Ben Mortenson

 
Prospective Graduate Students / Postdocs

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Professor

Research Interests

Accessibility
Assistive technology
Caregiving
Mobility
Outcome measures
Quality of Life and Aging
rehabilitation
Robotics
Social Aspects of Aging
Social participation
Spinal cord injury

Relevant Thesis-Based Degree Programs

Affiliations to Research Centres, Institutes & Clusters

Research Options

I am available and interested in collaborations (e.g. clusters, grants).
I am interested in and conduct interdisciplinary research.
 
 

Research Methodology

Mixed-methods research
Qualitative Research
Randomized Control Trials
survey research
Ethnography
Wheelchair skills mobility assessment lab

Graduate Student Supervision

Doctoral Student Supervision

Dissertations completed in 2010 or later are listed below. Please note that there is a 6-12 month delay to add the latest dissertations.

Human-centered innovations for improving the experience of family caregivers of people living with neurocognitive disorders (2022)

Informal caregivers are an important part of the Canadian healthcare system. At any given time, about 28% of Canadians are caregivers and up to 50% will become at some point in their lifetime. As more people are being diagnosed with neurocognitive disorders (NCDs) such as dementia, there will be an increasing demand on and for informal caregivers. Caring for a person with a NCD is strenuous and carers experience a high level of burden compared to non-caregivers. Since the care, support, and companionship provided by caregivers are invaluable, there is a need to provide them relief, so they can continue to provide the much-needed assistance while having an appreciable quality of life. Research suggests that appropriate assistive technology reduces stress, and reduces caregiver demands. Technologies have greater impact and relevance if users are involved in the selection and design process of such solutions. A human-centered approach to design promotes the creation of solutions that are usable and acceptable to users. The overall goal of this research was to involve informal caregivers and people with NCDs to explore their needs, identify potential technological solutions, prioritize these and develop an initial prototype of a potential solution to meet their caregiving needs. To achieve this goal, five sequential studies were conducted including a mixed-methods study to determine the problematic care activities of informal caregivers of people with disabilities, a systematic review to identify the needs of informal caregivers, a meta-analysis to evaluate the efficacy of technology-based interventions for meeting the needs of carers, a survey to identify the most prioritized technological solutions, including services for informal caregivers and human-centered prototyping of the most prioritized technology. This study found that people with NCDs and their caregivers prefer to be involved directly in identifying their needs and the practical measures to address them satisfactorily. Participants pointed out their unmet needs and continued to be interested in the process to determine the best solutions to address them. Specifically, as participants wanted a more effective web-based service to assist them when they hire support workers, we worked with them to co-design a medium-fidelity prototype of this service.

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Towards a conceptual framework of navigation for people who use wheeled mobility devices in the community (2021)

People with disabilities face challenges participating in all aspects of community life because transportation systems and infrastructure have not been built to meet their requirements. This is especially true for mobility device users trying to navigate complex and dynamic pedestrian environments. The goal our research was to explore how mobility device users planned and executed trips along unfamiliar routes, measure navigation-related outcomes, and develop a conceptual framework that can inform future research and practice. To address this goal, four studies were conducted that included a scoping review of the factors affecting the navigation of people with disabilities, a cross sectional study of the activity spaces of people who use mobility devices, a wheeling interview of people who use wheeled mobility devices to navigate unfamiliar environments, and a concept mapping exercise to create a conceptual framework of the factors affecting the route choices of people who use wheeled mobility devices in their community. The results of our studies suggest that personal, mobility device, environmental, and contextual factors affect where mobility device users can go in their community. The scoping review reinforced the need for more research that embodies the mobility experiences of people with disabilities by highlighting the limited number of studies that focus on them or the diversity of the navigational challenges they face. The findings from our novel research suggest that car ownership, seasonal effects, and walkability of neighbourhoods may influence access to local and regional access to destinations for mobility device users. Underlying factors such as poor signage, hazardous surfaces, and disorientation were evident during wheeling interviews. These factors may have contributed to the fact that trip plans were 20% further than the shortest possible distance, actual routes were 15% further than planned routes, and actual routes were 40% further than the shortest possible distance that was accessible. Manual wheelchair users expressed and demonstrated the greatest difficulties. The conceptual framework unified the research by depicting the relationships between factors that influenced the route choices of people who use wheeled mobility devices. This thesis has identified opportunities to improve navigation and make communities more universally accessible.

