Department of Occupational Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, PA, USA.
Department of Health Information Management, School of Health and Rehabilitation Sciences, University of Pittsburgh, PA, USA.
Disabil Rehabil Assist Technol. 2020 Nov;15(8):908-916. doi: 10.1080/17483107.2019.1629113. Epub 2019 Jun 19.
Telehealth affords rehabilitation professionals opportunities to expand access to intervention for people in rural areas. Complex interventions have not been adapted for remote delivery using mobile health technologies. Strategy training is a complex intervention that teaches clients skills for identifying barriers and solutions to engagement in meaningful activities. Our goal was to adapt the delivery of strategy training for remote delivery using mobile health technology. We conducted a sequential descriptive case series study ( = 5) in which community-dwelling participants with chronic stroke and prior exposure to strategy training used the iADAPTS mobile health application for 5 weeks. Expert practitioners advised revisions to the intervention process. Safety was assessed via monitoring occurrence of adverse events and risk for adverse events. Acceptability was assessed via the Client Satisfaction Questionnaire-8 (CSQ-8) and the Patient-Provider Connection Short Form of the Healing Encounters and Attitudes Lists (HEAL PPC). Revisions to the intervention process supported the delivery of strategy training using mobile health technology after stroke. No adverse events occurred and risk for adverse events was managed through the intervention process. Acceptability was high (CSQ-8, 25 to 32; HEAL PPC, 59.9 to 72.5). Strategy training can be adapted for delivery using mobile health technology, with careful consideration to methods for training participants on new technology and the intervention delivery. Future research should establish the efficacy and effectiveness of integrating mobile health in delivery of interventions that promote engagement in client-selected activities and community participation.Implications for rehabilitationTranslating the strategy training intervention from face-to-face to remote delivery required thoughtful adaptation of the intervention protocol.Strategies for training clients to use mobile health technology during intervention may be important when designing remotely delivered mHealth intervention protocols.Client safety should be considered within the design of the intervention protocol for a complex intervention designed to be delivered remotely.Future studies should examine the efficacy of complex rehabilitation interventions such as strategy training on clinical outcomes (e.g., community participation).
远程医疗为康复专业人员提供了机会,使他们能够为农村地区的人们扩大获得干预的机会。复杂的干预措施尚未通过移动健康技术适应远程提供。策略培训是一种复杂的干预措施,它教授客户识别参与有意义活动的障碍和解决方案的技能。我们的目标是通过移动健康技术为远程提供策略培训进行改编。我们进行了一项顺序描述性病例系列研究(n=5),其中患有慢性中风且之前接受过策略培训的社区居住参与者使用 iADAPTS 移动健康应用程序进行了 5 周的治疗。专家从业者提供了干预过程修订建议。通过监测不良事件的发生和不良事件的风险来评估安全性。通过客户满意度问卷-8(CSQ-8)和治疗经历和态度清单的患者-提供者连接简短形式(HEAL PPC)来评估可接受性。干预过程的修订支持了中风后使用移动健康技术进行策略培训的交付。没有发生不良事件,并且通过干预过程管理了不良事件的风险。可接受性很高(CSQ-8,25 到 32;HEAL PPC,59.9 到 72.5)。策略培训可以通过移动健康技术进行改编,需要仔细考虑培训参与者使用新技术和干预交付的方法。未来的研究应该建立将移动健康融入促进客户选择活动和社区参与的干预措施中的功效和有效性。
康复的意义
将策略培训干预从面对面转变为远程交付需要对干预方案进行深思熟虑的改编。
在设计远程提供的移动健康干预方案的协议时,培训客户使用移动健康技术的策略可能很重要。
在设计旨在远程提供的复杂干预方案的协议时,应考虑客户安全性。
未来的研究应该研究策略培训等复杂康复干预措施对临床结果(例如,社区参与)的疗效。