Preference clustering reveals divergent pathways for transfer-board design in a Living-Lab co-design study.

Background: Transfer boards demonstrate high abandonment rates despite mechanical simplicity, suggesting fundamental misalignment between current design approaches and user needs. Previous refinements have failed to improve adoption metrics over five decades. Objective: To determine whether wheelcha...

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Publicado en:Disability & Rehabilitation: Assistive Technology Vol. 21; no. 6; pp. 3117 - 3130
Autores principales: Trognon, Arthur, Poli, Alizée, Stortini, Natacha, Duman, Coralie, Mahdar-Recorbet, Loann, Altakroury, Hamza, Lambert, Julien, Abraham, Denis
Formato: research tables/charts Journal Article
Publicado: Taylor & Francis Ltd Aug2026
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Aug2026
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      pub: Taylor & Francis Ltd
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        10.1080/17483107.2026.2631059
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        atl: Preference clustering reveals divergent pathways for transfer-board design in a Living-Lab co-design study.
      aug:
        au:
          Trognon, Arthur
          Poli, Alizée
          Stortini, Natacha
          Duman, Coralie
          Mahdar-Recorbet, Loann
          Altakroury, Hamza
          Lambert, Julien
          Abraham, Denis
        affil: CLINICOG, Nancy, France
      sug:
        subj:
          Wheelchairs
          Patient Preference
          Assistive Technology Devices
          Equipment Design
          Human
          Funding Source
          Male
          Female
          Focus Groups
          Videoconferencing
          Adult
          Middle Age
          Aged
          Professional Organizations
          Multimethod Studies
          Interviews
          Vignettes
          Thematic Analysis
          Content Analysis
          Questionnaires
          Patient Handling
          Data Analysis Software
          Analysis of Variance
          Post Hoc Analysis
          Pearson's Correlation Coefficient
          Collaboration
          Friction
          Assistive Technology
          Emotions
          Correlational Studies
          Patient Autonomy
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Aged: 65+ years
          Male
          Female
      ab: Background: Transfer boards demonstrate high abandonment rates despite mechanical simplicity, suggesting fundamental misalignment between current design approaches and user needs. Previous refinements have failed to improve adoption metrics over five decades. Objective: To determine whether wheelchair users' transfer board preferences follow convergent or divergent distributions, and to identify distinct user segments with specific design priorities. Methods: Mixed-methods Living Lab study combining qualitative focus groups and quantitative preference mapping. Twenty-eight wheelchair users (mean age 51 ± 12 years, 57% women) participated in semi-structured focus groups exploring usage patterns, limitations, and design preferences. Subsequently, 44 wheelchair users (mean age 48.2 ± 13.3 years, 52% women) completed a 31-item questionnaire measuring preferences across usage, materials, and enhancement dimensions. Hierarchical clustering with Ward's method identified user segments. Four-way ANOVA with Tukey post-hoc tests examined cluster differences. Results: Three distinct clusters emerged with divergent preferences. Cluster B1 (n = 8, 18%) demonstrated technology-embracing preferences (Technology subfactor: Δ= +1.70 ± 0.58 vs baseline, p < 0.001; Improvements: Δ= +0.66 ± 0.23, p < 0.001). Cluster B2 (n = 10, 23%) exhibited simplicity-focused preferences, rejecting technological features (Δ=-2.35 ± 0.68 vs B1, p < 0.001) and portability enhancements (Practicality: Δ=-1.36 ± 0.53 vs baseline, p = 0.002) while reporting fewer usage constraints (Δ=-1.50 ± 0.41, p < 0.001). Cluster A (n = 26, 59%) showed intermediate preferences without directional commitment. Significant cluster × factor interactions [F(4,1292)=11.36, p < 0.001] confirmed non-convergent preference structures. Conclusions: Transfer board users distribute across three distinct segments with mutually exclusive design priorities rather than along a single sophistication continuum. These findings challenge the prevailing single-product optimisation paradigm and indicate that parallel development strategies targeting cluster-specific needs could reduce abandonment rates more effectively than iterative refinement towards universal solutions. IMPLICATIONS FOR REHABILITATION: Assistive technology abandonment rates suggest that user consultation at predetermined development milestones is insufficient—sustained co-design throughout the entire innovation process is essential for successful adoption. The assumption that a single optimal design exists for any assistive device may guarantee suboptimal outcomes when user populations have fundamentally divergent rather than convergent preferences. Technology acceptance in disability contexts involves complex negotiations between identity, stigma management, and practical utility that extend beyond simple cost-benefit calculations or feature optimisation. Living Lab methodologies that position disabled users as epistemic partners rather than test subjects can reveal critical design requirements invisible in controlled clinical settings.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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