A mHealth application to identify cognitive communication disorder after right hemisphere stroke: development and beta testing

Background: More than 50% of individuals admitted to hospital with a right hemisphere (RH) stroke may present with a cognitive communication disorder (CCD). However, there is a critical absence of evidence-based screening tools available for speech-language pathologists (SLPs) to identify this disorder. We developed and beta tested a new mobile health (mHealth) application to screen for CCD after an RH stroke, the Right Hemisphere Cognitive Communication Screener (RECOGNISE). Methods: Participants with RH stroke and SLPs evaluated RECOGNISE, accessible via an Android operating system. Both participant groups completed user acceptance surveys. Results: Six participants with RH stroke and three SLPs beta tested RECOGNISE. All participants with RH stroke reported that RECOGNISE was easy and enjoyable to use. Qualitative content analysis revealed three main themes: content of test items, user interface and accessibility. SLPs identified several positive features of RECOGNISE including its evidence-based grounding, capabilities unique to the app and ability to engage patients. User interface issues included challenges with app navigation, layout of images, and scoring inconsistencies. Conclusions: RECOGNISE is the first mHealth application developed to identify CCD after RH stroke. Findings suggest that with some user interface improvements, RECOGNISE has the potential to offer SLPs with an evidence-based tool to screen for CCD after RH stroke. Future research will establish the reliability and validity of RECOGNISE.