Research gaps in Intensive Comprehensive Aphasia Programs: A qualitative study

Background: Intensive Comprehensive Aphasia Programs (ICAPs) provide a variety of therapies for cohorts of individuals with aphasia. Converging evidence for proof of concept and acceptability data demonstrates that ICAPs improve patient outcomes; however, efforts to build the ICAP evidence base are vital to optimize its implementation and justify potential reimbursement. Aims: This qualitative study characterizes evidence gaps in the ICAP literature base from the perspective of international aphasiologists who implement ICAPs. Methods: Seven international ICAP program leaders participated in semi-structured interviews. A four-stage qualitative content analysis approach was applied by three trained independent raters to organize and elicit meaning from transcribed interviews. This qualitative study was approved by Idaho State University IRB (IRB-FY2021-270). Results: Program access was a prominent theme with subthemes of treatment candidacy (participant characteristics; cohort makeup), program scalability, telehealth options, and stakeholder needs. The second theme was program structure with subthemes of optimizing treatment dose, standardizing outcome measures, refining ICAP comprehensive components, defining the wide array of delivery model applications, and sustainability considerations. Conclusions: The ICAP evidence gap themes described in this study are integral to establishing a call to action for ICAP researchers and others who are fervent about intensive aphasia rehabilitation models. Building the ICAP evidence base will help to optimize implementation, justify potential reimbursement to insurers, contribute to the sustainability of this innovative service delivery model, and maximize rehabilitation options for individuals with aphasia.