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Peer mentoring in residential care: a mixed-methods study (2019)

A significant number of individuals living in residential care experience loneliness and depression. People engaged in peer mentoring draw benefits from the social and emotional connection; however, this approach is rare within these settings. The objectives of this study were to develop a new model of social citizenship based on peer mentoring, describe the development of a novel peer mentoring program; and collect feasibility data associated with its implementation (e.g., assessment of recruitment and sample; outcome measures and data collection; retention, program adherence and acceptability; and residents’ responses). The Peers Engaging and Empowering their Peers model, which has its foundations in social citizenship, provided the basis for a peer mentoring program in which community volunteers (community mentors) and resident volunteers (resident mentors) formed a supportive team and provided visits and guidance to other residents that were lonely or socially isolated (mentees). For the mixed-methods feasibility study, I enrolled community mentors (n = 65), resident mentors (n = 48) staff facilitators (n = 24) and mentees (n = 74) in 10 sites. Among resident mentors remaining at six months (n = 28), a significant reduction in loneliness scores (p = .014; d = .23) and depression scores (p = .048; d = .30) were noted. Sense of belonging, purpose in life and social identity were unchanged. In-depth interviews with a sample of resident mentors (n = 8) revealed positive perceptions of the program. Most of the feasibility objectives were met; however, low retention rates among resident mentors were noted as well as time and resource challenges. At six months, among the mentees from whom data could be obtained (n = 43), I found a significant reduction in loneliness (p = 0.02; d = .76) and depression (p = 0.02; d = .76), and a 60% increase in the number of monthly programs attended (p = 0.01; d = .37). Interviews with mentees (n = 32) indicated perceptions of the program were also positive. The study findings reveal a potential role that mentorship can play in enhancing social citizenship and lay the groundwork for future research.

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Master's Student Supervision

Theses completed in 2010 or later are listed below. Please note that there is a 6-12 month delay to add the latest theses.

Exploring prescribers' experiences of providing assistive technology to immigrants in Canada (2024)

The full abstract for this thesis is available in the body of the thesis, and will be available when the embargo expires.

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Understanding the experiences and quality of life of people with incomplete spinal cord injury who can ambulate (2023)

Background: Spinal cord injuries can have profound long-term consequences. However, less is known about the experiences of people with incomplete spinal cord injuries who can ambulate.Objectives: 1) To identify the needs and strengths of people with incomplete spinal cord injury who can ambulate and explore potential supports, services, and programs that would help them in the community. 2) To examine associations between subjective quality of life and other socio-demographic variables in this population and to explore differences in experiences of people with different levels of quality of life (i.e., low, moderate, and high).Materials and methods: Study 1, was a qualitative descriptive study, and study 2 was a mixed-method study. Semi-structured interviews and standardized measures of function, health, mobility, and life satisfaction were used as the main means of data collection. In study 1 quantitative data were used descriptively, and in study 2, participants were categorized into three levels of quality of life, and the experiences of participants in these groups were explored quantitatively and qualitatively. Results: The 24 participants were 55 years old on average, with 54% being male. In study 1, we identified three themes: (1) ‘I really couldn’t go there’, described the physical and social barriers experienced by participants (2) ‘In this netherworld’ revealed participant’s desire for greater social understanding of incomplete spinal cord injury, and (3) ‘I just don’t quit’, displayed the perseverance that participants demonstrated following their injury. In study 2, the quantitative portion indicated that the variables male sex, having attended rehabilitation, and being married were strongly associated with increased quality of life. The qualitative portion revealed how people with a low quality of life felt that the neighborhood-built environment was not supportive. People with a low and moderate level of quality of life reported feeling devalued by able-bodied people and reported that their mobility was deteriorating over time. Conclusion: The study findings emphasize how changes to the built and social environment are needed to improve accessibility and promote the inclusion of people with incomplete spinal cord injuries who can ambulate.

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Considering and selecting assistive technology among individuals with disabilities: a social network analysis of decision-making (2022)

