Background:
Parkinson's disease (PD) is one of the two most common neurodegenerative diseases affecting
millions worldwide. PD research generally focuses on motor functioning and calls for more
psychosocial interventions for people with Parkinson's disease (PWP).
The proposed VIPA intervention is an artificial intelligent personal assistant commonly used
within Western society but not Asian countries, facilitating users' daily living by
performing audio calls, messaging, and information searching. Recent literature showed VIPA
Implementation is promising for rehabilitation in older adults but warrants more
interventional studies to examine its efficacy and if it applies to other illnesses.
Therefore, this study will formulate a positive health-orientated VIPA intervention protocol
and investigate its efficacy in promoting PWP's sense of coherence and psychosocial
well-being.
Objectives of the study:
This is a 2-phase study, and the objectives are:
Phase 1:
To develop and validate the VIPA user protocol.
To examine the feasibility of the VIPA intervention.
Phase 2:
To investigate the preliminary efficacy of the VIPA intervention on PWP's SOC
To explore the users' experience of VIPA intervention among PWP.
Method:
Phase 1: 3 semi-structured focus group interviews will be held to generate items in user
protocol. Another 3 cognitive interviews will be held with PWP to test the face validity and
feasibility of the user protocol. 5 healthcare and information technology experts will then
be invited to assess the content validity of the protocol. Any item with an item content
validity index (i-CVI) score lower than 0.78 will be discarded or revised.
Phase 2: 60 participants will be randomized into the intervention group (IG) and control
group (CG). During the 8-week intervention period, IG participants will receive the user
protocol, a designated VIPA, a 30-minute VIPA training on day 1, and weekly technical support
phone calls. CG participants will receive usual care (no intervention will be provided to CG
participants), and they will continue their daily life during the intervention period. The
13-item Sense of Coherence Scale (SOC-13) will be set as the primary outcome, and secondary
outcomes are: 1. University of California, Los Angeles (UCLA) three-item loneliness scale; 2.
Parkinson's Disease Questionnaire (PDQ-8); 3. EuroQol-5 dimension-5 level; 4. Mental Health
Continuum Short Form; 5. System Usability Scale; 6. Brief Resilient Coping Scale; 7. Montreal
Cognitive Assessment; and 8. Self-report VIPA usage.
12 participants will then be selected through extreme case sampling to partake in
explanatory, in-depth interviews based on their SOC-13 score differences between baseline and
post-intervention tests to explore VIPA user experience.
Data analysis:
For qualitative data, content analysis will be used in phase 1, while in phase 2, in-depth
interview data will be analyzed through deductive thematic analysis according to the
salutogenic model. Quantitative data, such as demographic data, will be presented with
descriptive statistics. Chi-square test and independent t-test will be performed for baseline
comparison. Generalized Estimating Equations will be used to analyze group differences in all
primary and secondary outcomes.