Mixed methods, single case design, feasibility trial of a motivational conversational agent for rehabilitation for adults with traumatic brain injury

Abstract

Objective Rehabilitation for adults with traumatic brain injury (TBI) incorporates client-centred goal-setting and motivational support to achieve goals. However, face-to-face rehabilitation is time-limited. New therapy approaches which leverage care are warranted. Conversational agents (CAs) offer a human–computer interface with which a person can converse. This study tested the feasibility, usability and acceptability of using a novel CA – RehabChat – alongside brain injury rehabilitation. Design Mixed methods, single case design, feasibility pilot trial. Setting Ambulatory and community brain injury rehabilitation. Participants Adults with TBI receiving brain injury rehabilitation and clinicians providing this care. Intervention Following 1:1 training, client–clinician dyads used RehabChat for two weeks alongside usual care. Main measures Pre-post clinical measures (Motivation for Traumatic Brain Injury Rehabilitation Questionnaire, Rehabilitation Therapy Engagement Scale, Brain Injury Rehabilitation Trust Motivation Questionnaire-Relative, Brain Injury Rehabilitation Trust Motivation Questionnaire-Self) repeated measures (Hospital Anxiety and Depression Scale, researcher-developed wellbeing screening questions); and post-intervention (System Usability Scale (SUS), semi-structured 1:1 interview). Results Six participants (two clients and four clinicians) completed training. Two client–clinician dyads completed the intervention. Two other clinicians used RehabChat in a mock client–clinician session. SUS scores indicated good usability. Client well-being did not deteriorate. No adverse events were experienced. Interviews indicated RehabChat was feasible, acceptable and easy to use; and supported motivation, goal-setting and completing practice activities. Conclusions RehabChat was feasible and acceptable to use alongside usual ambulatory and community brain injury rehabilitation, had good usability and supported client needs. Further testing of RehabChat with a larger cohort for longer duration is warranted.