Abstract
ABSTRACT The delivery of Intensive Comprehensive Aphasia Programs (ICAPs) via telerehabilitation is a potential solution to the ongoing geographical, transport, and mobility barriers that people with aphasia (PWA) face in accessing this service model. To ensure the ICAP retains its evidence-based elements, configuration of the telerehabilitation system requires consideration of user and therapy task requirements. The human-centred design (HCD) process incorporates user and task considerations when developing technological systems. Therefore, the aim of this study was to use the HCD process to translate the Comprehensive High-dose Aphasia Therapy (CHAT) program for delivery via telerehabilitation (TeleCHAT). Methods The HCD translation process used consisted of five iterative stages. Relevant literature was reviewed, and speech-language pathologists (SLPs) experienced in delivering ICAPs were consulted to understand the therapy context. Researchers gathered therapy task and user requirements of PWA, support people (SP) and SLPs to engage in therapy. Technology that met user and therapy task requirements were identified and a preliminary technology configuration was tested in a simulated environment. The finalised system was tested in a pilot trial of TeleCHAT with a cohort of four PWA, two SPs, and two SLPs. Feedback and technical and user issues were collated from users and analysed to inform improvements to the TeleCHAT configuration and protocol. Results User and therapy task requirements to deliver TeleCHAT were identified with consideration of communication and participation supports for PWA. The configured technology system comprised of Zoom© as the videoconferencing platform of choice, and additional critical technical functions including screen and audio sharing of therapy content, and multi-point interaction using remote control and annotation tools. Simulation testing and a pilot trial of the configuration confirmed system operability and identified modifications to optimise functioning. Conclusion The HCD framework was used to successfully configure an optimal technology system for the delivery of TeleCHAT. The HCD framework can be used by clinicians to identify patient needs and configure optimal telerehabilitation systems for delivery of complex interventions.
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