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Related Experiment Video

Updated: Aug 6, 2025

Author Spotlight: Rehabilitation of Stroke Patients With a Digital Occupational Training System
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Lessons Learned and Future Actions: Modifying a Stroke Specific Self-Management Program.

Kimberly Hreha1, Mandi Sonnenfeld2, Annalisa Na3

  • 1Division of Occupational Therapy, Department of Orthopaedic Surgery, School of Medicine, Duke University, Durham, NC, United States.

Frontiers in Health Services
|March 17, 2023
PubMed
Summary

Adapting self-management programs for stroke survivors with multiple chronic conditions is essential. This study details modifications made to an evidence-based program due to implementation barriers, including a shift to online delivery.

Keywords:
consolidated framework for implementation researchimplementation scienceself-managementstroketranslational research

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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.