Usage and Feasibility of Web Applications in Speech‐Language Therapy: Insights from the Communication Bridge 2 Trial for Primary Progressive Aphasia
Bibliographic record
Abstract
BACKGROUND: Primary Progressive Aphasia (PPA) is a clinical dementia syndrome characterized by progressive language decline. Access to care for individuals living with PPA is limited by a shortage of evidence-based interventions and qualified clinicians. While technology-supported approaches show promise in improving access to care, there has been no systematic exploration of the factors affecting web application use in this population. This study evaluated the usage and feasibility of an app-based intervention through quantitative application engagement data and qualitative insights from semi-structured post-study interviews. METHOD: Participants enrolled in Communication Bridge-2 (NCT03371706, n = 95), a 12-month NIH stage 2 randomized controlled trial of speech-language therapy for PPA, were encouraged to complete app-based home practice exercises five days per week for 30 minutes per day. Usage was measured by weekly logins and completed home practice exercises. Feasibility was assessed through semi-structured post-study interviews (PSI; n = 79). Multi-methods analysis incorporated descriptive statistics and thematic coding of qualitative data. RESULT: On average, participants logged into the app 5.88 times per week (SD=1.29, range 1.29-18.90) to access exercises and educational materials across the ∼12-month duration of the intervention. On average, users completed 13.7 home practice exercises (SD=5.95) across 3.99 days per week (SD=1.19). PSI dyadic reports indicated few technical challenges with the application (n = 76, 85%) with the most common issues including software updates (n = 12) or connectivity problems (n = 10). Most (n = 80, 90%) found the computer-based format helpful, and many (n = 26, 29%) described the app as user-friendly and intuitive after initial training. Participants highlighted the app's role in fostering confidence and motivation for home communication practice. CONCLUSION: This study demonstrates high usage and feasibility of web applications to support communication and language intervention in PPA. Importantly, all participants logged into the app and completed home practice exercises at least weekly. Most participants experienced minimal technical challenges and found the web-based format easy to use following a brief technology orientation. These findings challenge assumptions about technology use in older adults with cognitive-communication impairments and provide support for web applications as viable tools for supporting evidence-based speech-language home practice exercises and educational videos to individuals with PPA and their communication partners.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.023 | 0.047 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".