title: Challenges of user-centred assistive technology provision in Australia: shopping without a prescription.
abstract: OBJECTIVE
  People with disability have a right to assistive technology devices and services, to support their inclusion and participation in society. User-centred approaches aim to address consumer dissatisfaction and sub-optimal outcomes from assistive technology (AT) provision, but make assumptions of consumer literacy and empowerment. Policy discourses about consumer choice prompt careful reflection, and this paper aims to provide a critical perspective on user involvement in assistive technology provision.
  
  
  METHODS
  User-centred approaches are considered, using literature to critically reflect on what user involvement means in AT provision. Challenges at the level of interactions between practitioners and consumers, and also the level of markets and policies are discussed, using examples from Australia.
  
  
  RESULTS
  There is no unanimous conceptual framework for user-centred practice. Power imbalances and differing perspectives between practitioners and consumers make it difficult for consumers to feel empowered. Online access to information and international suppliers has not surmounted information asymmetries for consumers or lifted the regulation of publicly funded AT devices.
  
  
  CONCLUSIONS
  Ensuring access and equity in the public provision of AT is challenging in an expanding market with diverse stakeholders. Consumers require personalised information and support to facilitate their involvement and choice in AT provision. Implications for Rehabilitation Variations in approaches informing AT provision practices have a profound impact on equity of access and outcomes for consumers. An internationalised and online market for AT devices is increasing the need for effective information provision strategies and services. Power imbalances between practitioners and consumers present barriers to the realisation of user-centred practice.
authors.affiliation: a School of Health and Rehabilitation Sciences, The University of Queensland , St Lucia , Australia .
authors.forename: Emily J
authors.initials: EJ
authors.lastname: Steel
authors.affiliation: b School of Health and Social Development, Deakin University , Burwood , Australia , and.
authors.forename: Natasha Ann
authors.initials: NA
authors.lastname: Layton
authors.affiliation: c School of Social Work and Human Services, The University of Queensland , St Lucia , Australia.
authors.forename: Michele M
authors.initials: MM
authors.lastname: Foster
authors.affiliation: a School of Health and Rehabilitation Sciences, The University of Queensland , St Lucia , Australia .
authors.forename: Sally
authors.initials: S
authors.lastname: Bennett
mesh_terms: D001315:Australia; D054626:Consumer Health Information / Q000379:methods; D006233:Persons with Disabilities / Q000534:rehabilitation*; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility / Q000458:organization & administration*; D006801:Humans; D018802:Patient-Centered Care / Q000458:organization & administration*; D024382:Professional Role; D012656:Self-Help Devices
keywords: Client-centred practice; consumers; people with disability; policy; reform