Introduction: About 15% of the global population have some form of disability. Assistive technology (AT) has a key role in addressing the associated burden of disability, and refers to any equipment or tool that helps improve the individual’s function and independence in activities of daily living. However, many people with disabilities experience unmet needs and have difficulty accessing required services and AT. In this regard, individuals with disabilities are involved in a decision-making process that includes interactions with their social networks, which have not been explored. The purpose of this study was to investigate: 1) How people with disabilities make decisions about AT, 2) how their AT-related social networks are constructed and influence their decisions about AT, and 3) how users’ AT decision-making process is influenced by personal and external factors.Methods: A total of 13 participants took part in this mixed-methods study. Data were collected through an online survey and in virtual one-on-one interview sessions. The qualitative portion included semi-structured interview questions about participants’ AT decision-making process and their social networks. The quantitative portion involved personal information to describe the sample and contact ratings to elicit qualitative data. NVivo software was used to code verbatim transcripts.Results: A model was developed to demonstrate the AT decision-making process of participants. It included three steps: recognizing a need, obtaining information, and choosing and obtaining AT. The process was a cycle, where participants would move from step 3 to step 1 if they decided to make any changes to their AT. The influence of social networks was present in all three steps. Participants’ social networks included peers, occupational therapists (OTs), doctors, organizations, vendors, family and friends, and internet and other materials. These groups had unique as well as overlapping roles with varying degrees of significance.Conclusion: Despite the implications of AT in improving the quality of life of individuals with disabilities, barriers in AT access and use persist. Understanding users’ AT decision-making process and the construct and influence of their AT-related social networks, as provided in this study, can help us target issues that need to be addressed through effective interventions.

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Exploring the COVID-19 pandemic related experiences of individuals with a spinal cord injury (2021)

Background: Individuals who have sustained a spinal cord injury have gone through a life changing experience. The current COVID-19 pandemic now introduces additional changes. Objectives: 1) To explore COVID-19 related lived-experiences of community dwelling individuals with a spinal cord injury at the beginning of the pandemic. 2) To identify what, if any, ongoing impact the COVID-19 pandemic has on the functioning and health of community dwelling individuals with a spinal cord injury over the first six months of the pandemic. Methods: We used a convergent parallel mixed-methods longitudinal design. In study 1, we conducted semi-structured interviews to explore participants’ experiences at a single time point. In study 2, participants completed standardized measures at three time points, assessing mental health, resilience, boredom, social support, technology use, life space, and participation. We analysed the qualitative data according to a phenomenological method (Groenewald, 2004). Repeated measures ANOVAs were used to identify longitudinal quantitative changes. Results: We collected data from 22 participants (Age: 5311, Female: n=9) for study 1 and 21 participants (Age: 5411, Female: n=9) for study 2. In study 1, we identified three themes. “Experiencing changes to mobility and daily life” described the changes to normal routines and the health care system. “Struggling with new challenges” explored frustrations, sources of anxiety, and the lack of social interaction. “Being resilient in the face of a new normal” identified strategies for coping and managing information. In study 2, we found a large effect size for participation (?2=0.20), which increased over time. We found medium effect sizes for anxiety (?2=0.12), that decreased over time, and for social network usage (?2=0.12), that fluctuated slightly but with an increased from time point one.Conclusions: The complex management of spinal cord injuries is compounded by the impact of COVID-19 related restrictions. Our results highlight potential issues with systemic bias and indicate a need for greater dialogue with the spinal cord injury community and increased accessibility. Future research should focus on finding efficacious ways of reducing the compounding impact that the COVID-19 pandemic has and on striving towards greater equity regarding factors such as employment and secondary health conditions.

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A mixed-methods study comparing skill performance between indoor and outdoor environments among experienced scooter users (2020)

Background: The Wheelchair Skills Test (WST) has been validated to assess scooter users’ skill performance and mobility confidence. Traditionally, the WST has been performed using a standardized indoor course; however, it has been suggested that an outdoor community-based setting may be a suitable alternative. However, no previous research has compared scooter skill performance in an indoor versus outdoor environment. Objectives: 1) To explore participants’ experiences with scooter use, 2) to determine the distribution of WST scores and how scores compare between indoor and outdoor environments, 3) to determine correlations between the indoor lab-based WST scores, the outdoor community-based WST scores, and the WST-Q scores, and explore participants’ perspectives on the representativeness of the WST, testing preferences, and suggestions for improvement, and 4) to determine the practicality of performing the WST in an outdoor community-based setting.. Methods: For this mixed-methods study, 20 scooter users who have used their devices for ≥ 3 months were recruited. Each participant was randomized to complete the WST twice – once in their community and once indoors within a two-week period. While testing in the community, detailed observations were made of the setting and the 28 representative skills on the WST (e.g., curbs, hills). Semi-structured interviews were conducted after completion of the WST in both environments. Results: Indoor and outdoor scores were not strongly correlated (r= 0.306, p=0.190) and demonstrated wide limits of agreement. The outdoor WST scores were weakly correlated with subjective capacity, confidence, performance, and mobility; however, this may have been related to a low variation in scores. When searching for WST obstacles in the community, the majority were easily found. . Whereas most participants preferred performing the WST in their community due to convenience and familiarity, they also perceived the indoor course as reflective of their community setting. Conclusion: These findings suggest that skills testing in the community is feasible; however, skills testing in indoor and outdoor settings are not comparable. Community-based testing may provide a better reflection of day to day performance of experienced users, but may not reflect user’s capacity in novel environments.  

