Community Access Through Remote Eyesight (CARE) Study
Study Details
Study Description
Brief Summary
Study is a randomized clinical trial evaluating the efficacy of novel mobile application technologies (including Seeing AI, Aira, and Supervision+) to improve quality of life in older adults with low vision by expanding community access and providing assistance with activities of daily living. Aira provides real-time remote personal assistance through a sighted Aira agent supplying direct feedback to assist with visual tasks. Seeing AI provides optical character recognition allowing any text to be read aloud, color identification, bar code reading, scene description, and facial recognition based on stored photos. Supervision + allows one to use the phone as a magnifier, providing magnification and contrast enhancement using the camera of the mobile phone. This study seeks to understand the potential of these technologies to improve daily activities, community participation, independence, and self-sufficiency in this group by examining a technological approach, which has not yet undergone rigorous investigation in a diverse population of older adults with visual impairment. Project objectives are to evaluate mobile applications in a wide range of visual disability, categorized into three groups: (1) mild to moderate visual acuity loss, (2) severe to profound visual acuity loss, and (3) legal blindness secondary to visual field loss. Participants are randomized to one of three intervention groups: (1) Supervision+ application, (2) Aira application, or (3) Seeing AI application for a period of 6 months. For the Aira intervention group, participants will be assigned either with 'restricted' access (current open access areas plus 30 minutes/month anywhere), or 'unrestricted' access (700 minutes), for a period of 3 months with a 3 month cross-over period. Outcome measures include assessment of changes at three- and six-months post-intervention for: visual ability, health state (including depression), self-efficacy, loneliness, life space, distances travelled from the home, and types of services obtained.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
N/A |
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Experimental: Seeing AI Smart Phone App Intervention: Behavioral: Low Vision Rehabilitation |
Behavioral: Low Vision Rehabilitation
Smart phone App
|
| Experimental: Supervision+ Smart Phone App Intervention: Behavioral: Low Vision Rehabilitation |
Behavioral: Low Vision Rehabilitation
Smart phone App
|
| Experimental: Aira Smart Phone App Intervention: Behavioral: Low Vision Rehabilitation |
Behavioral: Low Vision Rehabilitation
Smart phone App
|
Outcome Measures
Primary Outcome Measures
- Visual ability change score [AI questionnaire will be administered three times over 6 months: baseline, 3-months post-intervention and 6-months post-intervention]
The primary outcome measure is the person change score (before and after intervention), from the adaptive Massof Activity Inventory (AI) Questionnaire. The AI has an item bank of 510 items organized into 50 goals and 460 related visually-based tasks. Subscales range from 0 (not important) to 3 (very important). For those goals rated as important, subjects are asked to rate the task difficulty on subscales of 0 (impossible to do without help) to 5 (not difficult). Rasch analysis is employed to estimate visual ability from these difficulty ratings, on an interval scale. With Rasch analysis person measures are estimated, whereby a more positive person measure reflects greater visual ability. In this study, we will explore the the difference in person measures (i.e. change score) after the intervention at 3 and 6 months. A larger, more positive change score indicates greater visual ability since intervention.
Secondary Outcome Measures
- Health-related Quality of Life: SF-36 [will be administered three times over 6 months: baseline, 3-months post-intervention and 6-months post-intervention]
questionnaire; scale ranges from 1 (excellent) to 5 (poor), with higher values indicating greater difficulty.
- Beck Depression Inventory [will be administered three times over 6 months: baseline, 3-months post-intervention and 6-months post-intervention]
questionnaire; subscales range from 0 to 3, with higher values indicating greater depression.
- Community Living: Life Space Questionnaire [will be administered three times over 6 months: baseline, 3-months post-intervention and 6-months post-intervention]
questionnaire; subscales range from 1 (Yes) to 2 (No), with a higher total value indicating a more restricted life space.
- 3-item UCLA Loneliness Scale [will be administered three times over 6 months: baseline, 3-months post-intervention and 6-months post-intervention]
questionnaire; subscales range from 1 to 3, with a high value indicating increased loneliness.
- New General Self Efficacy Scale [will be administered three times over 6 months: baseline, 3-months post-intervention and 6-months post-intervention]
questionnaire; subscales range from 1 to 5, with a higher value indicating greater self-efficacy.
- App usage frequency [at 3 months post-intervention and 6 months post intervention]
App usage in minutes.
Other Outcome Measures
- Telephone Interview of Cognitive Status (TICS) [administered at time of enrollment]
questionnaire; with subscales 0 to 1, with higher scores indicating greater cognitive ability.
- Psychosocial Impact of Assistive Devices Scale (PIADS) [administered at 3-months post-intervention and 6-months post-intervention]
questionnaire; with subscales from -3 to 3, higher scores indicate greater affinity of a particular factor to assistive technology use.
- Aira Explorer Survey post intervention feedback [6 months]
(specific to those participants randomized to Aira); questionnaire, with subscales ranging from 0 to 10, higher scores indicate stronger agreement or helpfulness of the Aira App.
Eligibility Criteria
Criteria
Inclusion Criteria:
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age 55 years + (no upper limit)
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reside in CA state (for subjects enrolled at UCLA)
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reside in New England states of MA, NH or RI (for subjects enrolled at NECO)
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best-corrected visual acuity 20/40 to 20/800 in the better eye or visual field diameter less than 20 degrees in the better eye
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English speaking
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Ability to demonstrate proficiency with the smartphone and mobile app at 4 weeks post initial training
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no previous use of the Aira app, Seeing AI app or Super Vision+ app on a smartphone (<5 uses in lifetime)
Exclusion Criteria:
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out of the country for >2 weeks during study intervention period if cannot use their own international data plan on their own phone
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unable to successfully complete the initial on-boarding call for Aira service with an agent as documented by the Aira agent's log (if randomized to Aira)
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schedules not permitting participation in planned study duration (including planning to move or take extended vacation during study period)
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inability to understand study procedures or communicate responses in a consistent manner (cognitive impairment as per TICS)
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substance abuse
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significant hearing loss (unable to hear communication by phone)
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significant medical condition likely to limit participation or lifespan
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participating in another clinical trial that involves treatment that could impact visual function during the study period
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participant in another clinical trial that involves a treatment or intervention that could impact visual functioning
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begins use of a new vision-related app during the trial period for the study
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | UCLA Stein Eye Institute | Los Angeles | California | United States | 90095 |
| 2 | New England College of Optometry | Boston | Massachusetts | United States | 02115 |
Sponsors and Collaborators
- New England College of Optometry
- National Institute on Disability, Independent Living, and Rehabilitation Research
- University of California, Los Angeles
Investigators
None specified.Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- CARE