Accessibility and Applicability of Currently Available e-Mental Health Programs for Depression for People With Poststroke Aphasia: Scoping Review.

Stephanie Jane Clunne,Brooke Jade Ryan,Ian Kneebone,Annie Jane Hill,Caitlin Brandenburg

doi:10.2196/jmir.9864

Stephanie Jane Clunne, Brooke Jade Ryan + Show 3 more

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https://doi.org/10.2196/jmir.9864

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Abstract

BackgroundDepression affects approximately 60% of people with aphasia 1 year post stroke and is associated with disability, lower quality of life, and mortality. Web-delivered mental health (e-mental health) programs are effective, convenient, and cost-effective for the general population and thus are increasingly used in the management of depression. However, it is unknown if such services are applicable and communicatively accessible to people with poststroke aphasia.ObjectiveThe aim of this study was to identify freely available e-mental health programs for depression and determine their applicability and accessibility for people with poststroke aphasia.MethodsA Web-based search was conducted to identify and review freely available e-mental health programs for depression. These programs were then evaluated in terms of their (1) general features via a general evaluation tool, (2) communicative accessibility for people with aphasia via an aphasia-specific communicative accessibility evaluation tool, and (3) empirical evidence for the general population and stroke survivors with and without aphasia. The program that met the most general evaluation criteria and aphasia-specific communicative accessibility evaluation criteria was then trialed by a small subgroup of people with poststroke aphasia.ResultsA total of 8 programs were identified. Of these, 4 had published evidence in support of their efficacy for use within the general population. However, no empirical evidence was identified that specifically supported any programs’ use for stroke survivors with or without aphasia. One evidence-based program scored at least 80% (16/19 and 16/20, respectively) on both the general and aphasia-specific communicative accessibility evaluation tools and was subject to a preliminary trial by 3 people with poststroke aphasia. During this trial, participants were either unable to independently use the program or gave it low usability scores on a post-trial satisfaction survey. On this basis, further evaluation was considered unwarranted.ConclusionsDespite fulfilling majority of the general evaluation and aphasia-specific evaluation criteria, the highest rated program was still found to be unsuitable for people with poststroke aphasia. Thus, e-mental health programs require substantial redevelopment if they are likely to be useful to people with poststroke aphasia.

Highlights

BackgroundAphasia is a language disorder that can impact a person’s ability to understand and produce spoken language, read, write, calculate, and use gestures [1]
A total of 12 general search terms were used in the first stage of the Web-based search; they consisted of simple, lay keywords and did not include the words “stroke” or “aphasia.” As the most recent E-mental Health Strategy for Australia specifies the Government’s investment in Web-based cognitive behavioral therapy (CBT) programs [21], many of these search terms relate to CBT
During stage 2 of the Web-based search, the authors collaborated with an academic advisory group, consisting of clinicians and academics who work with people with poststroke aphasia, to generate a set of search terms they thought a person with poststroke aphasia might use if searching for Web-based treatment for depression

Summary

Introduction

BackgroundAphasia is a language disorder that can impact a person’s ability to understand and produce spoken language, read, write, calculate, and use gestures [1]. Methods: A Web-based search was conducted to identify and review freely available e-mental health programs for depression These programs were evaluated in terms of their (1) general features via a general evaluation tool, (2) communicative accessibility for people with aphasia via an aphasia-specific communicative accessibility evaluation tool, and (3) empirical evidence for the general population and stroke survivors with and without aphasia. One evidence-based program scored at least 80% (16/19 and 16/20, respectively) on both the general and aphasia-specific communicative accessibility evaluation tools and was subject to a preliminary trial by 3 people with poststroke aphasia During this trial, participants were either unable to independently use the program or gave it low usability scores on a post-trial satisfaction survey. E-mental health programs require substantial redevelopment if they are likely to be useful to people with poststroke aphasia

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