The “Better Conversations with Parkinson’s” programme: protocol for a feasibility study of communication partner training delivered via telehealth for people living with Parkinson’s (Preprint)

Abstract

BACKGROUND Parkinson’s can impact on people’s speech, cognition, pragmatics and language, therefore significantly affecting conversation with others. The speech and language therapy approach Communication Partner Training (CPT) is effective for a range of communication difficulties. However, speech and language therapy intervention for people with Parkinson’s predominantly focuses on impairments, with little provision of CPT for this population. Better Conversations is a CPT approach that involves working with a dyad (the person with the communication difficulty and a conversation partner) to build conversation skills. It is effective at reducing barriers to conversation, and for some it significantly increases targeted facilitatory strategies. Some approaches to CPT have been adapted to be delivered via telehealth. This can maximise ecological validity and convenience. Furthermore, telehealth is widely acceptable as a delivery method for other interventions in Parkinson’s. This paper presents the protocol for a pilot feasibility study of a Better Conversations CPT delivered via telehealth to people living with Parkinson’s and their conversation partners (CPs) called Better Conversations with Parkinson’s (BCP). OBJECTIVE The primary aim is to evaluate the feasibility of the BCP programme delivered via telehealth with a treatment group from a collaborating NHS site, to establish for a main trial whether BCP can be delivered as intended in an NHS setting. The aim is to establish: • the acceptability of the programme for people living with Parkinson’s, family members, and speech and language therapists (SLTs) • the feasibility of delivering the BCP programme • recruitment and retention rates • preliminary outcomes for participants • a sample size calculation • the most appropriate primary outcome measure METHODS Ethical approval for this study was obtained from London – Central Research Ethics Committee (reference: 22/LO/0332). This case series feasibility pilot study will recruit 10-12 dyads to ensure 10 complete datasets. Participants will be recruited by a collaborating NHS site, located in England. Participants will be involved for 16 weeks (weeks 1-2 pre-intervention measures; weeks 3-8 intervention; weeks 10 – 12 post-intervention measures; week 16 follow up interview). Quantitative and qualitative methods will be used to analyse study data. Speech, communication and quality of life assessment data will be analysed statistically to determine a suitably sensitive outcome measure. Descriptive statistics will be used to report on recruitment, attendance and attrition. Finally, acceptability and feasibility will be evaluated using participant feedback, interviews and the reflective diary and feedback of the SLT administering the therapy (the research assistant/ first author). This data will be analysed using descriptive statistics and reflexive thematic analysis. RESULTS This study was approved for funding from Parkinson’s UK. Study recruitment commenced in July 2022. The results of data analysis are expected to be available by September 2023. CONCLUSIONS Insights from this study will provide valuable information about the acceptability and feasibility of a remotely-delivered Better Conversations CPT approach for people living with Parkinson’s and their CPs. An outcome of this study will be a manualised BCP programme coproduced by people living with Parkinson’s, their families, and a group of expert SLTs. The study results will guide the next stages of intervention development.