Public health approaches to communication disability : a scoping review

Abstract

BACKGROUND : Low therapist to population ratio is widely reported in the literature, together with the impact of communication disability. This has resulted in personnel other than speech therapists being proposed to support the prevention of communication disabilities. It is therefore necessary to understand the nature of public health interventions for communication disability and define key concepts related to public health and communication disability. AIM : The main aim of the study is to explore how public health approaches to intervention are described and used in the existing literature on communication disability. METHODS : A systematic search using six electronic databases was conducted. The eligibility criteria were applied by two reviewers to the articles at title and abstract and full text level. Data were extracted from included articles and analysed against the general characteristics of the study and specific areas of public health. RESULTS : A total of 60 studies were included in the review. The majority of studies concerning public health and communication disability were conducted in high income countries. The main concepts of public health and the prevention levels were not defined extensively in the included studies. Public health approaches were frequently conducted in the home setting. Primary prevention activities were implemented more frequently than secondary prevention activities. Children together with their families were the most frequently targeted recipients of public health approaches, mainly due to risk factors such as language delay and low socio-economic status. Adults who were at risk of voice disorders due to being professional voice users were also recipients of prevention activities. Speech therapists were the most widely reported implementers of the interventions in the included studies. Measures to report outcomes varied, with standardised measures used most frequently in the studies to measure outcomes. CONCLUSIONS : Globally agreed-upon definitions of public health as they relate to communication disability are required. Future research should focus on the long-term impact of public health programmes for communication disability, the resource requirements for public health programmes, training of personnel who administer public health approaches and the use of social media in public health approaches to communication disability. Additionally, future research should consider polices and funding models of public health models for communication disability.