Background 

Currently there are 165,761 people in Canada living with aphasia today. The Aphasia and Communication Disabilities Program (ACDP) is a therapeutic and social group program for adults offered by March of Dimes Canada. Treating patients with communication challenges in a group setting has been in practice for many decades. Many experts argue it is as effective as individual speech therapy. Continued quality improvement in care is determined by the evaluation of community based interventions like ACDP. A comprehensive program evaluation of ACDP was undertaken from August 2017 to May 2018. 

Methods 

The areas targeted for evaluation were narrowed to five domains; pre-existing clinical evidence, program cost, functional improvement and well-being of patients, expectations and needs of patients/families and current staff/volunteer perspectives on program functions. 
 
A comprehensive literature review and two communicatively accessible questionnaires were developed based on the Life Participation Approach to Aphasia (LPAA)/Aphasia Framework for Outcomes Measurements (A-FORM) and the RYFF Scales of Psychological Well-Being. In addition, four focus groups and an online questionnaire were used to asses all four populations (patients, caregivers, volunteers and staff).

Results

Patients self-reported improvement in all four LPAA domains -  language and related impairments (84%), personal identity/attitude/feelings (80%), communication and language environment (74%) and participation in life situations (70%). Areas identified for continued quality improvement were as follows– administrative support, physical exercise, caregiver support, tools for staff and opportunities for peer support.

Conclusions 

Understanding self-reported outcomes and consistently targeting quality improvement are essential in community interventions – particularly ones with challenging populations that are under-researched.

The importance of self-reported outcomes and continued quality improvement: Aphasia and Communication Disabilities Program - A Program Evaluation.