Tarrant Mark, Carter Mary, Dean Sarah Gerard, Taylor Rod, Warren Fiona C, Spencer Anne, Adamson Jane, Landa Paolo, Code Chris, Backhouse Amy, Lamont Ruth A, Calitri Raff
Institute of Health Research, College of Medicine and Health, University of Exeter, Exeter, UK
Institute of Health Research, College of Medicine and Health, University of Exeter, Exeter, UK.
BMJ Open. 2021 Jan 13;11(1):e040544. doi: 10.1136/bmjopen-2020-040544.
Pilot feasibility randomised controlled trial (RCT) for the singing groups for people with aphasia (SPA) intervention to assess: (1) the acceptability and feasibility of participant recruitment, randomisation and allocation concealment; (2) retention rates; (3) variance of continuous outcome measures; (4) outcome measure completion and participant burden; (5) fidelity of intervention delivery; (6) SPA intervention costs; (7) acceptability and feasibility of trial and intervention to participants and others involved.
A two-group, assessor-blinded, randomised controlled external pilot trial with parallel mixed methods process evaluation and economic evaluation.
Three community-based cohorts in the South-West of England.
Eligible participants with post-stroke aphasia were randomised 1:1 to SPA or control.
The manualised SPA intervention was delivered over 10 weekly singing group sessions, led by a music facilitator and assisted by an individual with post-stroke aphasia. The intervention was developed using the Information-Motivation-Behavioural skills model of behaviour change and targeted psychosocial outcomes. Control and intervention participants all received an aphasia information resource pack.
Collected at baseline, 3 and 6 months post-randomisation, candidate primary outcomes were measured (well-being, quality of life and social participation) as well as additional clinical outcomes. Feasibility, acceptability and process outcomes included recruitment and retention rates, and measurement burden; and trial experiences were explored in qualitative interviews.
Of 87 individuals screened, 42 participants were recruited and 41 randomised (SPA=20, control=21); 36 participants (SPA=17, control=19) completed 3-month follow-up, 34 (SPA=18, control=16) completed 6-month follow-up. Recruitment and retention (83%) were acceptable for a definitive RCT, and participants did not find the study requirements burdensome. High fidelity of the intervention delivery was shown by high attendance rates and facilitator adherence to the manual, and participants found SPA acceptable. Sample size estimates for a definitive RCT and primary/secondary outcomes were identified.
The SPA pilot RCT fulfilled its objectives, and demonstrated that a definitive RCT of the intervention would be both feasible and acceptable.
NCT03076736.
开展一项针对失语症患者歌唱小组干预措施(SPA)的初步可行性随机对照试验(RCT),以评估:(1)参与者招募、随机分组和分配隐藏的可接受性与可行性;(2)保留率;(3)连续结局指标的方差;(4)结局指标的完成情况及参与者负担;(5)干预实施的保真度;(6)SPA干预成本;(7)试验及干预措施对参与者和其他相关人员的可接受性与可行性。
一项两组、评估者盲法的随机对照外部初步试验,同时进行平行混合方法过程评估和经济评估。
英格兰西南部的三个社区队列。
符合条件的中风后失语症患者按1:1随机分为SPA组或对照组。
标准化的SPA干预通过每周10次歌唱小组课程实施,由一名音乐引导员带领,并由一名中风后失语症患者协助。该干预措施依据行为改变的信息 - 动机 - 行为技能模型制定,目标是心理社会结局。对照组和干预组参与者均收到一份失语症信息资源包。
在基线、随机分组后3个月和6个月收集数据,测量候选主要结局指标(幸福感、生活质量和社会参与度)以及其他临床结局指标。可行性、可接受性和过程结局指标包括招募率和保留率以及测量负担;并通过定性访谈探索试验体验。
在87名筛查个体中,42名参与者被招募,41名被随机分组(SPA组 = 20名,对照组 = 21名);36名参与者(SPA组 = 17名,对照组 = 19名)完成了3个月随访,34名(SPA组 = 18名,对照组 = 16名)完成了6个月随访。对于一项确定性RCT而言,招募和保留率(83%)是可接受的,且参与者未觉得研究要求繁重。高出席率和引导员对手册的依从性表明干预实施具有高保真度,且参与者认为SPA是可接受的。确定了确定性RCT的样本量估计以及主要/次要结局指标。
SPA初步RCT实现了其目标,并表明该干预措施的确定性RCT将既可行又可接受。
NCT03076736。