Barriers and Readiness to Voice Therapy Among School Teachers: A Scoping Review.

Aim: This scoping review aimed to identify barriers and readiness to voice therapy among school teachers as reported in the literature. The objectives were to (1) report methods used to identify barriers and readiness, (2) list barriers faced by school teachers in accessing and participating in voice therapy programs, and (3) report readiness levels of school teachers to engage in voice therapy interventions aimed at improving vocal health.

Method: The study followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines for developing the protocol. Key terms were formulated, and articles were searched in databases, including Scopus, Medline, PubMed, Web of Science, SpringerLink, and Google Scholar. Results were collated and managed in Rayyan, where title and abstract screening was conducted. Full-text reviews were independently carried out by two reviewers, and data were charted and collated.

Results: From 29,698 articles, 229 were shortlisted, and 26 articles were analyzed. Identified barriers were classified into three themes: (1) awareness and perception about voice therapy, (2) constraints in seeking help, and (3) challenges in practicing or continuing therapy. Most studies reported the barriers and readiness factors based on surveys. However, the primary objective of those studies and the surveys was not specifically designed to elicit barriers or readiness. Three studies utilized the University of Rhode Island Change Assessment-VOICE scale to gauge readiness and mapped to transtheoretical framework. Most teachers were reported to be in the precontemplation and contemplation stages of transtheoretical framework of behavioral change.

Discussion/conclusion: The review provided a preliminary understanding of barriers and readiness to voice therapy among school teachers. The need for future research to use methods tailored to address geographical, socioeconomic, and cultural factors has been highlighted. A tool to assess barriers and readiness could help clinicians devise strategies to improve compliance and concordance of the patients undergoing voice interventions.