Effect of a Novel, Interactive Mobile APP on Voice Therapy Outcomes and Adherence

新颖的交互式移动应用程序对语音治疗结果和依从性的影响

基本信息

批准号：
8690488
负责人：
Eva van Leer
金额：
$ 12.54万
依托单位：
GEORGIA STATE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2014
资助国家：
美国
起止时间：
2014-05-16 至 2017-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8690488
关键词：
Academy Acoustics Address Adherence Adult Affect American Behavior Therapy Behavioral Caring Childhood Chronic Clinic Clinical Communication impairment Computer software Consensus Devices Diagnosis Drops Educational process of instructing Effectiveness Engineering Psychology Exercise Failure Feedback Foundations Frequencies Goals Health behavior Hoarseness Home environment Instruction Intervention Knowledge Laboratories Language Lead Longevity Maintenance Measurement Measures Mechanics Methods Modeling Motivation Outcome Outcome Measure Participant Pathologist Patient Self-Report Patients Pilot Projects Play Production Randomized Records Regression Analysis Reminder Systems Reporting Research Research Project Grants Self Efficacy Speech Speech Pathology Speech-Language Pathology Support Groups Techniques Technology Telephone Testing Translating Translations Treatment Efficacy Treatment outcome Universities Voice Voice Disorders Voice Quality Walking Writing adduct base comparison group compliance behavior cost cost effective design diet and exercise efficacy testing experience forgetting improved innovation interdisciplinary approach mobile application motor learning novel patient oriented programs public health relevance smoking cessation social standard of care success teacher theories therapy adherence therapy outcome tool usability vocal cord voice therapy

项目摘要

DESCRIPTION (provided by applicant): Poor patient adherence to treatment limits the effectiveness of behavioral voice therapy. While patients can produce a target voice technique with clinician feedback, they experience adherence failure between therapy sessions characterized by an inability to replicate the target technique independently, forgetting to practice, and forgetting to use the technique all day. Patient self-efficacy (i.e. task-specific confidence) to overcome these challenges is poor. Problem: In our past research, provision of voice therapy videos on mobile MP4 devices significantly increased adherence and self-efficacy (i.e., task-specific confidence), and improved voice outcomes but not significantly so. Therefore, to assist patients in self-evaluating voice technique and remembering to use it, a novel iOS- based software application or "app" was developed in our laboratory that provides interactive voice quality feedback (jitter and cepstral peak prominence values), reminds patients to practice, models individualized practice via therapy recordings, and records all practice for direc tracking of adherence (without self-report). Objective: The aims of this project are to test the efficacy of our mobile app in affecting 1) improved voice therapy outcomes and 2) improved adherence and self-efficacy for adherence. Strategy: Sixty adults diagnosed with adducted hyperfunctional voice production and referred for resonant voice therapy at the University of Cincinnati Voice Clinic and Emory Voice Center will be randomized to one of two conditions: 1) resonant voice therapy supplemented by standard-of-care written homework instructions or 2) resonant voice therapy supplemented by the mobile voice therapy adherence app. All participants will record their practice on loaned iPods but only half will receive the app. For aim 1, outcome measures (VHI scores, acoustic and perceptual analysis of CAPE-V recordings) will be obtained prior to and following 4 sessions of treatment. For aim 2, adherence will be examined for frequency and duration of patient self-recordings and recordings obtained through app use. Self-efficacy will be tracked weekly through the Voice Therapy Self- Efficacy Scale. Group differences for both aims will be calculated via t-tests, and effects of self-efficacy and adherence on outcomes will be examined with regression analysis. Significance: This project will yield clinical tools and findings that translate directly to clinical voice care, are relevant across speech-language pathology interventions, expand knowledge of adherence and motor learning, and hold potential to increase voice therapy efficacy without increased cost.

描述（由申请人提供）：患者对治疗的依从性差限制了行为声音治疗的有效性。虽然患者可以根据临床医生的反馈制定目标发声技术，但他们在治疗期间会出现坚持失败的情况，其特点是无法独立复制目标技术、忘记练习、忘记整天使用该技术。患者克服这些挑战的自我效能（即特定任务的信心）很差。问题：在我们过去的研究中，在移动 MP4 设备上提供语音治疗视频可以显着提高依从性和自我效能（即特定任务的信心），并改善语音结果，但效果并不明显。因此，为了帮助患者自我评估语音技术并记住使用它，我们实验室开发了一种新颖的基于 iOS 的软件应用程序或“应用程序”，它提供交互式语音质量反馈（抖动和倒谱峰值突出值），提醒患者练习时，通过治疗记录模拟个性化练习，并记录所有练习以直接跟踪依从性（无需自我报告）。目的：该项目的目的是测试我们的移动应用程序在以下方面的功效：1）改善语音治疗结果；2）提高依从性和依从性的自我效能。策略：60 名被诊断患有内收发声功能亢进并被转介到辛辛那提大学语音诊所和埃默里语音中心接受共振发声治疗的成年人将被随机分配到以下两种情况之一：1）共振发声治疗辅以标准护理书面作业说明或 2) 共振语音治疗辅以移动语音治疗依从性应用程序。所有参与者都会在借用的 iPod 上记录他们的练习，但只有一半的人会收到该应用程序。为了目标 1、结果测量（VHI 评分、CAPE-V 录音的声学和感知分析）将在 4 次治疗之前和之后获得。对于目标 2，将检查患者自我记录和通过应用程序使用获得的记录的频率和持续时间的依从性。每周通过语音治疗自我效能量表跟踪自我效能。这两个目标的组间差异将通过 t 检验计算，并通过回归分析检查自我效能和依从性对结果的影响。意义：该项目将产生直接转化为临床语音护理的临床工具和研究结果，具有相关性跨越言语病理学干预，扩大依从性和运动学习的知识，并有可能在不增加成本的情况下提高声音治疗的疗效。