Objective: The purpose of this investigation was to compare the effectiveness of telehealth vs. the traditional care model of phone calls at changing the target behavior of adherence to a swallowing exercise program delivered to those undergoing RT/CRT for treatment of HNC. Method: A single-subject comparison of competing interventions design was used. After baseline data was collected, telehealth sessions were administered during weeks two and three of RT/CRT followed by phone sessions given during weeks four and five. Results: Both telehealth and phone calls demonstrated a positive effect on adherence when compared to baseline data. Telehealth was introduced in phase B, showing an accelerating trend from baseline (phase A) with a mean adherence rate of 85.71%. Telehealth to phase C (telephone calls) demonstrated a decelerating trend, however exercise completion rates remained above those completed during phase A (baseline) at 46.42% vs. 2.85% respectively for a single participant. Conclusion: The data show that telehealth may have a positive impact on exercise adherence during RT/CRT, however, many confounding factors limit interpretation, such as enrollment of a single participant, expected onset of negative treatment sequalae related to RT/CRT at the mid-point of the study, and the inability to alternate the introduction of phases B and C with an additional. The importance of any intervention type during treatment for HNC can be drawn for this participant, however future larger scale studies are recommended to validate telehealth as a superior method.
