Design and usability evaluation of COOK, an assistive technology for meal preparation for persons with severe TBI

Abstract

Aim

In Canada, 100,000 people suffer a traumatic brain injury (TBI) every year. The prevalence of moderate to severe TBI is highest for young men, who will live an average of 50 years with this chronic condition associated with physical, emotional and cognitive deficits. Meal preparation, a complex activity with high safety risks, is one of the most significant activities impacted by TBI. Technology shows great promise to support their overall functioning, but no context-aware technology is available to support meal preparation for this population. The main goal of this study was to design and test a technology to support meal preparation with and for persons with severe TBI living in a supported-living residence.

Methodology

As part of a transdisciplinary technology project linking rehabilitation and informatics, COOK (Cognitive Orthosis for coOKing) was designed with and for future users and stakeholders with a user-centred design methodology. COOK was implemented in three participants’ apartments, and its usability was evaluated at 1, 3 and 6 months post-implementation.

Results

COOK is a context-aware assistive technology consisting of two main systems: security and cognitive support system. After implementation of COOK, participants were able to resume safe preparation of meals independently. Usability testing showed good effectiveness and an acceptable level of satisfaction.

Conclusion

COOK appears promising for rehabilitating clients with cognitive disabilities, improving safety in a home environment, and diminishing the need for human supervision. Future studies will need to explore how COOK can be adapted to a broader TBI population, other environments, and other clienteles.

Implications for rehabilitation

• This paper presents a promising context-aware assistive technology for cognition designed with and for clients with severe brain injury to support their independence in meal preparation;

• COOK, (Cognitive Orthesis for coOKing) is the first cooking assistant in which evidence-based cognitive rehabilitation interventions have been translated into smart technological assistance, to support cognition and ensure safety in a real-life context;

• Its context-aware characteristic ensures that users receive the assistance they need at the right time and at the right moment.

• The long-term perspective regarding the use of COOK in clinical practice is promising as this technology has the potential of becoming an additional means of supporting the rehabilitation of people with cognitive impairments and becoming part of a comprehensive solution to help them live at home more independently.

Keywords:

• User-centred design
• cognitive rehabilitation
• assistive technology for cognition
• traumatic brain injury
• meal preparation safety
• meal preparation independence

Acknowledgements

The authors are grateful to all the contributors in the COOK design: the three residents, the staff related to the residence, the occupational therapists from the Rehabilitation centre of Estrie, the fire prevention service of the city and all the researchers and students involved in related aspects of the COOK project. The authors offer a special thanks to Fanny Le Morellec, ergonomist, for her support in planning the design process. The authors also thank Pierre-Yves Groussard, coordinator of the computer science team, who programmed COOK and allowed them to realize this project. This work was supported by the Collaborative Health Research Projects initiative (joint programme from the Canadian Institutes of Health Research and the Natural Sciences and Engineering Research Council of Canada). N. Bier is supported by a salary award grant from the Fonds de la recherche du Québec -Santé.

Disclosure statement

The authors declared no potentials conflict of interest with respect to the research, authorship, and/or publication of this article.

The project description is available on the Université de Sherbrooke website: https://www.usherbrooke.ca/domus/en/recherche/nos-projets-de-recherche/cook-assistant-culinaire/

A video of the project has been produced and is accessible via this link: https://www.youtube.com/watch?v=o0jkauWLBGo

Notes

1 The living laboratory context means that the design, implementation and exploration of the usability of technologies is carried out with and for all partners: the university laboratory, the residence and the rehabilitation center. The main goal of the laboratory is to transform in a long-term perspective this residence into a smart home.

2 Level of independence, as measured by the Instrumental Activity of Daily living Profile (IADL) ecological evaluation used to document the future user’s profile (Bottari, Dassa, Rainville, & Dutil, 2009b), refers to whether the person is dependent, requires verbal and physical assistance, requires verbal of physical assistance, is independent with difficulty or is independent, to formulate a goal, plan, carry out the task and verify goal attainment.

Additional information

Funding

This work was supported by the Collaborative Health Research Projects initiative funding opportunity offered by the Canadian Institutes of Health Research under Grant [PRCS 508397] in partnership with the Natural Sciences and Engineering Research Council under Grant [CPG 151960]. N. Bier is supported by a salary award from the Fonds de la recherche du Québec-Santé.