Developing a Digital Health Intervention for Conversation Skills After Brain Injury (convers-ABI-lity) Using a Collaborative Approach: Mixed Methods Study

BackgroundPeople 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 comm...

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Main Authors: Petra Avramović, Rachael Rietdijk, Belinda Kenny, Emma Power, Leanne Togher
Format: Article
Language:English
Published: JMIR Publications 2023-08-01
Series:Journal of Medical Internet Research
Online Access:https://www.jmir.org/2023/1/e45240
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author Petra Avramović
Rachael Rietdijk
Belinda Kenny
Emma Power
Leanne Togher
author_facet Petra Avramović
Rachael Rietdijk
Belinda Kenny
Emma Power
Leanne Togher
author_sort Petra Avramović
collection DOAJ
description BackgroundPeople 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. ObjectiveWe 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. MethodsThis 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. ResultsCollaborative 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. ConclusionsThis 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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spelling doaj.art-720286e6f7844944aa896f0c116e031a2023-08-09T14:31:15ZengJMIR PublicationsJournal of Medical Internet Research1438-88712023-08-0125e4524010.2196/45240Developing a Digital Health Intervention for Conversation Skills After Brain Injury (convers-ABI-lity) Using a Collaborative Approach: Mixed Methods StudyPetra Avramovićhttps://orcid.org/0000-0002-0264-952XRachael Rietdijkhttps://orcid.org/0000-0003-4343-4039Belinda Kennyhttps://orcid.org/0000-0002-5054-7309Emma Powerhttps://orcid.org/0000-0002-2638-0406Leanne Togherhttps://orcid.org/0000-0002-4518-6748 BackgroundPeople 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. ObjectiveWe 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. MethodsThis 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. ResultsCollaborative 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. ConclusionsThis 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.https://www.jmir.org/2023/1/e45240
spellingShingle Petra Avramović
Rachael Rietdijk
Belinda Kenny
Emma Power
Leanne Togher
Developing a Digital Health Intervention for Conversation Skills After Brain Injury (convers-ABI-lity) Using a Collaborative Approach: Mixed Methods Study
Journal of Medical Internet Research
title Developing a Digital Health Intervention for Conversation Skills After Brain Injury (convers-ABI-lity) Using a Collaborative Approach: Mixed Methods Study
title_full Developing a Digital Health Intervention for Conversation Skills After Brain Injury (convers-ABI-lity) Using a Collaborative Approach: Mixed Methods Study
title_fullStr Developing a Digital Health Intervention for Conversation Skills After Brain Injury (convers-ABI-lity) Using a Collaborative Approach: Mixed Methods Study
title_full_unstemmed Developing a Digital Health Intervention for Conversation Skills After Brain Injury (convers-ABI-lity) Using a Collaborative Approach: Mixed Methods Study
title_short Developing a Digital Health Intervention for Conversation Skills After Brain Injury (convers-ABI-lity) Using a Collaborative Approach: Mixed Methods Study
title_sort developing a digital health intervention for conversation skills after brain injury convers abi lity using a collaborative approach mixed methods study
url https://www.jmir.org/2023/1/e45240
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