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Understanding health literacy and eHealth literacy among individuals with spinal cord injury: a mixed-methods study (2020)

Introduction: With recent advancements in internet technologies, the field of eHealth has grown as a medium for facilitating self-care. As eHealth transitions into becoming the new standard for providing healthcare in the twenty-first century, it is important to make sure that no one gets left behind. This purpose of this research was to (1) evaluate eHealth literacy levels among individuals with spinal cord injury (SCI), (2) find predictors of eHealth literacy, (3) explore how they seek health information, (4) learn about their experiences with internet-based health resources, and (5) identify barriers and facilitators to their engagement with eHealth technologies.Methods: This research used a mixed-methods design. A total of 30 community-dwelling individuals with SCI were recruited. Quantitative survey data were collected on participants’ eHealth literacy, general health literacy, and demographic data. Qualitative interviews were conducted with a subset of study participants (n=20). Results: The average age of participants was 46 years old, and 15 participants were male and 15 were female. A total of 23 participants experienced traumatic SCI and 7 participants experienced non-traumatic SCI. Participants demonstrated moderate levels of eHealth literacy (30.7 out of 40) and general health literacy (18 out of 20). Significant, positive correlations were found between general health literacy and demographic factors, including age, income, and education. Employment status prior to SCI (employed vs not employed) was found to be a significant predictor of eHealth literacy. Participants’ living arrangement (alone vs not alone) was found to be a significant predictor of general health literacy. Three overarching themes emerged from a qualitative analysis of participants’ experiences with eHealth technologies, which include eHealth technologies’ role in (1) bridging a trust gap with users, (2) being accessible to individuals with SCI, and (3) serving as a facilitator for social engagement. Conclusion: This study demonstrated the diverse range of eHealth literacy levels in SCI populations and how users experience eHealth technologies. Long term, these findings may serve a tool to inform health technology developers and researchers on how to provide more accessible and easy-to-use eHealth technologies for individuals with SCI.

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A peer mentorship to enhance active lifestyle and community integration in people with Spinal Cord Injury: I-wheel (2019)

Wheelchair maintenance is an important factor in wheelchair mobility. Currently, there is no standardized training resource available to teach wheelchair users about the maintenance or set-up of their manual wheelchairs. Purpose: The purpose of this feasibility research was to assess the feasibility of conducting an experimental study to evaluate the wheelchair maintenance training program. Method: The research program had two main phases. Phase 1 included the development of learning materials, evaluation forms and tests. We performed reliability tests on the 3-cone test and wheelchair maintenance knowledge test and report them in chapter two and three. Phase 2 entailed a feasibility study. In this study, we conducted a wheelchair maintenance workshop to train the mentors (n=5) and then assigned each mentor three mentees (n =15). Each mentor conducted a one-on-one peer-session with each mentee and each mentee completed assigned tests and questionnaires during three assessment visits (baseline, and 2 and 4 weeks after their peer session). Feasibility outcomes were evaluated, and all mentees completed an exit survey at the end of the wheelchair maintenance training program. Results: The 3-cone test and the wheelchair maintenance knowledge test are reliable (ICC >0.9) to use in clinical research. In feasibility study for wheelchair maintenance training, the process outcome (recruitment rate: mentor 71%, mentee 25%), resource outcome (retention rate (>90%), adherence (>90%), fidelity (>80%), completion rate (>90%) and training satisfaction (>90%) and preliminary evaluation outcomes were achieved. Scheduling (management outcome) was challenging and we were not able to meet the goal projected for this outcome, however we were able to complete all the sessions. Conclusion: The 3-cone test and the wheelchair maintenance knowledge test appear to be useful and reliable to be used in the clinical setting. Summary and descriptive results from the feasibility study were sufficient to justify conducting a subsequent randomized controlled trial. We hope to replicate the findings of wheelchair maintenance training by demonstrating the change in mechanical efficacy of wheelchair and the increased knowledge about wheelchair maintenance in the future. This evidence could then be used to support changes in teaching and knowledge improvement in wheelchair maintenance.

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Publications

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