Using a Motivational RehabChat App for Brain Injury Rehabilitation

This study incorporates a chatbot app intervention – RehabChat – which is used alongside usual brain injury rehabilitation care by client-clinician dyads to support goal-setting and goal pursuit. RehabChat has been co-designed with clients with brain injury, and with clinicians providing brain injury rehabilitation. The software platform for RehabChat is the Virtual Human platform by Clevertar Pty Ltd. All data collected by RehabChat is securely stored by Clevertar. RehabChat is an adjunct tool which helps clients achieve their rehabilitation goals and complete their practice activities by providing personalised reminders and motivational cues in-between structured therapy appointments. Early results from previous work suggest that RehabChat supports client motivation and therapy engagement. RehabChat is used on a computing device (for example an iPad or laptop) and provides a human-computer interface with which a person can converse. The User Interface includes on the left side a human-like avatar on the left side, and text bubbles for the conversation dialogues the right side. The avatar speaks each dialogue, and the client types or clicks options to enter their responses. RehabChat is used by the client-clinician dyad at weekly appointments to enter in and update key rehabilitation content for the client’s needs (including goals, practice activities, and symptom checks). The client also uses RehabChat independently in-between appointments for reminders and motivation about their rehabilitation goals and practice activities. The content of RehabChat is delivered as an interactive conversation, with the avatar explaining points and asking questions, and the client entering answers in response. There are two RehabChat Modules – a Training Module (completed by the participant during initial 1:1 training facilitated by the researcher), and a Rehabilitation Module (completed by a client-clinician dyad alongside usual care). The Training Module conversation is about simple topics of the weather, and of travelling in one’s local area. This Module has two parts: the first part is completed with researcher providing support and cues as needed to assist learning; and the second part is completed independently by the participant, to ensure they feel confident using RehabChat. The Rehabilitation Module focuses on goal-setting, completing prescribed practice activities in-between weekly appointments, progress reviews etc. The client-clinician dyad work through the Rehabilitation Module alongside at weekly appointments, and the client uses RehabChat independently in-between appointments. RehabChat can be used as an adjunct intervention in varied brain injury rehabilitation contexts including outpatients, home and community services, tele-rehabilitation, and inpatient care. The intended end-users for our work are adult clients with brain injury or stroke, and clinicians who provide rehabilitation care for these clients. In the current project, participants receive 1:1 training to learn to use RehabChat. The 1:1 training session lasts approximately one hour and includes the following: an overview discussion of how RehabChat is used alongside usual care; a RehabChat User Guide is provided and explained; the participant completes the RehabChat Training module. The participant can repeat the Training Module as many times as they like until they feel confident using the RehabChat software platform. After the participant has completed the 1:1 training, the participant then chooses if they would like to use RehabChat alongside usual rehabilitation care for any duration up to a maximum of six weeks. The intervention duration is determined by the client-clinician dyad. This project will recruit from governance-approved settings (private and NGO settings, and public hospitals), and additional approvals will be obtained for recruitment from other public health services to expand recruitment over the data collection period. The intended sample size is 12-20 client-clinician dyads. All participants will complete an informed consent process. Individuals who do not consent to use RehabChat will not be included in this study. The aims of this study are to appraise the feasibility, acceptability, and usability of using RehabChat alongside usual brain injury rehabilitation care. We will gather quantitative outcome measures data and qualitative interview data. Additionally, we will extract usage data from the software portal for the Rehabilitation Module with these data categories including duration of use; and which sections of RC were completed e.g. weekly reviews (at appointments), and doing practice activities (independent use between appointments). The findings of this study will inform about any needed design updates for RehabChat, and the development of a larger randomised controlled trial.