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Folder N, Power E, Rietdijk R, Christensen I, Togher L, Parker D. The Effectiveness and Characteristics of Communication Partner Training Programs for Families of People With Dementia: A Systematic Review. Gerontologist 2024; 64:gnad095. [PMID: 37439771 PMCID: PMC10949353 DOI: 10.1093/geront/gnad095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Indexed: 07/14/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Communication partner training (CPT) is essential in dementia care. Despite families being the largest group of community carers, previous reviews primarily focused on formal carers. This study aimed to understand the characteristics and effectiveness of CPT for families of people with dementia. RESEARCH DESIGN AND METHODS The systematic review included intervention/protocol studies on dementia CPT for families, excluding formal carers and programs not focused on communication. CINAHL, PsycINFO, SpeechBITE, Medline, SCOPUS, and Embase were searched between November 30 and December 6, 2021. After deduplication, 3,172 records were screened. Quality assessment used JBI Critical Appraisal tools and the Mixed Methods Appraisal Tool. Data synthesis utilized three reporting tools, the International Classification of Functioning, Disability, and Health, and content analysis. RESULTS Of 30 studies (27 programs), there were 10 quasi-experimental, 5 RCTs, 4 mixed methods, 4 case studies, 4 qualitative, and 2 protocols. Studies were published between 1998 and 2021 and included 671 family members. Characteristics varied with 7/27 programs including consumers during creation and one program including telehealth. One study included all reporting tool criteria. Programs typically used 4 intervention functions, with 12/27 programs addressing 3 behavior change areas. 33/74 outcome measures targeted the "Environment" of the person with dementia. Studies showed positive improvements in communication skills and knowledge, with mixed results on behavior/psychosocial outcomes. Qualitative results identified improvements in conversation and attitudes. DISCUSSION AND IMPLICATIONS CPT for families improves communication outcomes, however, quality of studies varied significantly. Future research should address gaps in telehealth, consumer involvement, and intervention descriptions.
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Affiliation(s)
- Naomi Folder
- Faculty of Health, Graduate School of Health, University of Technology Sydney, Ultimo, New South Wales, Australia
| | - Emma Power
- Faculty of Health, Graduate School of Health, University of Technology Sydney, Ultimo, New South Wales, Australia
| | - Rachael Rietdijk
- Faculty of Medicine and Health, Sydney School of Health Sciences, The University of Sydney, Glebe, New South Wales, Australia
| | - Iben Christensen
- Department of Nordic Studies and Linguistics, University of Copenhagen, Copenhagen, Hovedstaden, Denmark
| | - Leanne Togher
- Faculty of Medicine and Health, Sydney School of Health Sciences, The University of Sydney, Glebe, New South Wales, Australia
| | - Deborah Parker
- Faculty of Health, Graduate School of Health, University of Technology Sydney, Ultimo, New South Wales, Australia
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Brunner M, Rietdijk R, Summers K, Southwell K, Avramovic P, Power E, Miao M, Rushworth N, MacLean L, Brookes AM, Togher L. 'It gives you encouragement because you're not alone': A pilot study of a multi-component social media skills intervention for people with acquired brain injury. Int J Lang Commun Disord 2024; 59:543-558. [PMID: 36417179 DOI: 10.1111/1460-6984.12806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 09/30/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND People with an acquired brain injury (ABI) find it challenging to use social media due to changes in their cognition and communication skills. Using social media can provide opportunities for positive connection, but there is a lack of interventions specifically designed to support safe and successful social media use after ABI. AIMS To investigate the outcomes of completing a social media skills intervention and identify barriers and facilitators for future implementation. METHODS & PROCEDURES The study used a mixed-methods, pre-post-intervention design. A total of 17 adults with an ABI were recruited. Participants completed an intervention that included a short self-guided course about social media skills (social-ABI-lity course), and then participated in a private, moderated Facebook group over a 12-week period (social-ABI-lity Facebook group). Data were collected over this period through observation of group activity and weekly surveys. They were also collected on social media use and quality of life at pre-intervention, post-intervention and after 3 months. Participants provided feedback on the experience of participating in the programme via a post-intervention interview. OUTCOMES & RESULTS At post-intervention, there were significant improvements in confidence in using Facebook (p = 0.002) and enjoyment of using Facebook to connect with others (p = 0.013). There was no significant change in reported quality of life, although participants described the multiple benefits of connection they perceived from involvement in the group. Observational data and feedback interviews were informative about the feasibility and acceptability of the intervention. CONCLUSIONS & IMPLICATIONS This pilot study provided preliminary evidence that an intervention comprising a short, self-guided training course and a private, moderated Facebook group improved outcomes for people with ABI. Key recommendations for future implementation include embedding active peer moderators within groups and taking an individualized approach to delivery of the intervention. WHAT THIS PAPER ADDS What is already known on the subject Research has documented the challenges that people with ABI experience in using social media, and the difficulty for rehabilitation clinicians in providing appropriate support in this field. What this paper adds to existing knowledge This pilot study reports the outcomes of people with ABI completing a short, self-guided social media skills course and participating in a private, moderated Facebook group. After the intervention, participants reported significantly increased confidence and enjoyment in using Facebook, described the benefits of connection found in the groups, and suggested potential improvements for future implementation. What are the potential or actual clinical implications of this work? With the growing use of social media for connection and participation, there is a professional obligation to address social media communication skills in cognitive-communication rehabilitation for people with ABI. The findings of this study will inform interventions and future research to assist people with ABI to build their social media skills for communication, social support and a sense of connection.
