Multilevel barriers to using assistive technology devices among older hispanics from poor and disadvantaged communities: the relevance of a gender analysis.

Purpose: To get a rich description of the barriers to using assistive technology (AT) among men and women ≥65 years living in poor and disadvantaged communities in Puerto Rico, an issue not well described among older people.

Methods: We conducted qualitative interviews assisted by videos of AT and guided by the Matching Person and Technology Model and the Gender Analysis Framework with a purposive sample of 23 men and women. Participants were asked questions regarding reasons for not using AT, willingness for using AT, their identified gender roles and gender-related activities, and bargaining positions. They were also asked about their access to resources to acquire AT, bargaining positions, the stigma associated with AT use, and the characteristics of AT. Directed content analysis with input from a Community Advisory Board was used for the interpretation of the results.

Results: The predominant barrier (for both men and women) to using AT devices were: lack of information about AT s and access to money for their purchase, lack of availability and cost of such devices, and (self)-stigma. More women than men experienced limited access to AT services, limited access to and control of money, limited skills for using AT, and less bargaining power for making independent decisions. More men than women expressed a lack of functional need and personal preferences other than using AT devices for managing difficulties in activities.

Conclusion: There are gender differences concerning the multilevel barriers to using AT devices among older Hispanics residing in low-income communities.IMPLICATIONS FOR REHABILITATIONOlder Hispanic men and women in this study experienced different obstacles to using assistive technology (AT) they need for compensating their functional disabilities in daily living activities.Women in this study reported having less access to money and AT services, diminished skills for using AT devices, and less power to make independent decisions to access AT devices compared to men.To ensure the equitable provision of AT, cultural as well as gender-related factors concerning AT use need to be considered.Future research should focus on women's functional health, also should focus on the development of gender-sensitive and culturally competent AT interventions to improve older Hispanics from poor communities function and opportunities for ageing at their homes and in their communities.