Effect of the Fake Phone Call App on Patient Adherence Behavior and Motivation in Conversation Training Therapy: A Randomized Crossover Trial
Clinical Snapshot
PICO Framework
| P — Population | Eleven patients referred for voice therapy with voice disorders requiring conversation training therapy |
| I — Intervention | Fake Phone Call app-supported homework practice for conversational voice training |
| C — Comparator | Standard-of-care homework completion without app support |
| O — Outcomes | Practice frequency, practice fidelity, goal commitment, motivation, usability, utility, and voice therapy outcomes including self-reported generalization |
Bottom Line
This small randomized crossover trial (n=11) suggests that a 'Fake Phone Call' mobile app may improve homework adherence and motivation in voice therapy patients undergoing conversation training. While the crossover design strengthens internal validity by having patients serve as their own controls, the extremely small sample size severely limits confidence in the findings and generalizability. The study found significantly improved practice frequency, fidelity, and goal commitment with app support, and suggested additional benefits when the app was introduced early in therapy. However, critical methodological details are missing, including effect sizes, confidence intervals, dropout rates, and cost considerations. The inability to blind participants and assessors introduces bias risk. While the intervention addresses a genuine clinical need and appears feasible, these preliminary findings require replication in larger, more robust trials before clinical implementation can be recommended. Speech pathologists should view this as promising pilot data rather than definitive evidence for practice change.
Key Findings
P Value: Described as 'significant' but specific values not provided
Effect Size: Not reported
Primary Outcome: App support significantly increased practice frequency, practice fidelity, and goal commitment
Nnt Or Sensitivity: Not calculable from available data
Confidence Interval: Not reported
Clinical Application
App-based intervention appears feasible with good usability ratings, though implementation costs and technical requirements unclear Relevant to Australian speech pathology practice; app-based interventions align with telehealth initiatives; would require evaluation under TGA medical device regulations if commercialized Patients with voice disorders requiring conversation training therapy, particularly those with adherence challenges
Abstract
PURPOSE: The Fake Phone Call app was previously developed and feasibility-tested for conversational target voice practice in resonant voice therapy. The purpose of the present study was to examine its effect on adherence and motivation for conversational practice in conversation training therapy (CTT) as well as its usability and utility in CTT. METHOD: Eleven patients referred for voice therapy served as their own control in a randomized crossover trial comparing 1 week of app-supported homework practice with 1 week of standard-of-care homework completion in CTT. Dependent variables included adherence and motivation variables. In addition, usability and utility as well as outcomes were examined at study completion. RESULTS: App support significantly increased practice frequency, practice fidelity, and goal commitment for practice. Usability and utility were good. Exploratory investigation revealed that patients randomized to receive the app condition first and the standard-of-care condition second had greater gains on all study variables and significantly greater self-reported generalization at treatment completion. CONCLUSION: Fake Phone Call support significantly improves adherence and motivation for CTT, with additional benefits when provided earlier in therapy.
References
- 1.van Leer, E., Gillespie, A. I., Shelly, S., & Voyles, C. (2026). Effect of the Fake Phone Call App on Patient Adherence Behavior and Motivation in Conversation Training Therapy: A Randomized Crossover Trial. American Journal of Speech-Language Pathology. https://doi.org/10.1044/2025_AJSLP-25-00364
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