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Affiliation(s)
- Melissa Brunner
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Rachael Rietdijk
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | | | - Kylie Southwell
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Petra Avramovic
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Emma Power
- Graduate School of Health, The University of Technology Sydney, Sydney, NSW, Australia
| | - Melissa Miao
- Graduate School of Health, The University of Technology Sydney, Sydney, NSW, Australia
| | | | - Liza MacLean
- Insurance and Care NSW (icare), Sydney, NSW, Australia
| | | | - Leanne Togher
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
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Rietdijk R, Brunner M, Conroy P, Jayes M, Togher L. It's a changing landscape: Complexity and innovation in cognitive-communication rehabilitation for people with acquired brain injury (ABI). Int J Lang Commun Disord 2024; 59:429-432. [PMID: 38400580 DOI: 10.1111/1460-6984.13022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/25/2024]
Affiliation(s)
- Rachael Rietdijk
- Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Melissa Brunner
- Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Paul Conroy
- School of Linguistic, Speech and Communication Sciences, Trinity College Dublin, Dublin, Republic of Ireland
| | - Mark Jayes
- Faculty of Health and Education, Manchester Metropolitan University, Manchester, UK
| | - Leanne Togher
- Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
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Miao M, Morrow R, Salomon A, Mcculloch B, Evain JC, Wright MR, Murphy MT, Welsh M, Williams L, Power E, Rietdijk R, Debono D, Brunner M, Togher L. Digital Health Implementation Strategies Coproduced With Adults With Acquired Brain Injury, Their Close Others, and Clinicians: Mixed Methods Study With Collaborative Autoethnography and Network Analysis. J Med Internet Res 2023; 25:e46396. [PMID: 37725413 PMCID: PMC10548320 DOI: 10.2196/46396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 05/10/2023] [Accepted: 08/03/2023] [Indexed: 09/21/2023] Open
Abstract
BACKGROUND Acquired brain injuries (ABIs), such as stroke and traumatic brain injury, commonly cause cognitive-communication disorders, in which underlying cognitive difficulties also impair communication. As communication is an exchange with others, close others such as family and friends also experience the impact of cognitive-communication impairment. It is therefore an internationally recommended best practice for speech-language pathologists to provide communication support to both people with ABI and the people who communicate with them. Current research also identifies a need for neurorehabilitation professionals to support digital communication, such as social media use, after ABI. However, with >135 million people worldwide affected by ABI, alternate and supplementary service delivery models are needed to meet these communication needs. The "Social Brain Toolkit" is a novel suite of 3 interventions to deliver communication rehabilitation via the internet. However, digital health implementation is complex, and minimal guidance exists for ABI. OBJECTIVE This study aimed to support the implementation of the Social Brain Toolkit by coproducing implementation knowledge with people with ABI, people who communicate with people with ABI, clinicians, and leaders in digital health implementation. METHODS A maximum variation sample (N=35) of individuals with living experience of ABI, close others, clinicians, and digital health implementation leaders participated in an explanatory sequential mixed methods design. Stakeholders quantitatively prioritized 4 of the 7 theoretical domains of the Nonadoption, Abandonment, Scale-up, Spread, and Sustainability (NASSS) framework as being the most important for Social Brain Toolkit implementation. Qualitative interview and focus group data collection focused on these 4 domains. Data were deductively analyzed against the NASSS framework with stakeholder coauthors to determine implementation considerations and strategies. A collaborative autoethnography of the research was conducted. Interrelationships between considerations and strategies were identified through a post hoc network analysis. RESULTS Across the 4 prioritized domains of "condition," "technology," "value proposition," and "adopters," 48 digital health implementation considerations and 52 tailored developer and clinician implementation strategies were generated. Benefits and challenges of coproduction were identified. The post hoc network analysis revealed 172 unique relationships between the identified implementation considerations and strategies, with user and persona testing and responsive design identified as the potentially most impactful strategies. CONCLUSIONS People with ABI, close others, clinicians, and digital health leaders coproduced new knowledge of digital health implementation considerations for adults with ABI and the people who communicate with them, as well as tailored implementation strategies. Complexity-informed network analyses offered a data-driven method to identify the 2 most potentially impactful strategies. Although the study was limited by a focus on 4 NASSS domains and the underrepresentation of certain demographics, the wealth of actionable implementation knowledge produced supports future coproduction of implementation research with mutually beneficial outcomes for stakeholders and researchers. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/35080.
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Affiliation(s)
- Melissa Miao
- Graduate School of Health, Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Rosemary Morrow
- Stakeholder with living experience of acquired brain injury, Sydney, Australia
| | - Alexander Salomon
- Stakeholder with living experience of acquired brain injury, Sydney, Australia
| | - Ben Mcculloch
- Stakeholder with living experience of acquired brain injury, Sydney, Australia
| | - Jean-Christophe Evain
- Acquired Brain Injury Rehabilitation Ward, Caulfield Hospital, Alfred Health Network, Melbourne, Australia
- Stakeholder with living experience of acquired brain injury, Melbourne, Australia
| | - Meg Rebecca Wright
- Stakeholder with living experience of acquired brain injury, Blenheim, Australia
| | - Marie Therese Murphy
- Stakeholder with living experience as a communication partner of a person with acquired brain injury, Sydney, Australia
- Faculty of Education, Western Sydney University, Sydney, Australia
- Faculty of Education and Social Work, The University of Sydney, Sydney, Australia
| | - Monica Welsh
- Brain Injury Rehabilitation Unit, South Australian Brain Injury Rehabilitation Service, Adelaide, Australia
| | - Liz Williams
- Brain Injury Rehabilitation Community and Home (BIRCH), South Australian Brain Injury Rehabilitation Service, Adelaide, Australia
| | - Emma Power
- Graduate School of Health, Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Rachael Rietdijk
- Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Deborah Debono
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Melissa Brunner
- Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Leanne Togher
- Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
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Avramović P, Rietdijk R, Kenny B, Power E, Togher L. Developing a Digital Health Intervention for Conversation Skills After Brain Injury (convers-ABI-lity) Using a Collaborative Approach: Mixed Methods Study. J Med Internet Res 2023; 25:e45240. [PMID: 37556179 PMCID: PMC10448295 DOI: 10.2196/45240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 04/14/2023] [Accepted: 05/03/2023] [Indexed: 08/10/2023] Open
Abstract
BACKGROUND People with acquired brain injury (ABI) experience communication breakdown in everyday interactions many years after injury, negatively impacting social and vocational relationships. Communication partner training (CPT) is a recommended intervention approach in communication rehabilitation after ABI. Access to long-term services is essential, both in rural and remote locations. Digital health has potential to overcome the challenges of travel and improve cost efficiencies, processes, and clinical outcomes. OBJECTIVE We aimed to collaboratively develop a novel, multimodal web-based CPT intervention (convers-ABI-lity) with key stakeholders and evaluate its feasibility for improving conversation skills after brain injury. METHODS This mixed methods study consisted of 3 key stages guided by the Integrate, Design, Assess, and Share (IDEAS) framework for developing effective digital health interventions. Stage 1 included the integration of current end-user needs and perspectives with key treatment and theoretical components of existing evidence-based interventions, TBI Express and TBIconneCT. Stage 2 included the iterative design of convers-ABI-lity with feedback from end-user interviews (n=22) analyzed using content analysis. Participants were individuals with ABI, family members, health professionals, and paid support workers. Stage 3 included the evaluation of the feasibility through a proof-of-concept study (n=3). A total of 3 dyads (a person with ABI and their communication partner [CP]) completed 7 weeks of convers-ABI-lity, guided by a clinician. The outcome measures included blinded ratings of conversation samples and self-report measures. We analyzed postintervention participant interviews using content analysis to inform further intervention refinement and development. RESULTS Collaborative and iterative design and development during stages 1 and 2 resulted in the development of convers-ABI-lity. Results in stage 3 indicated positive changes in the blinded ratings of conversation samples for the participants with traumatic brain injury and their CPs. Statistically reliable positive changes were also observed in the self-report measures of social communication skills and quality of life. Intervention participants endorsed aspects of convers-ABI-lity, such as its complementary nature, self-guided web-based modules, clinician sessions, engaging content, and novel features. They reported the intervention to be relevant to their personal experience with cognitive-communication disorders. CONCLUSIONS This study presents the outcome of using the IDEAS framework to guide the development of a web-based multimodal CPT intervention with input from key stakeholders. The results indicate promising outcomes for improving the conversation skills of people with ABI and their CPs. Further evaluation of intervention effectiveness and efficacy using a larger sample size is required.
