City Research Online

Abstract

Purpose: To use the Capability, Opportunity, and Motivation-to-Behaviour system (COM-B) and Theoretical Domains Framework (TDF) to identify barriers and facilitators to telehealth assessment; and to use these findings to develop a telehealth assessment toolkit for clinicians working with people with post-stroke aphasia.

Method: Data from three previously published studies were inductively analysed using a meta-synthesis approach to identify themes to telehealth assessment. Themes were deductively mapped to the TDF and COM-B to identify barriers and facilitators. These findings informed the intervention functions and behaviour change techniques (BCTs) used to design a telehealth assessment toolkit.

Result: Inductive themes were mapped to 12 TDF domains. Physical opportunity and cognitive capability were key facilitators, while reduced motivation was a barrier. Intervention functions included education, training and enablement, with 11 BCTs identified. The resulting online, self-guided, seven-module training toolkit includes interactive tasks, demonstration videos and certification.

Conclusion: The COM-B and TDF provided a systematic and feasible method for designing a telehealth assessment toolkit. This resource supports clinicians to deliver person-centred online assessments and offer practical, theory-informed guidance that promotes digital inclusion for people with aphasia.

Publication Type:	Article
Additional Information:	© 2026, The Authors . This is the accepted manuscript of an article published by Taylor and Francis. Please refer to the publisher’s terms and conditions for information on re-use.
Publisher Keywords:	Aphasia, stroke, COM-B, TDF, behaviour change, telehealth, speech and language therapy
Subjects:	P Language and Literature > P Philology. Linguistics Q Science > QA Mathematics > QA75 Electronic computers. Computer science R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine R Medicine > RC Internal medicine
Departments:	School of Health & Medical Sciences School of Health & Medical Sciences > Department of Allied Health
SWORD Depositor:	Symplectic Administrator

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