Effectiveness of Telepractice by Smartphone App Technology in Preventing Voice Problems

Study Overview
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Brief Summary
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Voice disorders in teachers have a significant impact on communication, quality of life, and economic costs to the healthcare system. We need to advance the prevention of voice disorders in teachers by testing an online telepractice model with synchronous (in real-time) and asynchronous (stored and accessed later) methods. The current study will investigate the effectiveness of the theoretically-driven Global Voice Prevention Model (GVPM) delivered by two methods; 1) online telepractice (synchronous and asynchronous) and 2) traditional, in-person for vocally healthy physical education and vocal music student teachers. Effectiveness of the model will be assessed by voice-related measures captured daily on a smartphone app during student teaching, matching the asynchronous aspects of the telepractice model and representing the effects of vocal loading from teaching.

Official Title
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Effectiveness of Telepractice by Smartphone App Technology in Preventing Voice Problems

Conditions
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Prevention of Voice Disorders in Student Teachers

Intervention / Treatment
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* Behavioral: Telepractice Global Voice Prevention Model
* Behavioral: In-person Global Voice Prevention Model
* Behavioral: Telepractice, Vocal Hygiene and Vocal Education


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: senior at West Chester University as of fall 2016 and fall 2017, student teaching during spring 2017 or 2018, healthy voice user, owns a smartphone Exclusion Criteria: -

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 60 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Behavioral: Telepractice Global Voice Prevention Model<br>Participants will complete the Global Voice Prevention Model (GVPM) through West Chester University's Desire 2 Learn (D2L) software program. Synchronous and asynchronous learning opportunities are provided through D2L over a four week period. The GVPM includes vocal hygiene, vocal education, and vocal training. | Behavioral: Telepractice Global Voice Prevention Model<br> <br> |
| Experimental: Behavioral: In-person Global Voice Prevention Model<br>Participants will complete the Global Voice Prevention Model (GVPM) at West Chester University in-person. The GVPM will meet for 2 hours once a week for four weeks. The GVPM includes vocal hygiene, vocal education, and vocal training. | Behavioral: In-person Global Voice Prevention Model<br> <br> |
| Sham Comparator: Behavioral: Telepractice, Vocal Hygiene and Vocal Education<br>Participants will complete Vocal Hygiene and Vocal Education through West Chester University's Desire 2 Learn (D2L) software program. Asynchronous learning opportunities are provided through D2L over a one week period. | Behavioral: Telepractice, Vocal Hygiene and Vocal Education<br> <br> |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Presence and frequency of a voice problem | Question will be asked twice a day before and after teaching. | AM (before teaching) and PM (after teaching) 5 days a week for up to 3 months. | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Acoustic: fundamental frequency | Participants will record sustained aaaahhh, we were away a year ago, and describe their voice for 15 seconds twice a day before and after teaching. | AM (before teaching) and PM (after teaching) 5 days a week for up to 3 months. | 
| Acoustic: standard deviation of fundamental frequency | Participants will record sustained aaaahhh, we were away a year ago, and describe their voice for 15 seconds twice a day before and after teaching. | AM (before teaching) and PM (after teaching) 5 days a week for up to 3 months. | 
| Acoustic: jitter% | Participants will record sustained aaaahhh, we were away a year ago, and describe their voice for 15 seconds twice a day before and after teaching. | AM (before teaching) and PM (after teaching) 5 days a week for up to 3 months. | 
| Acoustic: shimmer% | Participants will record sustained aaaahhh, we were away a year ago, and describe their voice for 15 seconds twice a day before and after teaching. | AM (before teaching) and PM (after teaching) 5 days a week for up to 3 months. | 
| Acoustic: cepstral peak prominence | Participants will record sustained aaaahhh, we were away a year ago, and describe their voice for 15 seconds twice a day before and after teaching. | AM (before teaching) and PM (after teaching) 5 days a week for up to 3 months. | 
| Perceptual: Voice Handicap Index | Quality of life questions. | AM (before teaching) and PM (after teaching) 5 days a week for up to 3 months. | 
| Perceptual: Vocal Fatigue Index | Vocal fatigue questions | AM (before teaching) and PM (after teaching) 5 days a week for up to 3 months. | 
| Perceptual: perceptions of voice | Perceptions of voice based on the Consensus-auditory Perceptual Evaluation of Voice. | AM (before teaching) and PM (after teaching) 5 days a week for up to 3 months. | 
| Aerodynamic: sustained aaaaahhhhh | Participants will say aaaaahhhh as long as they can to determine how well they are managing airflow with phonation twice a day before and after teaching. | AM (before teaching) and PM (after teaching) 5 days a week for up to 3 months. | 
| Aerodynamic: s/z ratio | Participants will say s and z as long as they can to determine how well they are managing airflow with phonation twice a day before and after teaching. | AM (before teaching) and PM (after teaching) 5 days a week for up to 3 months. |