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Affiliation(s)
- Petra Avramović
- Discipline of Speech Pathology, Faculty of Medicine and Health, The University of Sydney, Camperdown, Australia
| | - Rachael Rietdijk
- Discipline of Speech Pathology, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Belinda Kenny
- Discipline of Speech Pathology, School of Health Sciences, Western Sydney University, Sydney, Australia
| | - Emma Power
- Discipline of Speech Pathology, Graduate School of Health, University of Technology Sydney, Sydney, Australia
| | - Leanne Togher
- Discipline of Speech Pathology, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
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Miao M, Debono D, Power E, Rietdijk R, Brunner M, Togher L. Digital Health Interventions for Adults with Acquired Brain Injury and Their Close Others: Implementation, Scalability, and Sustainability in the COVID-19 Context. Stud Health Technol Inform 2023; 304:96-100. [PMID: 37347578 DOI: 10.3233/shti230379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/24/2023]
Abstract
The Social Brain Toolkit is a novel suite of web-based interventions to support people with acquired brain injury and their close others with communication difficulties post-injury. The aim of this study was to investigate potential impacts of the Toolkit's wider political, economic, regulatory, professional, and sociocultural context on its implementation, scalability, and sustainability. Nine people with academic, healthcare or industry experience implementing digital health interventions prior to and during COVID-19 were individually interviewed. Data were deductively analysed according to the Non-adoption, Abandonment, Scaleup, Spread and Sustainability framework, with a focus on the domain of the 'Wider system'. Results indicated that COVID-19 facilitated a pivot to virtual care models which was timely for the implementation of the Social Brain Toolkit; political and economic changes were entwined; and risk management, data compliance and governance were key considerations for healthcare professionals and organisations.
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Affiliation(s)
- Melissa Miao
- University of Technology Sydney, Sydney, Australia
| | | | - Emma Power
- University of Technology Sydney, Sydney, Australia
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7
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Brunner M, Rietdijk R, Avramovic P, Power E, Miao M, Rushworth N, MacLean L, Brookes AM, Togher L. Developing Social-ABI-lity: An Online Course to Support Safe Use of Social Media for Connection After Acquired Brain Injury. Am J Speech Lang Pathol 2023; 32:924-940. [PMID: 36492293 DOI: 10.1044/2022_ajslp-22-00099] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
PURPOSE People who have an acquired brain injury (ABI) experience challenges using social media. Inversely, rehabilitation clinicians report feeling inadequately prepared to support them in its use. We aimed to develop a collaboratively designed, evidence-based online training resource to support people with an ABI to learn about using social media. Key recommendations for course design have previously been identified through a mixed methods approach, including (a) qualitative exploration of the experiences of people who use social media after ABI, (b) a scoping review to identify key features and effective teaching approaches from existing social media skills training programs. METHOD Further design recommendations were obtained in this mixed methods study through (c) collaborative design of course content and features with 23 people, including people with living experience of ABI and other key stakeholders, and (d) a pilot trial of the course prototype with four participants who had an ABI (two men, two women; aged 28-69 years). RESULTS Training needs to be interactive, including practical components addressing online safety and wellbeing, and to explain how to use social media platforms to connect with others. The first social-ABI-lity prototype incorporated these findings. Pilot data indicated that the prototype was beneficial, with participants demonstrating small increases in social media confidence and knowledge. Areas for further refinement were also identified. CONCLUSION The social-ABI-lity self-directed online course is the first of its kind to support people with an ABI in using social media and will be a valuable resource for rehabilitation clinicians internationally. This resource may drive sustainable changes in participation by helping people with ABI to build their social media mastery and to participate in supportive online networks.
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Affiliation(s)
- Melissa Brunner
- Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia
| | - Rachael Rietdijk
- Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia
| | - Petra Avramovic
- Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia
| | - Emma Power
- Graduate School of Health, The University of Technology Sydney, New South Wales, Australia
| | - Melissa Miao
- Graduate School of Health, The University of Technology Sydney, New South Wales, Australia
| | | | - Liza MacLean
- Insurance and Care NSW (icare), Sydney, Australia
| | | | - Leanne Togher
- Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia
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Avramovic P, Rietdijk R, Attard M, Kenny B, Power E, Togher L. Cognitive and Behavioral Digital Health Interventions for People with Traumatic Brain Injury and Their Caregivers: A Systematic Review. J Neurotrauma 2023; 40:159-194. [PMID: 35819294 DOI: 10.1089/neu.2021.0473] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Traumatic brain injury (TBI) leads to cognitive linguistic deficits that significantly impact on quality of life and well-being. Digital health offers timely access to specialized services; however, there are few synthesized reviews in this field. This review evaluates and synthesizes reports of digital health interventions in TBI rehabilitation and caregiver education. Systematic searches of nine databases (PsycINFO, MEDLINE, CINAHL, Embase, Cochrane Library, Scopus, Web of Science Core Collection, speechBITE, and PsycBITE) were conducted from database inception to February 2022. Studies were included of interventions where the primary treatment focus (> 50%) was on improving communication, social, psychological or cognitive skills of people with TBI and/or communication partners. Data on participants, characteristics of the interventions, outcome measures and findings were collected. Risk of bias was accounted for through methodological quality assessments (PEDro-P and PEDro+, Risk of Bias in N-of-1 Trials) and intervention description. Qualitative data was analyzed using thematic synthesis. Forty-four articles met eligibility criteria: 20 randomized controlled trials, three single-case experimental designs, six non-randomized controlled trials, nine case series studies, and two case studies. Studies comprised 3666 people with TBI and 213 carers. Methodological quality was varied and intervention description was poor. Most interventions were delivered via a single digital modality (e.g., telephone), with few using a combination of modalities. Five interventions used co-design with key stakeholders. Digital health interventions for people with TBI and their caregivers are feasible and all studies reported positive outcomes; however, few included blind assessors. Improved methodological rigor, clearly described intervention characteristics and consistent outcome measurement is recommended. Further research is needed regarding multi-modal digital health interventions.
