R2 Determining the efficacy of a mobile telerehabilitation portal for delivery of cognitive and vocational rehabilitation
The overall goal of this task will be to implement the mobile TR applications, developed over the first two years of the RERC under D1, using single case study design to document functional outcomes in remote rehabilitation services across three activities: 1) applied cognitive rehabilitation (ACR); 2) Follow-up Cognitive Rehabilitation/Case Management, and 3) job coaching. We chose these three activities because they represent specific, real rehabilitation activities with limited resources under current face-to-face modalities, and may be better served by a TR application. This will include a curriculum educating participants on brain health and cognitive function, guided assessments of their environment and their everyday function to identify current obstacles, serve as a substrate for a variety of cognitive accommodations, and provide options to identify and track personal goals, progress toward them.
Single Case Study Design
Expected Findings and Deliverables:
- A 12-week manualized course of cognitive rehabilitation that can be delivered remotely via a mobile smartphone application that connects to our web-based TR portal infrastructure, including:
- A curriculum educating participants on brain health and cognitive function
- Guided assessments of their environment and their everyday function to identify current obstacles
- A substrate for a variety of cognitive accommodations
- Options to identify and track personal goals, progress toward them
- A smartphone application that will allow the cognitive rehabilitation therapists to maintain ongoing communication with their clients. The application will:
- Integrate a variety of client-specific strategies
- Allow the therapist to monitor and track client progress and modify strategies to improve client function
- A smartphone application that will support individuals as they return to volunteer or competitive employment settings by providing remote rather than onsite job coaching services, including:
- Reminders of tasks “pushed” from the portal to the participant
- Storage and retrieval of auditory or written scripts to redirect or calm a participant in a challenging interpersonal situation at work
- Interactive checklists to guide the individual in initiating and completing routine work activities
- More complex visual or verbally mediated “decision trees” to help the individual problem-solve on the job
Once the change in time frames was approved, moving up the start date of R2 to 10/1/2010, we initiated work on this project. The methodology and approach have been finalized for Study 1. The study involves three separate, but interrelated research protocols to evaluate the usability, reliability, and efficacy of telerehabilitation for the delivery of cognitive rehabilitation. In order to establish a baseline efficacy of a cognitive rehabilitation protocol, a study will be conducted to evaluate the efficacy of a 15-week Ecologically Oriented Rehabilitation of Memory (EON-MEM) protocol. Clinical usability, accessibility, and standardization will be assessed through participatory development and cognitive walkthroughs designed to evaluate the functionality of the telerehabilitation portal. A quasi experimental study in which participants are stratified into a treatment group and matched to a no-contact control group will evaluate the efficacy of telerehabilitation for the delivery of the 15-week EON-MEM.
We are currently developing the IRB for this study.
This project is not scheduled to begin until Year 3 of the award