Communication partner training with familiar partners of people with aphasia: A systematic review and synthesis of barriers and facilitators to implementation

Abstract

Background: Factors influencing the implementation of communication partner training (CPT) with familiar partners of people with aphasia (PWA) have previously been documented using disparate approaches. To date there has been no synthesis of these factors using a common theoretical framework. Investigating CPT implementation factors using a common theoretical framework may further our understanding of universal barriers and guide future development of tailored, theoretically informed implementation strategies. Aims:(1) To determine the perceived and/or observed barriers and facilitators to implementing CPT with familiar partners of adults with aphasia; (2) to map extracted barriers and facilitators to a common theoretical framework;(3) to synthesize extracted barriers and facilitators; and (4) to identify potential implementation strategies to address the most frequently identified barriers and facilitators. Methods & Procedures: A systematic review was conducted in accordance withPreferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Four electronic databases (MEDLINE, EMBASE, CINAHL, Web of Science) were systematically searched in April 2021. Empirical qualitative and/or quantitative research studies reporting barriers/facilitators to speech-language therapists (SLTs) implementing CPT with familiar partners of adults with aphasia were included. The search was limited to English or French articles with no date limit applied. Methodological quality of included studies was assessed using the Mixed-Methods Appraisal Tool (MMAT). A framework and content analysis was then conducted to extract and synthesize the implementation factors in alignment with the Theoretical Domains Framework (TDF), followed by a theoretically informed mapping exercise to identify potential implementation strategies.

The role of education, concept knowledge, work setting and clinical experience in communication partner training: A survey of Flemish speech and language therapists

“…Furthermore, both groups reported lack of resources and material, setting‐dependent factors and PWA‐ or CP‐dependent factors as barriers, which are also mentioned in the review by Shrubsole et al. (2022). However, the lack of resources and material in the present study (38.78%, Table 3) was remarkably lower than in the study by Chang et al.…”

“… Note : Categorisation of the barriers according to the Theoretical Domains Framework as described by Shrubsole et al. (2022) is presented between square brackets.…”

“…This classification was based on both the TDF and the examples provided in Shrubsole et al. (2022). It should be noted that in Flanders CPT as a term is not commonly used.…”

“…Barriers to both CPT delivery and non-delivery were classified by the first author in keeping with the TDF and other relevant domains not included in TDF. This classification was based on both the TDF and the examples provided in Shrubsole et al (2022). It should be noted that in Flanders CPT as a term is not commonly used.…”

“…A recent review and synthesis of barriers and facilitators to CPT implementation has mapped barriers and facilitators onto eight domains of the Theoretical Domains Framework (TDF; environmental context and resources; social influences; beliefs about consequences; skills; memory, attention and decision‐making; knowledge; beliefs about capabilities; and reinforcement) as a basis to develop theoretically informed implementation strategies for CPT (Shrubsole et al., 2022). These findings are of uttermost importance for the field of CPT, since theory‐informed implementation can reduce the practice–evidence gap.…”