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Affiliation(s)
- Petra Avramovic
- Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, Australia.,NHMRC Center of Research Excellence in Aphasia Rehabilitation, Australia
| | - Rachael Rietdijk
- Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, Australia.,NHMRC Center of Research Excellence in Aphasia Rehabilitation, Australia
| | - Michelle Attard
- Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, Australia.,NHMRC Center of Research Excellence in Aphasia Rehabilitation, Australia
| | - Belinda Kenny
- School of Health Sciences, University of Western Sydney, Sydney, New South Wales, Australia
| | - Emma Power
- Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia.,NHMRC Center of Research Excellence in Aphasia Rehabilitation, Australia
| | - Leanne Togher
- Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, Australia.,NHMRC Center of Research Excellence in Aphasia Rehabilitation, Australia
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Yiew K, Togher L, Power E, Brunner M, Rietdijk R. Differentiating Use of Facial Expression between Individuals with and without Traumatic Brain Injury Using Affectiva Software: A Pilot Study. Int J Environ Res Public Health 2023; 20:1169. [PMID: 36673925 PMCID: PMC9858815 DOI: 10.3390/ijerph20021169] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 12/18/2022] [Accepted: 12/24/2022] [Indexed: 06/17/2023]
Abstract
This study investigated the feasibility of using an automated facial coding engine, Affectiva (integrated in iMotions, version 8.2), for evaluating facial expression after traumatic brain injury (TBI). An observational cross-sectional study was conducted based on facial expression data from videos of participants with TBI and control participants. The aims were to compare TBI and control groups, and identify confounding factors affecting the data analysis. Video samples of two narrative tasks (personal event and story retell) from ten participants with severe TBI and ten control participants without TBI were analyzed using Affectiva. Automated data on participants' engagement, smile and brow furrow were compared statistically between and within groups. Qualitative notes for each sample were also recorded. Affectiva detected a higher percentage of time of engagement for TBI participants than for control participants on both tasks. There was also a higher percentage of time of smiling for TBI participants in one task. Within groups, there were no significant differences between the two narrative tasks. Affectiva provides standardized data about facial expression and may be sensitive to detecting change in the use of facial expression after TBI. This study also identified factors to avoid during videorecording to ensure high quality samples for future research.
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Affiliation(s)
- Kelly Yiew
- Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2006, Australia
| | - Leanne Togher
- Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2006, Australia
| | - Emma Power
- Graduate School of Health, University of Technology Sydney, Sydney, NSW 2007, Australia
| | - Melissa Brunner
- Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2006, Australia
| | - Rachael Rietdijk
- Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2006, Australia
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Miao M, Rietdijk R, Brunner M, Debono D, Togher L, Power E. Implementation of Web-Based Psychosocial Interventions for Adults With Acquired Brain Injury and Their Caregivers: Systematic Review. J Med Internet Res 2022; 24:e38100. [PMID: 35881432 PMCID: PMC9328122 DOI: 10.2196/38100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Revised: 05/16/2022] [Accepted: 06/15/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND More than 135 million people worldwide live with acquired brain injury (ABI) and its many psychosocial sequelae. This growing global burden necessitates scalable rehabilitation services. Despite demonstrated potential to increase the accessibility and scalability of psychosocial supports, digital health interventions are challenging to implement and sustain. The Nonadoption, Abandonment, Scale-Up, Spread, and Sustainability (NASSS) framework can offer developers and researchers a comprehensive overview of considerations to implement, scale, and sustain digital health interventions. OBJECTIVE This systematic review identified published, peer-reviewed primary evidence of implementation outcomes, strategies, and factors for web-based psychosocial interventions targeting either adults with ABI or their formal or informal caregivers; evaluated and summarized this evidence; synthesized qualitative and quantitative implementation data according to the NASSS framework; and provided recommendations for future implementation. Results were compared with 3 hypotheses which state that complexity (dynamic, unpredictable, and poorly characterized factors) in most or all NASSS domains increases likelihood of implementation failure; success is achievable, but difficult with many complicated domains (containing multiple interacting factors); and simplicity (straightforward, predictable, and few factors) in most or all domains increases the likelihood of success. METHODS From a comprehensive search of MEDLINE, EMBASE, PsycINFO, CINAHL, Scopus, speechBITE, and neuroBITE, we reviewed primary implementation evidence from January 2008 to June 2020. For web-based psychosocial interventions delivered via standard desktop computer, mobile phone, tablet, television, and virtual reality devices to adults with ABI or their formal or informal caregivers, we extracted intervention characteristics, stakeholder involvement, implementation scope and outcomes, study design and quality, and implementation data. Implementation data were both narratively synthesized and descriptively quantified across all 7 domains (condition, technology, value proposition, adopters, organization, wider system, and their interaction over time) and all subdomains of the NASSS framework. Study quality and risk of bias were assessed using the 2018 Mixed Methods Appraisal Tool. RESULTS We identified 60 peer-reviewed studies from 12 countries, including 5723 adults with ABI, 1920 carers, and 50 health care staff. The findings aligned with all 3 hypotheses. CONCLUSIONS Although studies were of low methodological quality and insufficient number to statistically test relationships, the results appeared consistent with recommendations to reduce complexity as much as possible to facilitate implementation. Although studies excluded individuals with a range of comorbidities and sociocultural challenges, such simplification of NASSS domain 1 may have been necessary to advance intervention value propositions (domain 3). However, to create equitable digital health solutions that can be successfully implemented in real-world settings, it is recommended that developers involve people with ABI, their close others, and health care staff in addressing complexities in domains 2 to 7 from the earliest intervention design stages. TRIAL REGISTRATION PROSPERO International Prospective Register of Systematic Reviews CRD42020186387; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020186387. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.1177/20552076211035988.
