Better Conversations with Dysarthria - Parkinson’s, version 1.0
Research type
Research Study
Full title
Better Conversations for people living with Parkinson’s: A new telehealth approach to speech therapy
IRAS ID
296412
Contact name
Steven Bloch
Contact email
Sponsor organisation
University College London
Clinicaltrials.gov Identifier
Z6364106/2021/11/40, UCL Data Protection Registration Number
Duration of Study in the UK
1 years, 4 months, 6 days
Research summary
Summary of Research
This project will develop and test a personalised speech and language therapy programme for people living with Parkinson’s. The therapy will be delivered remotely in partnership with an NHS service already specialising in telehealth. Up to 70% of people living with Parkinson's experience speech and voice changes. Not being understood or being able to join in can lead to frustration, stress/anxiety, social isolation and wider relationship problems.
Our new therapy is called Better Conversations with Dysarthria - Parkinson's (BCD-P), and currently involves six weekly 1-hour sessions with a speech therapist. It will be delivered remotely via a computer. It works to support everyday communication between a person with Parkinson’s and their key communication partner (a 'dyad'). BCD-P is personalised to a dyad’s own communication strengths and challenges. This involves using video feedback. A dyad will make video recordings of themselves talking to each-other. These are used by the therapist to explain how communication works, and understand what is problematic for them and why. Practical communication goals will be agreed. These goals will be addressed through a combination of activities and feedback. Participants will commit to completing therapy sessions and assessment sessions before and after therapy to measure outcomes. Participants will be fully supported to use the technology and to talk about their own communication. We are experienced in this approach and will ensure there is time for emotional support.
Summary of Results
Background: Targeting conversation between people with Parkinson’s related speech change and significant others can improve communicative effectiveness and experience. Communication partner training (CPT) has been investigated almost exclusively in a face-to-face delivery format. Online intervention may offer more accessible options to a wider range of participants.
Aims: The primary aim is to evaluate the feasibility of the Better Conversations with Parkinson’s (BCP) program delivered via telehealth. The aim is to establish: (1) the acceptability of the program for people living with Parkinson’s, family members, and the speech and language therapist; (2) the feasibility of delivering the BCP program; (3) recruitment and retention rates; (4) a sample size calculation; and (5) the most appropriate primary outcome measure.
Methods and Procedures: This case-series feasibility pilot study recruited 7 dyads. Participants were involved for 6 weeks direct intervention delivered by one SLT, with additional pre and post measures and interviews. Acceptability and feasibility were evaluated using participant feedback, interviews, and a reflective diary and feedback of the SLT. These data were analyzed using descriptive statistics and reflexive thematic analysis. Descriptive statistics were used to report on recruitment, attendance, and attrition.
Results and Outcomes: Results show a high degree of acceptability from the study participants including: deliverability, the therapeutic alliance, methods used, and expectations/beliefs. The cohesion between the temporal perspectives (the SLT’s expectations prior to delivering the BCP and actual experience) as well as the SLT’s positive responses towards the intervention also indicates that the intervention was delivered as intended. The flexible delivery format and content supported successful implementation of the intervention, with particularly positive feedback about video analysis of conversation supporting acceptability. Implementation challenges centre around technical aspects of video delivery. Iterative refining of the intervention to standardise timings of sessions would be beneficial.
Conclusions and Implications: The results indicate that online delivery of the BCP program is feasible in terms of client and SLT acceptability and deliverability, and thus may be viable for future Parkinson’s communication intervention programs. These results pave the way for a larger study that will evaluate the efficacy of a BC-P program.REC name
London - Central Research Ethics Committee
REC reference
22/LO/0332
Date of REC Opinion
24 May 2022
REC opinion
Further Information Favourable Opinion