Predicting and Influencing Voice Therapy Adherence Using Social–Cognitive Factors and Mobile Video Purpose Patient adherence to voice therapy is an established challenge. The purpose of this study was (a) to examine whether adherence to treatment could be predicted from three social–cognitive factors measured at treatment onset: self-efficacy, goal commitment, and the therapeutic alliance, and (b) to test whether the provision of clinician, ... Research Article
Research Article  |   May 01, 2015
Predicting and Influencing Voice Therapy Adherence Using Social–Cognitive Factors and Mobile Video
 
Author Affiliations & Notes
  • Eva van Leer
    Georgia State University, Atlanta
  • Nadine P. Connor
    University of Wisconsin–Madison
  • Disclosure: The authors have declared that no competing interests existed at the time of publication.
    Disclosure: The authors have declared that no competing interests existed at the time of publication.×
  • Correspondence to Eva van Leer: eva.van.leer@gmail.com
  • Editor: Jody Kreiman
    Editor: Jody Kreiman×
  • Associate Editor: Rebecca Leonard
    Associate Editor: Rebecca Leonard×
Article Information
Speech, Voice & Prosodic Disorders / Voice Disorders / Speech, Voice & Prosody / Research Articles
Research Article   |   May 01, 2015
Predicting and Influencing Voice Therapy Adherence Using Social–Cognitive Factors and Mobile Video
American Journal of Speech-Language Pathology, May 2015, Vol. 24, 164-176. doi:10.1044/2015_AJSLP-12-0123
History: Received September 18, 2012 , Revised March 17, 2013 , Accepted October 23, 2014
 
American Journal of Speech-Language Pathology, May 2015, Vol. 24, 164-176. doi:10.1044/2015_AJSLP-12-0123
History: Received September 18, 2012; Revised March 17, 2013; Accepted October 23, 2014
Web of Science® Times Cited: 7

Purpose Patient adherence to voice therapy is an established challenge. The purpose of this study was (a) to examine whether adherence to treatment could be predicted from three social–cognitive factors measured at treatment onset: self-efficacy, goal commitment, and the therapeutic alliance, and (b) to test whether the provision of clinician, self-, and peer model mobile treatment videos on MP4 players would influence the same triad of social cognitive factors and the adherence behavior of patients.

Method Forty adults with adducted hyperfunction with and without benign lesions were prospectively randomized to either 4 sessions of voice therapy enhanced by MP4 support or without MP4 support. Adherence between sessions was assessed through self-report. Social cognitive factors and voice outcomes were assessed at the beginning and end of therapy. Utility of MP4 support was assessed via interviews.

Results Self-efficacy and the therapeutic alliance predicted a significant amount of adherence variance. MP4 support significantly increased generalization, self-efficacy for generalization, and the therapeutic alliance. An interaction effect demonstrated that MP4 support was particularly effective for patients who started therapy with poor self-efficacy for generalization.

Conclusion Adherence may be predicted and influenced via social–cognitive means. Mobile technology can extend therapy to extraclinical settings.

Acknowledgments
This work was supported in part by National Institute on Deafness and Other Communication Disorders Grant F31DC009526, awarded to the first author (Eva van Leer). We are indebted to Glen Leverson for statistical support.
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