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Affiliation(s)
- Melissa Miao
- University of Technology Sydney, Sydney, Australia
| | | | | | | | | | - Emma Power
- University of Technology Sydney, Sydney, Australia
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Brunner M, Rietdijk R, Togher L. Training Resources Targeting Social Media Skills to Inform Rehabilitation for People Who Have an Acquired Brain Injury: Scoping Review. J Med Internet Res 2022; 24:e35595. [PMID: 35482369 PMCID: PMC9100544 DOI: 10.2196/35595] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 03/04/2022] [Accepted: 03/29/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND In 2020 and 2021, people increasingly used the internet to connect socially and professionally. However, people with an acquired brain injury (ABI) experience challenges in using social media, and rehabilitation professionals have reported feeling underprepared to support them in its use. To date, no review of social media skills training to inform ABI rehabilitation has been conducted. OBJECTIVE This scoping review aimed to examine research on interventions addressing social media skills and safety, with a focus on people living with health conditions; free web-based resources for the general public on social media skills training; and currently available online support groups for people with ABI. METHODS An integrative scoping review was conducted, with a systematic search strategy applied in March and November 2020 across OvidSP (MEDLINE, AMED, PsycINFO, and Embase), Scopus, Web of Science, CINAHL, Google Scholar, Google, and Facebook. The data collected were critically appraised and synthesized to describe the key content and features of social media training resources. RESULTS This review identified 47 peer-reviewed academic articles, 48 social media training websites, and 120 online support groups for people with ABI. A key recommendation was interactive training with practical components addressing cybersafety, how to use platforms, and how to connect with others. However, no social media training resources that were relevant and accessible for people with ABI were identified. CONCLUSIONS Training resources to support people with ABI in safely using social media are limited. The key content to be addressed and the features to be incorporated into web-based social media training were determined, including the need for interactive training that is co-designed and safe and incorporates practical components that support people with ABI. These findings can be used to inform the development of web-based evidence-based support for people with ABI who may be vulnerable when participating in social media.
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Affiliation(s)
- Melissa Brunner
- Faculty of Medicine and Health, University of Sydney, Eora Nation, Camperdown, Australia
| | - Rachael Rietdijk
- Faculty of Medicine and Health, University of Sydney, Eora Nation, Camperdown, Australia
| | - Leanne Togher
- Faculty of Medicine and Health, University of Sydney, Eora Nation, Camperdown, Australia
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Miao M, Power E, Rietdijk R, Debono D, Brunner M, Salomon A, Mcculloch B, Wright MR, Welsh M, Tremblay B, Rixon C, Williams L, Morrow R, Evain JC, Togher L. Coproducing Knowledge of the Implementation of Complex Digital Health Interventions for Adults with Acquired Brain Injury and their Communication Partners: Protocol for a Mixed Methods Study. JMIR Res Protoc 2022; 11:e35080. [PMID: 35006082 PMCID: PMC8787662 DOI: 10.2196/35080] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Accepted: 11/24/2021] [Indexed: 02/06/2023] Open
Abstract
Background The Social Brain Toolkit, conceived and developed in partnership with stakeholders, is a novel suite of web-based communication interventions for people with brain injury and their communication partners. To support effective implementation, the developers of the Social Brain Toolkit have collaborated with people with brain injury, communication partners, clinicians, and individuals with digital health implementation experience to coproduce new implementation knowledge. In recognition of the equal value of experiential and academic knowledge, both types of knowledge are included in this study protocol, with input from stakeholder coauthors. Objective This study aims to collaborate with stakeholders to prioritize theoretically based implementation targets for the Social Brain Toolkit, understand the nature of these priorities, and develop targeted implementation strategies to address these priorities, in order to support the Social Brain Toolkit’s implementation. Methods Theoretically underpinned by the Nonadoption, Abandonment, Scale-up, Spread, and Sustainability (NASSS) framework of digital health implementation, a maximum variation sample (N=35) of stakeholders coproduced knowledge of the implementation of the Social Brain Toolkit. People with brain injury (n=10), communication partners (n=11), and clinicians (n=5) participated in an initial web-based prioritization survey based on the NASSS framework. Survey completion was facilitated by plain English explanations and accessible captioned videos developed through 3 rounds of piloting. A speech-language pathologist also assisted stakeholders with brain injury to participate in the survey via video teleconference. Participants subsequently elaborated on their identified priorities via 7 web-based focus groups, in which researchers and stakeholders exchanged stakeholder perspectives and research evidence from a concurrent systematic review. Stakeholders were supported to engage in focus groups through the use of visual supports and plain English explanations. Additionally, individuals with experience in digital health implementation (n=9) responded to the prioritization survey questions via individual interview. The results will be deductively analyzed in relation to the NASSS framework in a coauthorship process with people with brain injury, communication partners, and clinicians. Results Ethical approval was received from the University of Technology Sydney Health and Medical Research Ethics Committee (ETH20-5466) on December 15, 2020. Data were collected from April 13 to November 18, 2021. Data analysis is currently underway, with results expected for publication in mid-2022. Conclusions In this study, researchers supported individuals with living experience of acquired brain injury, of communicating with or clinically supporting someone post injury, and of digital health implementation, to directly access and leverage the latest implementation research evidence and theory. With this support, stakeholders were able to prioritize implementation research targets, develop targeted implementation solutions, and coauthor and publish new implementation findings. The results will be used to optimize the implementation of 3 real-world, evidence-based interventions and thus improve the outcomes of people with brain injury and their communication partners. International Registered Report Identifier (IRRID) DERR1-10.2196/35080
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Affiliation(s)
- Melissa Miao
- University of Technology Sydney, Sydney, Australia
| | - Emma Power
- University of Technology Sydney, Sydney, Australia
| | | | | | | | | | | | | | - Monica Welsh
- See Authors' Contributions, Australia.,Brain Injury Rehabilitation Unit, South Australian Brain Injury Rehabilitation Service, Hampstead Rehabilitation Centre, Adelaide, Australia
| | | | - Caleb Rixon
- See Authors' Contributions, Australia.,Genyus Network, Melbourne, Australia
| | - Liz Williams
- See Authors' Contributions, Australia.,Brain Injury Rehabilitation Community and Home, South Australian Brain Injury Rehabilitation Service, Hampstead Rehabilitation Centre, Adelaide, Australia
| | | | - Jean-Christophe Evain
- See Authors' Contributions, Australia.,Acquired Brain Injury Rehabilitation Centre, Caulfield Hospital, Alfred Health Network, Melbourne, Australia
