DESCRIPTION (provided by applicant): The proposed study addresses the prevention of voice disorders in vocally healthy student teachers through telepractice methods. To date, the majority of telepractice methods have facilitated synchronous (i.e., in real-time) clinician-client
interactions via videoconferencing. Results of such applications have indicated positive treatment outcomes similar to traditional in-person methods. Asynchronous methods (i.e., store and access later) have been used minimally as a way to supplement in-person services or to validate and record synchronous encounters. No prior work has tested a telepractice model, using a combination of synchronous and asynchronous methods, delivered totally online with no in-person interactions. In addition, no prior work has investigated the effects of such a model through smartphone application (app) technology. Consistent with the NIDCD's strategic plan to improve prevention of voice disorders and to develop telepractice and emerging technology platforms, this proposal addresses critical needs by testing an online telepractice model through a smartphone app. The current proposal is conducted within the context of a long-range goal to create and test novel delivery methods for the prevention, assessment, and treatment of voice disorders. Voice disorders appear to be the most common communication disorder across the lifespan and are more prevalent in professional voice users who depend on their voice for work, such as teachers. Physical education (PE) and vocal music (VM) teachers are at a higher risk for reporting voice disorders as compared with other teachers and student teachers also reported a high prevalence of voice complaints as compared with same age peers who were not teaching. The present proposal will advance prevention of voice disorders through an innovative online telepractice model aimed at student teachers in high-risk specialties, such as PE and VM. The proposed study will test the effectiveness of the theoretically-driven Global Voice Prevention Model (GVPM) delivered by two methods; 1) online telepractice, and 2) traditional in-person. Effectiveness will be assessed by voice-related measures captured daily on a smartphone app, matching the asynchronous aspects of the telepractice model and representing the effects of vocal loading from teaching. The central aims are: 1) to finalize the parameters of the smartphone app to maximize the sequence of the measures, user interface, data storage on the web portal, and automation scripts during testing with pilot participants (year
one); and 2) to compare the effectiveness of a telepractice GVPM, in-person GVPM, and control condition for preventing voice problems in vocally healthy PE and VM student teachers during student teaching by voice-related measures captured on a smartphone app. The results will be useful at a practical level by advancing telepratice and by improving clinical outcomes research for the prevention of voice disorders. In addition, the results will lay the groundwork for future studies involving long-term follow-up data of teachers beyond student teaching and testing an online telepractice method for voice treatment with data collection measures via the app.
