodeler, the case coordinator, and payers) and family members using wireless telecommunications and cloud access. Additionally, the HESTIA report will serve as an information focal point for the team. The report will identify and describe the lack of person-environment-activity fit as a) specific needs and b) suggested intervention ideas. The practitioner will use this report in discussion with the client and family to prioritize the areas of intervention. Then, on review of the suggested ideas, an individualized set of interventions can be tailored, a final plan documented, implemented and outcomes re-evaluated at a follow-up.

Application of PEO Model

When a patient receives a home evaluation, an evaluator will be able to use HESTIA to complete the evaluation. The Person Module data are collected by the home evaluator either in person or via telephone or real-time video with the client and family.

An iPad displaying an example of the Person Module. Client name: John Doe. Client Age: 65. Gender: Male. Diagnosis: Left below knee amputation, diabetes, peripheral neuropathy, retinopathy. Assistive Technology: Uses a wheelchair for mobility, bed side commode. Wheelchair width: 2 feet. Shoulder flexion: 0-150 degrees.

The Activity Module is completed next focuses on the individual’s performance as well as activity preferences. Prompts in ADL performance will use a standard set of activities essential for independent living. The Activity Module will also collect data around areas considered important as Quality of Life indicators, such as bathroom activities. The Activity Module prompts the individual and family members to identify priorities and preferences related to the activity performance.

An iPad displaying an example of the Activity Module for John Doe. Activities of Daily Living include Dressing: Set-up required. Bathing: Moderate assistance required. Grooming: Set-up required. Toileting: Set-up required. Toilet Transfer: Moderate assistance required. Cooking: Wife completes. Cleaning: Wife completes.

The last module is an Environment Module, where more automated data collection occurs. The home has hundreds of measures that could be entered and variables to consider. Like the other modules, efficiency is designed as a part of the smart HESTIA system. Based on the activity, performance needs, and client/family preferences, the items in the environment are ranked and prioritized. For example, if the individual has no problem performing certain activities, there would not be a need to perform a detailed evaluation of the associated environmental features.

An iPad displaying an example of the Environment Module, in the Home. Type of home: Split live 2-story. Bedroom present on: 2nd floor. Number of bedrooms: 3. Stairs required to access bedroom: 18. Bathrooms present on: 1st floor, 2nd floor. Number of bathrooms: 2. Entrances: Front door. Number of stairs to enter: 5. Handrails present: Yes

Lastly, the HESTIA Report Module displays a summary of all three modules integrating person, activity, and environment into a summary of needs. The report lists important household activities identified by the client, areas of poor performance, environmental barriers, and anticipated level of funding.

Early Development

Flowchart depicting a branching question, the initial question is “Where is the door located?” Branches into two choices that are Interior and Exterior. Arrows from these boxes both lead to the question “Is the door in a series?” A branch leads to Yes and one branch to No. The Yes branch leads to “Distance between Doors” and then “Number of Doors Swinging into the same Space.” Then this branch and the No branch leads to Type of Door choices. 3 types of door include Swinging, Sliding, and Pocket

The Hestia Technical Team created a server-based Application Programming Interface (API) that can be used by both the mobile and web interfaces and will store and retrieve data from a database. The mobile development targets the Apple iOS platform and iPad form factor and an Android version will be developed soon after. Interfaces will include accessibility hooks to allow usage with screen readers such as VoiceOver on iOS and accounting for color-blindness. The Access Ratings of Buildings (AR-B) Project developed branching questions for each accessibility category in the home, and are used in the Hestia App to prompt the evaluator to use the tools in the app, minimizing time and effort.

Integrated measurement tools from the Technical Team Members at Marquette University include a sign font measurement tool, accelerometer to detect slope, the cameral to detect light intensity, and microphone to detect sound intensity. The Team continues to develop the suite of available measurement tools.

Development of Storyboards and Screen Cadence

The look of Hestia logo has evolved over the past year: The progression of smart mobile app design:

Team/Staff

  • Texas Women's University
    • Noralyn Pickens, PhD, OT
    • Suzanne Burns, MOT, OTR/L
  • University of Wisconsin - Milwaukee
    • Roger O. Smith, PhD, OT, FAOTA Resna Fellow
    • Nathan Spaeth, BS
    • Meg Zimont, BA
    • Kaivahn Sarkaratpour, BA
    • Megan Schreiber, BA, OTS
    • Dennis Tomashek, MS
    • Brian Schermer, PhD
    • Michael J. Brondino, PhD
  • Marquette University
    • Sheikh Iqbal Ahamed, PhD
    • Amit Kumar Saha, BS
  • Temple University
    • Rochelle Mendonca, PhD

National Advisory Board

  • Bryant & Stratton College
    • Sandy Ceranski, MS, OTR
  • Texas Woman's University-Dallas
    • Mary Thompson, PhD, PT, GCS
  • Rebuilding Together
    • Karen Smith, OT/L, CAPS
  • Western Michigan University
    • Carla Chase, Ed.D
  • Independence First
    • Diana Sullivan, ADA Access Specialist

Presentations/Publications

Burns, S., Smith, R. O., & Pickens, N.D. (2015). Embedding interdisciplinary best practices in the design of a client-centered home assessment app (poster). Paper presented at the ACRM 92nd Annual Conference, Progress in Rehabilitation Research (PIRR), Dallas, TX.

Pickens, N.D., Burns, S., & Smith, R.O. (2015, May). Development of a multifaceted software evaluation for home reintegration: Content development and validation of a home modifications assessment mobile app. Poster at the Fourth Annual Occupational Therapy Summit of Scholars, Los Angeles, CA.

Pickens, N. D., Smith, R. O., & Burns, S. (2015). Development of a multi-faceted software evaluation for home reintegration. Paper presented at the RESNA 38th International Conference on Technology and Disability: Research, Design, Practice and Policy, Denver, CO.

Acknowledgements:

The HESTIA project is supported in part by the National Institute of Disability, Independent Living, and Rehabilitation Research (NIDILRR), grant number 90IF0083 (formerly H133G140222). The opinions contained in this presentation do not necessarily represent the policy of the funding sources, and you should not assume endorsement by the Federal Government.

Contact Us

For more information, or if you are interested in assisting with any of the development or testing of the HESTIA system, please contact us at r2d2@uwm.edu.Please include your contact information and indicate if you are located in the Milwaukee, WI area.