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Miao M, Power E, Rietdijk R, Brunner M, Debono D, Togher L. A Web-Based Service Delivery Model for Communication Training After Brain Injury: Protocol for a Mixed Methods, Prospective, Hybrid Type 2 Implementation-Effectiveness Study. JMIR Res Protoc 2021; 10:e31995. [PMID: 34889770 PMCID: PMC8704121 DOI: 10.2196/31995] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 10/18/2021] [Accepted: 10/20/2021] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Acquired brain injuries (ABIs) commonly cause cognitive-communication disorders, which can have a pervasive psychosocial impact on a person's life. More than 135 million people worldwide currently live with ABI, and this large and growing burden is increasingly surpassing global rehabilitation service capacity. A web-based service delivery model may offer a scalable solution. The Social Brain Toolkit is an evidence-based suite of 3 web-based communication training interventions for people with ABI and their communication partners. Successful real-world delivery of web-based interventions such as the Social Brain Toolkit requires investigation of intervention implementation in addition to efficacy and effectiveness. OBJECTIVE The aim of this study is to investigate the implementation and effectiveness of the Social Brain Toolkit as a web-based service delivery model. METHODS This is a mixed methods, prospective, hybrid type 2 implementation-effectiveness study, theoretically underpinned by the Nonadoption, Abandonment, Scale-up, Spread, and Sustainability (NASSS) framework of digital health implementation. We will document implementation strategies preemptively deployed to support the launch of the Social Brain Toolkit interventions, as well as implementation strategies identified by end users through formative evaluation of the Social Brain Toolkit. We will prospectively observe implementation outcomes, selected on the basis of the NASSS framework, through quantitative web analytics of intervention use, qualitative and quantitative pre- and postintervention survey data from all users within a specified sample frame, and qualitative interviews with a subset of users of each intervention. Qualitative implementation data will be deductively analyzed against the NASSS framework. Quantitative implementation data will be analyzed descriptively. We will obtain effectiveness outcomes through web-based knowledge tests, custom user questionnaires, and formal clinical tools. Quantitative effectiveness outcomes will be analyzed through descriptive statistics and the Reliable Change Index, with repeated analysis of variance (pretraining, posttraining, and follow-up), to determine whether there is any significant improvement within this participant sample. RESULTS Data collection commenced on July 2, 2021, and is expected to conclude on June 1, 2022, after a 6-month sample frame of analytics for each Social Brain Toolkit intervention. Data analysis will occur concurrently with data collection until mid-2022, with results expected for publication late 2022 and early 2023. CONCLUSIONS End-user evaluation of the Social Brain Toolkit's implementation can guide intervention development and implementation to reach and meet community needs in a feasible, scalable, sustainable, and acceptable manner. End user feedback will be directly incorporated and addressed wherever possible in the next version of the Social Brain Toolkit. Learnings from these findings will benefit the implementation of this and future web-based psychosocial interventions for people with ABI and other populations. TRIAL REGISTRATION Australia and New Zealand Clinical Trials Registry ACTRN12621001170819; https://anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12621001170819, Australia and New Zealand Clinical Trials Registry ACTRN12621001177842; https://anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12621001177842, Australia and New Zealand Clinical Trials Registry ACTRN12621001180808; https://anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12621001180808. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/31995.
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Affiliation(s)
- Melissa Miao
- University of Technology Sydney, Sydney, Australia
| | - Emma Power
- University of Technology Sydney, Sydney, Australia
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Miao M, Power E, Rietdijk R, Brunner M, Togher L. Implementation of online psychosocial interventions for people with neurological conditions and their caregivers: A systematic review protocol. Digit Health 2021; 7:20552076211035988. [PMID: 34567610 PMCID: PMC8456620 DOI: 10.1177/20552076211035988] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 07/11/2021] [Indexed: 11/17/2022] Open
Abstract
Background As the burden of neurological conditions increases globally, online psychosocial interventions offer a potentially scalable solution to enabling healthcare access. However, their successful development and implementation require research into electronic healthcare implementation specifically. Methods Using a search strategy combining the concepts of implementation, electronic healthcare, psychosocial interventions and neurological conditions, we will conduct comprehensive electronic searches for primary implementation evidence in MEDLINE, EMBASE, PsycINFO, CINAHL, Scopus, SpeechBITE and NeuroBITE databases. Included studies will be analysed according to the Non-adoption, Abandonment, Scale-Up, Spread, and Sustainability framework, appraised using the Mixed-Methods Appraisal Tool and evaluated for theoretical underpinning in implementation science, with hybrid studies of effectiveness-implementation research classified according to the type of hybrid design. Discussion This review will be the first to use a theoretical underpinning in the Non-adoption, Abandonment, Scale-Up, Spread, and Sustainability framework to evaluate strengths and gaps in existing implementation research into online psychosocial interventions for people with neurological conditions and/or their caregivers. The results may be useful to provide direction and recommendations for future clinical implementation and research into online psychosocial interventions for people with neurological conditions and/or their caregivers. Systematic review registration PROSPERO 2020: CRD42020186387.
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Affiliation(s)
- Melissa Miao
- Graduate School of Health, University of Technology Sydney, Australia
| | - Emma Power
- Graduate School of Health, University of Technology Sydney, Australia
| | - Rachael Rietdijk
- Faculty of Medicine and Health, The University of Sydney, Australia
| | - Melissa Brunner
- Faculty of Medicine and Health, The University of Sydney, Australia
| | - Leanne Togher
- Faculty of Medicine and Health, The University of Sydney, Australia
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Rietdijk R, Power E, Attard M, Togher L. Acceptability of telehealth-delivered rehabilitation: Experiences and perspectives of people with traumatic brain injury and their carers. J Telemed Telecare 2020; 28:122-134. [PMID: 32460583 DOI: 10.1177/1357633x20923824] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Communication skills training for people with traumatic brain injury (TBI) and their carers is recommended best practice. Delivery via telehealth could improve access to this training. This paper focuses on the acceptability of telehealth delivery of communication skills training. METHODS A mixed-methods investigation of acceptability of telehealth to people with TBI and their carers was incorporated into a clinical trial. Thirty-six people with TBI (23 metropolitan and 13 regional) and their carers were recruited. Metropolitan participants were randomly allocated to telehealth or in-person intervention at a 1:3 ratio. Regional participants were allocated to telehealth. Telehealth and in-person participants were compared on retention, time to complete the programme, home practice completion and therapeutic alliance ratings. Participants completed semi-structured interviews regarding their views on telehealth, which were analysed using thematic analysis. RESULTS There were no significant differences between telehealth and in-person participants in retention rate, time to complete the programme, degree of home practice completion or therapeutic alliance ratings. Three themes were identified: 'telehealth delivery opens a window for access to rehabilitation in the context of my daily life', 'in-person delivery offers rehabilitation based on natural human interaction' and 'weighing telehealth against in-person delivery'. DISCUSSION Participants found telehealth delivery acceptable, as indicated by the similarity between groups in the quantitative process measures, and as reported in interviews. Some reported a preference for in-person delivery if there had been a choice of delivery mode. Participants described characteristics of the two delivery modes which were relevant to their attitudes towards telehealth.
