1 Introduction

The signatory countries of the Convention on the Rights of Persons with Disabilities have ratified that they would take appropriate measures to facilitate access to Assistive Technology (AT) solutions for those who need them to improve independence in daily life and equal participation in society. In this Convention, countries have committed themselves to establishing laws and policies in order to guarantee the right of access to AT services and resources to all persons with disabilities who need them (Decree no. 6,949, dated August 25, 2009).

Despite the worldwide effort to facilitate access to AT resources and services, it is noted that the rate of abandonment or non-use remains high. International studies continue to indicate that 30% of prescribed resources are abandoned in the first year after acquisition (^{Federici, Meloni, & Borsci, 2016}). Brazilian studies found a lower rate of abandonment, around 20% (^{Sugawara, Ramos, Alfieri, & Battistella, 2018}; ^{A. C. Braccialli, Deliberato, Braccialli, & Araújo, 2016}; ^{Cruz & Emmel, 2015}). It should be noted that in the poorest countries, access to AT is lower, between 5 and 15 percent of those in need have access (^{Matter, Harniss, Oderud, Borg, & Eide, 2017}).

The abandonment may be related to a failure in the evaluation process due to an incompatibility between the needs of the user, the environment of use and the provided AT. Thus, there is a need to implement AT services that accompany the entire supply process, from the moment of user evaluation to the monitoring of the use of Assistive Technology (^{Federici & Borsci, 2016}).

A key element in providing AT is the quality of service delivery, which is the process by which an individual will go through to get a solution that meets his/her needs. In addition to the service, other aspects should be considered: (a) good quality products with affordable prices; (b) the end users and the professionals involved need to know the existing solutions; (c) there must be professionals who evaluate, provide advice and support; (d) there must be policies and procedures in order to decide on the eligibility of certain financing solutions and mechanisms; (e) there must be training in use; (f) there must be follow-up services; and (g) there must be an infrastructure for maintenance and repair of equipment purchased. For the implementation of these measures, it has been proposed the creation of a standard international model for AT supply. Researchers from different countries have proposed the adoption of a model that ensures that: the user remains at the center of all activities; enables interdisciplinary interaction; is applicable to any type or level of disability; and addresses the factors that influenced user satisfaction or the abandonment of AT (^{De Witte, Steel, Gupta, Ramos, & Roentgen, 2018}).

In an Assistive Technology product delivery service, a user needs assessment process should be included with appropriate and standardized assessment tools, as well as trained personnel to work with people with disabilities and their families to perform these assessments. Products cannot be effectively distributed without a replacement plan and loan. Several AT products need to be tested for a short period of time before deciding on their suitability for a specific user. Although this process is commonly available in high-income countries, it is an obstacle in low and middle income countries, especially when one considers the long period of time required to request and purchase an AT product (^{Smith et al., 2018}).

In this perspective, the Assistive Technology Assessment Process (ATA) has been pointed out as a proposal for a service model to provide AT resources, in which the process is user-centered and oriented (^{L. M. P. Braccialli, Braccialli, & Silva, 2018}; ^{Federici et al., 2015}; ^{Federici & Borsci, 2016}). ATA is based on four pillars: (a) in the biopsychosocial model of the International Classification of Functioning, Disability and Health (ICF), mainly in the dimensions that interfere in the functionality of the user; (b) incorporates the concept Matching, Person & Technology (MPT) and makes use of the tools of this model during the process; c) considers that overcoming an incapacity transcends the delivery of an AT, in line with the MPT model emphasizes the need to combine the resource to the user, and that the environment of use must be considered; (d) the need for a multidisciplinary team to monitor the whole process (^{L. M. P. Braccialli et al., 2018}).

The MPT model and its instruments have been the most cited in the international literature and used to verify the predisposition to use AT during prescription and delivery (^{Alves, Matsukura, & Scherer, 2017}; ^{A. C. Braccialli, 2017}; ^{L. M. P. Braccialli et al., 2018}). It is a collaborative approach in which the AT user and the prescriber will work together to select the most appropriate technology for the use of a particular person. The model highlights three areas that influence the use of AT: (a) environmental factors; (b) the needs, personal and psychosocial characteristics and preferences of consumers; (c) and whether the functions and characteristics of the desirable AT is appropriate, whether it can be used without discomfort or stress, cost, ease of use and transportability (^{Alves, 2013}).

In order to assist in the evaluation process, based on the MPT model, a series of standardized instruments was developed that, through an individualized and user-centered approach, proposes to make the most appropriate match between the individual and technology (^{Scherer & Federici, 2015}). The MPT model consists of the following instruments: Survey of Technology Use - SOTU, Assistive Technology Device Predisposition Assessment - ATD-PA, Educational Technology Device Predisposition Assessment - ET PA, Workplace Technology Device Predisposition Assessment - WT PA, besides two worksheets: Initial Worksheet for the Matching Person & Technology Process and History of Support Use.

The author of the MPT model proposes a flowchart to assist the multidisciplinary team in the process of choosing the best instrument for the evaluation and prescription of AT resources for the different contexts (Figure 1).

Fonte: ^{A. C. Braccialli (2017)}.

Figure 1 Flow diagram of the use of instruments in the MPT model. 

In order to use MPT tools, the first step is for users and professionals to jointly set goals and targets to be achieved. Next, the template proposes completing the Initial Worksheet for the Matching Person & Technology Process and the History of Support Use worksheets.

The Initial Worksheet for the Matching Person & Technology Process aims to determine which technologies are potentially useful to that user. Completing the History of Support Use allows to identify which technologies have already been used, which ones are desired, and which ones are required for that user (^{Alves, 2017}).

