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Type 3 hybrid effectiveness-implementation study implementing and evaluating the Comprehensive High-dose Aphasia

Marie-Pier McSween1,2, Jade K Dignam1,2, Kirstine Shrubsole1,2,3

  • 1Queensland Aphasia Research Centre, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia.

BMJ Open
|May 18, 2026
PubMed
Summary

This study evaluates the Comprehensive High-dose Aphasia Treatment (CHAT) programme for aphasia rehabilitation. It assesses CHAT

Keywords:
Implementation ScienceREHABILITATION MEDICINESpeech pathologyStroke

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Area of Science:

  • Neuroscience
  • Rehabilitation Medicine
  • Health Services Research

Background:

  • Aphasia rehabilitation faces evidence-practice gaps and service delivery barriers.
  • The Comprehensive High-dose Aphasia Treatment (CHAT) programme offers intensive, evidence-based therapy.
  • Implementation strategies are crucial for integrating CHAT into existing services.

Purpose of the Study:

  • To evaluate the clinical implementation of the CHAT programme.
  • To assess the clinical effectiveness of CHAT compared to usual care.
  • To determine the cost-effectiveness of real-world CHAT implementation.

Main Methods:

  • A type 3 hybrid effectiveness-implementation study across six Australian health services.
  • Four participant groups: people with aphasia, support persons, clinicians, and stakeholders.
  • Before-and-after study with 'usual care', 'implementation transition', and 'intervention implementation' phases.

Main Results:

  • Primary outcome: delivery of evidence-based aphasia treatment (CHAT) via quality indicators.
  • Secondary outcomes: changes in language impairment, communication effectiveness, confidence, and quality of life.
  • Embedded mixed-methods process and economic evaluations will be conducted.

Conclusions:

  • The study will provide insights into the implementation, effectiveness, and cost-effectiveness of the CHAT programme.
  • Findings will inform the optimization of aphasia treatment in rehabilitation settings.
  • Outputs include publications, conference presentations, and a training package.