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Affiliation(s)
- Rachael Rietdijk
- The University of Sydney, Faculty of Medicine and Health, Australia
| | - Emma Power
- The University of Technology Sydney, Graduate School of Health, Australia.,The University of Sydney, Faculty of Medicine and Health, Australia
| | - Michelle Attard
- The University of Sydney, Faculty of Medicine and Health, Australia
| | - Leanne Togher
- The University of Sydney, Faculty of Medicine and Health, Australia
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Rietdijk R, Power E, Attard M, Heard R, Togher L. Improved Conversation Outcomes After Social Communication Skills Training for People With Traumatic Brain Injury and Their Communication Partners: A Clinical Trial Investigating In-Person and Telehealth Delivery. J Speech Lang Hear Res 2020; 63:615-632. [PMID: 32078409 DOI: 10.1044/2019_jslhr-19-00076] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Purpose The aim of the study was to investigate the effectiveness of social communication skills training (TBIconneCT) for people with traumatic brain injury (TBI) and their communication partners, delivered in-person or via telehealth, on quality of conversations. Method This study is a clinical trial, including an in-person intervention group (n = 17), a telehealth intervention group (n = 19), and a historical control group (n = 15). Participants were adults at least 6 months post moderate-to-severe TBI with social communication skills deficits and their usual communication partners. Participants completed a casual and purposeful conversation task at pre-intervention, postintervention, and a follow-up assessment. A blinded assessor evaluated conversations using the Adapted Measure of Participation in Conversation and the Adapted Measure of Support in Conversation. Treatment effects were examined by comparing groups on change in ratings between pre- and posttraining. Maintenance of effects was examined using change between posttraining and follow-up assessment. The trial protocol was registered with the Australian New Zealand Clinical Trials Registry (ACTRN12615001024538). Results Trained participants with TBI had significant improvements in participation in casual conversation compared to controls. Trained communication partners also had significant improvements compared to controls on ratings of support in casual conversations. However, treatment effects were not maintained at follow-up for two of eight measures. Comparisons between outcomes of in-person and telehealth groups found negligible to small effect sizes for six of eight measures. Conclusions The findings reinforce previous studies demonstrating the efficacy of communication partner training after TBI. Telehealth delivery produced similar outcomes to in-person delivery.
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Affiliation(s)
- Rachael Rietdijk
- The University of Sydney, Sydney School of Health Sciences, New South Wales, Australia
| | - Emma Power
- The University of Sydney, Sydney School of Health Sciences, New South Wales, Australia
- The University of Technology Sydney, Graduate School of Health, New South Wales, Australia
| | - Michelle Attard
- The University of Sydney, Sydney School of Health Sciences, New South Wales, Australia
| | - Robert Heard
- The University of Sydney, Sydney School of Health Sciences, New South Wales, Australia
| | - Leanne Togher
- The University of Sydney, Sydney School of Health Sciences, New South Wales, Australia
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Rietdijk R, Power E, Brunner M, Togher L. The reliability of evaluating conversations between people with traumatic brain injury and their communication partners via videoconferencing. Neuropsychol Rehabil 2018; 30:1074-1091. [DOI: 10.1080/09602011.2018.1554533] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Rachael Rietdijk
- The University of Sydney, Faculty of Health Sciences, Sydney, NSW, Australia
| | - Emma Power
- The University of Sydney, Faculty of Health Sciences, Sydney, NSW, Australia
- The University of Technology Sydney, Graduate School of Health, Sydney, NSW, Australia
| | - Melissa Brunner
- The University of Sydney, Faculty of Health Sciences, Sydney, NSW, Australia
- The University of Technology Sydney, Graduate School of Health, Sydney, NSW, Australia
| | - Leanne Togher
- The University of Sydney, Faculty of Health Sciences, Sydney, NSW, Australia
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O'Rourke A, Power E, O'Halloran R, Rietdijk R. Common and distinct components of communication partner training programmes in stroke, traumatic brain injury and dementia. Int J Lang Commun Disord 2018; 53:1150-1168. [PMID: 30295014 DOI: 10.1111/1460-6984.12428] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2018] [Revised: 08/10/2018] [Accepted: 09/10/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Communication partner training (CPT) programmes for health and care staff working with people with the neurologically based communication disorders associated with stroke, traumatic brain injury (TBI) and dementia are efficacious in improving communication. However, current programmes are lengthy and disorder specific, and therefore may not be suitable as staff training tools in environments with people with multiple communication disorders, and services with a variety of neurological populations. AIMS To identify common and distinct components of CPT programmes for stroke, TBI and dementia in order to determine whether there are common delivery methods and content that can be consolidated to improve implementation of CPT in health and care services. METHODS & PROCEDURES A qualitative enquiry was used. Four CPT programmes targeting three disorders were identified from systematic reviews and literature searches. Programme data were recorded onto data sheets from manuals, study articles and supplementary materials, and were categorized using the Intervention Taxonomy (ITAX). Content analysis and elements of constant comparative analysis were employed to analyse the CPT programmes. OUTCOMES & RESULTS Delivery characteristics were similar across all four programmes. All were delivered face to face in either group or individual contexts. However, duration varied from 1 to 35 h. Six of the 12 categories of information provided were common across all programmes, including 'strategy' 'background to disorder', 'information about communication', 'information about program', 'negative behaviours to avoid' and 'purpose of program'. Programmes differed in the types of skill-building techniques used, with the most common being videos (3/4 programmes), discussions (2/4 programmes) and trainer demonstrations (2/4 programmes). While strategies provided to trained partners targeted similar domains of communication, only 3/96 individual strategies were common to all programmes. CONCLUSIONS & IMPLICATIONS There are both common and distinct components in content and delivery methods across CPT programmes. Further research is needed to evaluate the distinct components of the programmes, to determine which individual strategies are efficacious, and which approach to skill-building techniques is most effective. The present study has contributed a comprehensive list of programme components, which can form a basis for describing and refining CPT programmes in future.