In the next step of the technology prescribing process, the practitioner will have to opt for a specific instrument to match technology, user and environment as shown in Figure 1. In order to prescribe a technology for: education - the Educational Technology Device Predisposition Assessment - ET PA, in our case translated into Portuguese by Braccialli (^{A. C. Braccialli, 2017}), will be used; health - the Healthcare Technology Device Predisposition Assessment will be used; work - Workplace Technology Device Predisposition Assessment - WT PA; and for the predisposition to use Assistive Technology in general - the Assistive Technology Device Predisposition Assessment - ATD-PA, in this case translated by Alves (^{Alves, 2017}; ^{Alves et al., 2017}).

In order to favor the use of the MPT conceptual model in Brazil, the study aimed to translate and adapt culturally to the Brazilian Portuguese language the Initial Worksheet for the Matching Person & Technology Process and History of Support and Healthcare Technology Device Predisposition Assessment - HCT PAN instruments.

2 Method

It is a methodological research that aims at the development, validation and evaluation of methods or instruments. In order to carry out the study, the author was previously asked to authorize the instrument for translation and cultural adaptation. After authorization, the project was sent to the Research Ethics Committee of the Faculty of Philosophy and Sciences of UNESP - Marília, São Paulo, Brazil, and approved - CAAE 52363815300005406.

The study was developed in 5 stages: initial translation; reconciled translation; back translation; equivalence of item analysis; and pre-test.

3 Data analysis

The analysis of the reconciled translation stage was performed by means of absolute frequency and relative analysis of each item and presented in tabular form. For the equivalence of item and pre-test stages, the analysis was performed through the concordance index, as proposed by ^{Fagundes (2015)}.

Concordance Index values greater than 90% have very high reliability; between 80% and 89% is considered high, between 66% and 79% is acceptable and values below 66% indicate that the issues are difficult to understand and need to be reviewed (^{Bauer & Gaskell, 2002}).

4 Results

The results were presented in the following sequence: 1) reconciled translation; 2) back translation; 3) equivalence of items; 4) pre-test.

5 Discussion

Effective deployment of Assistive Technology devices relies on competent assessments and service providers who are properly trained and able to identify the needs and goals of the user. For the appropriate match of Assistive Technology product and user, an assessment process is required with appropriate assessment tools and trained personnel to work with people with disabilities and their families (^{Smith et al., 2018}).

The need to establish a standard international method for the provision of Assistive Technology has been pointed out. Standardization based on a conceptual model and on appropriate assessment tools would make the comparison of services and results obtained possible, as well as the verification of the impact of existing policies and guidance of the development of new policies (^{De Witte et al., 2018}).

Studies have emphasized the importance of the MPT model as well as of its instruments during the technology supply process (^{Alves et al., 2017}; ^{A. C. Braccialli, 2017}; ^{L. M. P. Braccialli et al., 2018}).

Based on these assumptions, to adapt culturally and make available in the Brazilian Portuguese language the Initial Worksheet for the Matching Person & Technology Process and History of Support and Healthcare Technology Device Predisposition Assessment - HCT PA instruments, which make up the MPT model, can bring advantages in developing new instruments. A culturally adapted version enables the comparison of data between different cultures and countries, and the quantification of how much the results differ or are similar in different regions (^{Coster & Mancini, 2015}).

The Initial Worksheet for the Matching Person & Technology Process and History of Support instruments should be used at the beginning of the assessment process to verify the predisposition to use AT resources associated with other instruments that are already available in the Brazilian Portuguese language, ET PA Br (^{A. C. Braccialli, 2017}) and ATD PA Br (^{Alves, 2017}).

The process of translation and cultural adaptation must follow a rigorous and solid scientific system in order to avoid mistakes. Thus, the process in this study was based on international guidelines and each step was rigorously followed (^{L. M. P. Braccialli, 2016}; ^{Coster & Mancini, 2015}; ^{Guillemin et al., 1993}; ^{Reichenheim & Moraes, 2007}).

There is a concern that the initial translation should be carried out by two or more translators independently, allowing different writing choices and the comparison of translations to ensure a more accurate final version. The recommendations were followed, and the translators were independently assisted by the project coordinator, who was fluent in English, had previous knowledge of the instrument and expertise in the area of knowledge, which was useful in guiding the translators in relation to specific terms of the area (^{Coster & Mancini, 2015}).

The item reconciliation stage was carried out by a team of experts in the field of knowledge and with a domain of the original version of the instrument, which enabled a more precise analysis and less difficulties in the processes that followed, according to ^{Braccialli (A. C. Braccialli, 2017}).

The participation of the author of the original instruments in the analysis process helped to guarantee the equivalence of the new version with the original one (^{Lapa et al., 2017})

Rigorous care in the previous stages seems to have been fundamental in ensuring that, in subsequent phases, item equivalence and pre-test, there was a high degree of agreement. It is also worth noting that the participation in the pre-test of professionals with extensive experience in AT supply services and with users with disabilities made identifying the difficulties and the understanding of the items of the instruments possible; to make final adjustments to the Portuguese version and verify the feasibility of using the instrument in the Brazilian context.

The final version of the instruments translated and adapted to Brazilian Portuguese language presented a good level of acceptability and comprehension, being suitable for use by multiprofessional teams that provide Assistive Technology resources for users with disabilities.

It is worth noting that the availability of the instruments in the Brazilian Portuguese language will enable systematized assessments to facilitate the prescription of Assistive Technology resources in a more assertive way and to reduce their abandonment after acquisition.