Developing and Testing a Smartphone Application to Enhance Adherence to Voice Therapy: A Pilot Study

Vrushali Angadi, Ming Yuan Chih, Joseph Stemple

Research output: Contribution to journalArticlepeer-review


The present study aimed to develop a smartphone application (app) that addressed identified barriers to success in voice therapy; accessibility, and poor adherence to home practice. The study objectives were (1) to investigate if app use enhanced adherence to the home practice of voice therapy and (2) to test app usability. Maximizing the effectiveness of voice therapy is vital as voice disorders are detrimental to personal and professional quality of life. A single-blinded randomized clinical trial was completed for the first objective. Participants included normophonic individuals randomly assigned to the app group or the traditional group. The primary outcome measure was adherence measured as the number of missed home practice tasks. The second objective was completed through usability testing and a focus group discussion. The app group (n = 12) missed approximately 50% less home practice tasks as compared to the traditional group (n = 13) and these results were statistically significant (p = 0.04). Dropout rates were comparable between the two groups. Usability results were positive for good usability with high perceived usefulness and perceived ease of use. App use resulted in improved adherence to home practice tasks. App usability results were positive, and participants provided specific areas of improvement which are achievable. Areas for improvement include app engagement and willingness to pay.

Original languageEnglish
Article number2436
JournalInternational Journal of Environmental Research and Public Health
Issue number3
StatePublished - Feb 2023

Bibliographical note

Funding Information:
This project was funded by the Myron and Elaine Jacobson Entrepreneurship Award through the University of Kentucky College of Health Sciences.

Publisher Copyright:
© 2023 by the authors.


  • adherence
  • mHealth
  • vocal function exercises
  • voice disorders
  • voice therapy

ASJC Scopus subject areas

  • Pollution
  • Public Health, Environmental and Occupational Health
  • Health, Toxicology and Mutagenesis


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