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Affiliation(s)
- Angela O'Rourke
- Discipline of Speech Pathology, Faculty of Health Sciences, University of Sydney, Sydney, NSW, Australia
| | - Emma Power
- Discipline of Speech Pathology, Faculty of Health Sciences, University of Sydney, Sydney, NSW, Australia
| | - Robyn O'Halloran
- Discipline of Speech Pathology, School of Allied Health, La Trobe University, Melbourne, VIC, Australia
| | - Rachael Rietdijk
- Discipline of Speech Pathology, Faculty of Health Sciences, University of Sydney, Sydney, NSW, Australia
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Rietdijk R, Power E, Brunner M, Togher L. A single case experimental design study on improving social communication skills after traumatic brain injury using communication partner telehealth training. Brain Inj 2018; 33:94-104. [DOI: 10.1080/02699052.2018.1531313] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Rachael Rietdijk
- Faculty of Health Sciences, The University of Sydney, Sydney, Australia
| | - Emma Power
- Faculty of Health Sciences, The University of Sydney, Sydney, Australia
- Graduate School of Health, The University of Technology, Sydney, Australia
| | - Melissa Brunner
- Faculty of Health Sciences, The University of Sydney, Sydney, Australia
- Graduate School of Health, The University of Technology, Sydney, Australia
| | - Leanne Togher
- Faculty of Health Sciences, The University of Sydney, Sydney, Australia
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Togher L, McDonald S, Tate R, Rietdijk R, Power E. The effectiveness of social communication partner training for adults with severe chronic TBI and their families using a measure of perceived communication ability. NeuroRehabilitation 2016; 38:243-55. [DOI: 10.3233/nre-151316] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Leanne Togher
- Speech Pathology, Faculty of Health Sciences, The University of Sydney, Sydney, NSW, Australia
- National Health and Medical Research Council (NHMRC) Centre of Research Excellence in Brain Recovery, Sydney, NSW, Australia
| | - Skye McDonald
- School of Psychology, The University of New South Wales, Sydney, NSW, Australia
- National Health and Medical Research Council (NHMRC) Centre of Research Excellence in Brain Recovery, Sydney, NSW, Australia
| | - Robyn Tate
- John Walsh Centre for Rehabilitation Research, Northern Clinical School, Faculty of Medicine, University of Sydney, Sydney, NSW, Australia
- National Health and Medical Research Council (NHMRC) Centre of Research Excellence in Brain Recovery, Sydney, NSW, Australia
| | - Rachael Rietdijk
- Speech Pathology, Faculty of Health Sciences, The University of Sydney, Sydney, NSW, Australia
- National Health and Medical Research Council (NHMRC) Centre of Research Excellence in Brain Recovery, Sydney, NSW, Australia
| | - Emma Power
- Speech Pathology, Faculty of Health Sciences, The University of Sydney, Sydney, NSW, Australia
- National Health and Medical Research Council (NHMRC) Centre of Research Excellence in Brain Recovery, Sydney, NSW, Australia
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Rietdijk R, Simpson G, Togher L, Power E, Gillett L. An exploratory prospective study of the association between communication skills and employment outcomes after severe traumatic brain injury. Brain Inj 2013; 27:812-8. [DOI: 10.3109/02699052.2013.775491] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Rietdijk R, Togher L, Power E. Supporting family members of people with traumatic brain injury using telehealth: a systematic review. J Rehabil Med 2013; 44:913-21. [PMID: 23027316 DOI: 10.2340/16501977-1058] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE To describe the effectiveness of using telehealth programs to provide training or support to family members of people with traumatic brain injury. DESIGN Systematic review. DATA SOURCES Intervention studies were identified by searching Medline, CINAHL, PsycINFO, Web of Science, Scopus, the Cochrane library, Embase, PsycBITE and ProQUEST. STUDY SELECTION Studies included in the review reported an intervention involving family members of adults or children with traumatic brain injury, delivered at a distance through use of technology (including telephone, websites or video-conferencing). Reliability of inclusion of studies in the review was high (Kappa = 0.816) based on a second reviewer evaluating a random sample of 25% of the 830 references originally identified from the database search. DATA EXTRACTION Data describing the participants, interventions and outcomes were extracted from each study. The quality of studies was evaluated using the PEDro-P scale. DATA SYNTHESIS The review identified 7 randomised controlled trials, 4 non-randomised controlled trials and 5 case series studies. The studies involved a variety of program formats and intervention targets. All but one study reported positive outcomes of the telehealth programs, however very few studies used blinded assessors. CONCLUSIONS Telehealth programs for family members of people with traumatic brain injury are feasible, with positive outcomes reported. Further research is needed to strengthen the evidence for the use of telehealth in comparison to face-to-face interventions, and to provide information to guide clinical decision-making.
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Affiliation(s)
- Rachael Rietdijk
- Disipline of Speech Pathology, Faculty of Health Sciences, The University of Sydney, Sydney, Australia
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Togher L, McDonald S, Tate R, Power E, Rietdijk R. Training communication partners of people with severe traumatic brain injury improves everyday conversations: A multicenter single blind clinical trial. J Rehabil Med 2013; 45:637-45. [DOI: 10.2340/16501977-1173] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Togher L, Power E, Rietdijk R, McDonald S, Tate R. An exploration of participant experience of a communication training program for people with traumatic brain injury and their communication partners. Disabil Rehabil 2012; 34:1562-74. [PMID: 22360709 DOI: 10.3109/09638288.2012.656788] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE To investigate the experiences of participants who attended communication training programs for people with traumatic brain injury (TBI) and their everyday communication partners (CP) as part of a non-randomised controlled trial. METHOD The participants were people with TBI and their CP, who were family members or carers of the people with TBI. Twenty-six participants (13 participants with TBI and 13 CP) completed the JOINT program, which involved participants with TBI and CP attending the program together. Fourteen participants with TBI completed the TBI SOLO training program, which did not involve the participation of a CP. Semi-structured videotaped interviews were completed by all participants at the end of the training. Using a six-step generic analysis procedure, data were categorised into topics and then subtopics to identify conceptually discrete units. RESULTS Participants described improvements in communication skills, the impact of improved communication skills, valuable components of the programs and components that needed changes. CONCLUSION The accounts of participants provided additional evidence for the effectiveness of the training programs, assisted with identifying helpful components of the training and demonstrated the usefulness of a qualitative research methodology as part of evaluating the outcomes of the clinical trial.
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Affiliation(s)
- Leanne Togher
- Speech Pathology, Faculty of Health Sciences, The University of Sydney, Sydney, Australia.
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