This is a feasibility and pilot study to refine and test LISTEN, an AI-based augmentative and alternative communication (AAC) smartphone app, integrated into the patient's personal electronic device, to augment and facilitate communication in patients with tumor-related aphasia (TRA) and their care partners. The study will assess the feasibility and acceptability of LISTEN in patients with TRA and their care partners.
The study will be conducted in three phases: (1) Refinement, (2) Pre-pilot, and (3) Open pilot feasibility study. In the Refinement phase, a functional prototype of LISTEN will be developed and iteratively refined with 10 patient-care-partner dyads (20 participants), stratified by tumor grade and illness stage. Usability will be assessed through think-aloud interviews, System Usability Scale (SUS), and qualitative exit interviews. The Pre-pilot phase will test LISTEN in real-world scenarios with 10 dyads, making final adjustments before the open pilot. The Open pilot will recruit 20 dyads (40 participants) to assess feasibility and acceptability using validated implementation measures (AIM, IAM, FIM). Participants will be followed for up to 16 weeks, with study visits occurring weekly to biweekly. Data will be collected and stored in REDCap, and participants will be compensated for their time. The study is minimal risk, with anticipated risks limited to emotional distress during interviews or technical difficulties with the app. The study is supported by Dana-Farber Cancer Institute and the Department of Defense.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
NONE
Enrollment
80
LISTEN is a smartphone app leveraging AI and large language models (LLMs) to support personalized, adaptive communication for individuals with tumor-related aphasia. The app is customized with user-specific information and deployed through mobile applications with voice input/output capabilities.
Brigham & Woman's Hospital
Boston, Massachusetts, United States
Dana-Farber Cancer Center
Boston, Massachusetts, United States
Usability of LISTEN Assessed by the System Usability Scale (SUS) [Phase 1]
Usability of the LISTEN prototype will be evaluated using the System Usability Scale (SUS) in patients with treatment-resistant anxiety (TRA) and their care partners. Participants will engage in think-aloud usability testing during daily communication scenarios, followed by completion of the SUS questionnaire after each session. The primary outcome is defined as a mean SUS score ≥70 across all participants, indicating acceptable usability.
Time frame: Up to 12 months (Phase 1 refinement period).
Acceptability of LISTEN Assessed by Acceptability of Intervention Measure (AIM) [Phase 2]
Acceptability of the LISTEN application will be evaluated using the AIM developed by Weiner et al. (2017) to assess participants' perceived acceptability of the intervention in real-world settings; the outcome is defined as a mean AIM score ≥4 across all participants based on a 5-point Likert scale (1 = completely disagree to 5 = completely agree), indicating favorable acceptability.
Time frame: Up to 24 months (pre-pilot study period).
Appropriateness of LISTEN Assessed by Intervention Appropriateness Measure (IAM) [Phase 2]
Appropriateness of the LISTEN application will be evaluated using the IAM developed by Weiner et al. (2017) to assess the perceived fit, relevance, and suitability of the intervention for the target population and context; the outcome is defined as a mean IAM score ≥4 across all participants based on a 5-point Likert scale (1 = completely disagree to 5 = completely agree), indicating favorable appropriateness.
Time frame: Up to 24 months (pre-pilot study period).
Feasibility of LISTEN Assessed by Feasibility of Intervention Measure (FIM) [Phase 2]
Feasibility of the LISTEN application will be evaluated using the FIM developed by Weiner et al. (2017) to assess the extent to which the intervention can be successfully used and implemented in real-world settings; the outcome is defined as a mean FIM score ≥4 across all participants based on a 5-point Likert scale (1 = completely disagree to 5 = completely agree), indicating favorable feasibility.
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Time frame: Up to 24 months (pre-pilot study period).
Acceptability of LISTEN Assessed by Acceptability of Intervention Measure (AIM) [Phase 3]
Acceptability of the LISTEN application will be evaluated of using AIM developed by Weiner et al. (2017) to assess participants' perceived acceptability of the intervention in real-world settings; participants will engage in a three-stage intervention (preparation, training, and testing at 4-week intervals), and the outcome is defined as a mean AIM score ≥4 across all participants based on a 5-point Likert scale (1 = completely disagree to 5 = completely agree), indicating favorable acceptability.
Time frame: At the end of the open pilot study (up to 48 months).
Appropriateness of LISTEN Assessed by Intervention Appropriateness Measure (IAM) [Phase 3]
Appropriateness of the LISTEN application will be evaluated using IAM developed by Weiner et al. (2017) to assess the perceived fit, relevance, and suitability of the intervention for the target population and context; participants will engage in a three-stage intervention (preparation, training, and testing at 4-week intervals), and the outcome is defined as a mean IAM score ≥4 across all participants based on a 5-point Likert scale (1 = completely disagree to 5 = completely agree), indicating favorable appropriateness.
Time frame: At the end of the open pilot study (up to 48 months).
Feasibility of LISTEN Assessed by Feasibility of Intervention Measure (FIM) [Phase 3]
Feasibility of the LISTEN application will be evaluated using FIM developed by Weiner et al. (2017) to assess the extent to which the intervention can be successfully used and implemented in real-world settings; participants will engage in a three-stage intervention (preparation, training, and testing at 4-week intervals), and the outcome is defined as a mean FIM score ≥4 across all participants based on a 5-point Likert scale (1 = completely disagree to 5 = completely agree), indicating favorable feasibility.
Time frame: At the end of the open pilot study (up to 48 months).
Sustained Use of LISTEN at 12 Weeks
Sustained use of LISTEN will be assessed as the proportion of patients reporting ongoing use of augmentative and alternative communication (AAC) at 12 weeks following intervention initiation. Feasibility is defined as ≥50% of patients demonstrating sustained use.
Time frame: At 12 weeks following intervention initiation.
Session Duration of LISTEN Use
Session duration will be assessed as the length of time participants interact with the LISTEN application during each use session
Time frame: During participant use throughout the study period (up to 48 months).
Task Completion Rate of LISTEN
Task completion rate will be assessed as the proportion of tasks successfully completed by participants during interactions with the LISTEN application.
Time frame: During participant use throughout the study period (up to 48 months).
Error Rate During LISTEN Use
Error rate will be assessed as the frequency of user errors encountered during interactions with the LISTEN application.
Time frame: During participant use throughout the study period (up to 48 months).
Qualitative Usability Themes Identified From Think-Aloud Protocols and Exit Interviews
Qualitative data from think-aloud protocols and exit interviews will be transcribed and analyzed using rapid thematic content analysis to identify usability themes and inform iterative refinement of the LISTEN application.
Time frame: At the end of each session and throughout the study period (up to 48 months).