Lessons Learned and Future Actions: Modifying a Stroke Specific Self-Management Program

Area of Science:

• Health Services Research
• Rehabilitation Medicine
• Implementation Science

Background:

• Self-management programs effectively support individuals managing chronic health conditions independently.
• Adapting these programs for specific diagnostic groups, like stroke survivors, is crucial for their efficacy.
• Stroke survivors often present with multiple chronic conditions, necessitating tailored self-management support.

Purpose of the Study:

• To document modifications made during the implementation of a stroke-specific self-management program.
• To identify barriers encountered during program delivery and strategies employed to overcome them.
• To report preliminary data from a small cohort of stroke survivors with multiple chronic conditions.

Main Methods:

• A prospective type III hybrid implementation-effectiveness trial was conducted with community-dwelling stroke survivors interested in self-management.
• Modifications were tracked using researcher reflections, identified barriers, and strategies documented via field notes.
• The Consolidated Framework for Implementation Research (CFIR) guidelines were utilized for reporting.

Main Results:

• Twenty-five individuals consented to participate (42% of eligible sample); five continued engagement at 3 months.
• Multiple implementation barriers were identified, leading to seven protocol modifications.
• The COVID-19 pandemic necessitated a shift from in-person to online delivery of the intervention.

Conclusions:

• The Consolidated Framework for Implementation Research (CFIR) facilitated comprehensive reporting of barriers and strategies.
• Study modifications were essential to address the prevailing research climate and the specific needs of the stroke cohort.
• Further research with larger cohorts is needed to implement effective strategies and ascertain the intervention's clinical effectiveness.