Development of an mHealth Application for Self-Management of Post-Stroke Aphasia: Protocol for Experience-Based Co-Design, User Experience Testing, Feasibility Field Test and Process Evaluation

Background: Speech and language therapy for post-stroke aphasia (language/communication impairment) improves language and communication in the short-term; however, access to therapy is limited, and effects are not always maintained. Mobile Health (mHealth) applications may support long-term therapy access and maintenance of gains. We present a protocol for the co-design and evaluation of a novel mHealth application for self-managed aphasia therapy. Methods: An mHealth application will be developed using Experience-Based Co-Design and Human-Centred Design with people with aphasia (PWA), significant others (SO) and health professionals (HPs). Focus groups will explore self-management experiences and establish co-design priorities using the nominal group technique (n = 10–15 each group). The prototype will be co-designed in eight workshops (n = 4 each group) and evaluated via adapted user-experience (UX) testing. UX testing will use pluralistic walk-throughs, think-aloud evaluations and measures of satisfaction (SUS) and acceptance/intended use (UTAUT-2) (PWA n = 10, SO n = 5, HP n = 10). Feasibility and preliminary efficacy (primary outcomes of treatment adherence and goal attainment) will be assessed through a 4-week field test, followed by focus groups (PWA and SO, n = 20 each). A process evaluation will assess factors influencing (1) the process and outcomes of research involvement, and (2) the functioning and acceptability of the prototype application. Discussion: Outcomes will include a prototype co-designed mHealth application for self-management of post-stroke aphasia and evidence of acceptability, usability and preliminary efficacy. The process evaluation will increase understanding of the adjustments required to support meaningful participation of PWA in co-design, and future directions for application development and scale-up. WHAT THIS PAPER ADDS: What is already known on this subject mHealth apps can assist self-management through personalised goals, interactive support and in-the-moment feedback. What this paper adds to existing knowledge This paper describes the protocol for the co-design and evaluation of a novel mHealth application for self-managed post-stroke aphasia treatment (AphasiaFit). What are the potential or actual clinical implications of this work? The outcome of our research will be a co-designed mHealth application for self-managed post-stroke aphasia treatment. Clinical implementation of this application may increase access and adherence to aphasia therapy in the chronic phase of stroke recovery.