JMIR Publications

ABSTRACT

Background:

People with acquired brain injury (ABI) experience communication breakdown in everyday interactions many years after injury, negatively impacting on 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, including rural and remote locations. Digital health has potential to overcome the challenges of travel and improve cost efficiencies, processes and clinical outcomes.

Objective:

To collaboratively develop a novel multimodal online communication partner training program with key stakeholders (convers-ABI-lity) and evaluate its feasibility for improving conversation skills after brain injury.

Methods:

This mixed-methods study consisted of three key stages guided by the Integrate, Design, Evaluate, Assess and Share (IDEAS) Framework for developing effective digital health interventions. Stage I: integration of current end-user needs and perspectives with key treatment and theoretical components of existing evidence-based interventions, TBI Express and TBIconneCT. Stage II: iterative design of convers-ABI-lity with feedback from end-user interviews (n = 22) analyzed using content analysis. Participants were people with ABI, family members, health professionals and paid support workers. Stage III: evaluate feasibility through proof-of-concept study (n = 3). Three dyads (a person with ABI and their communication partner) completed 7 weeks of convers-ABI-lity, guided by a clinician. Outcome measures included blinded ratings of conversation samples and self-report measures. Participants completed interviews post-intervention, which were analyzed using content analysis to inform further intervention refinement and development.

Results:

Collaborative and iterative design and development during Stages I and II resulted in the build of convers-ABI-lity. Results in Stage III indicated positive changes on blinded ratings of conversation samples for the participants with TBI and their communication partners. Statistically reliable positive changes were also observed on self-report measures of social communication skill and quality of life. Intervention participants endorsed aspects of convers-ABI-lity such as complementary self-guided online modules, clinician sessions, engaging content and novel features. They reported the program to be relevant to their personal experience with cognitive-communication disorder.

Conclusions:

This study presents the outcome of using the IDEAS framework to guide the development of an online multimodal communication partner training intervention, with input from key stakeholders. Results indicate promising outcomes for improving conversation skills for people with ABI and their communication partners. Further evaluation of intervention effectiveness and efficacy with a larger sample size is required.