Providing aphasia-friendly information in the healthcare setting: Applying the Theoretical Domains Framework to identify factors that influence speech pathologists' self-reported practice

Background The Australian stroke guidelines recommend aphasia-friendly formatting of written health information to improve comprehension for people with aphasia. Despite recommendations, accessible written health information is not routinely provided to people with aphasia. Previous researchers have explored barriers and facilitators to the provision of aphasia-friendly information; however, questions remain about what factors influence provision of aphasia-friendly information across the continuum of stroke care. Aims To explore speech pathologists' perceptions regarding current practice and the factors influencing the provision of aphasia-friendly written information to people with post-stroke aphasia across the stroke care continuum. Methods and Procedures Semi-structured interviews were conducted with twelve speech pathologists working across acute, subacute and community-based settings. Data were analysed using an inductive thematic approach and themes mapped to the Theoretical Domains Framework (TDF). Outcomes and Results Speech pathologists from all settings reported inconsistent provision of aphasia-friendly written information. Key factors influencing practice were identified and mapped to eight of the 14 TDF domains. Environmental context and resources and Beliefs about consequences were related to 13 of the 24 factors identified as influencing practice. Key factors influencing practice included lack of time and resources, aphasia severity, patients' psychological well-being, relevance of information, patient priorities, clinical setting and multidisciplinary team collaboration. Conclusions A wide range of factors influenced provision of aphasia-friendly written information in the healthcare setting. Implementation of practice requires consideration of the environmental context and resources, clinicians' beliefs, and team collaboration in stroke information provision.