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What matters to program partners when implementing a community-based exercise program for people post-stroke? A

Gayatri Aravind1,2, Kainat Bashir1, Jill I Cameron3,4

  • 1Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada.

Frontiers in Rehabilitation Sciences
|August 30, 2023
PubMed
Summary
This summary is machine-generated.

Community-based exercise programs post-stroke require understanding implementation from multiple viewpoints. Managers prioritized cost-benefit, while staff focused on preparedness for successful program delivery.

Keywords:
balancecommunity exerciseconsolidated framework for implementation researchcostimplementationmobilitystroketheoretical domains framework

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Area of Science:

  • Rehabilitation Medicine
  • Public Health
  • Implementation Science

Background:

  • Community-based exercise programs integrating healthcare-community partnerships (CBEP-HCP) support lifelong physical activity for stroke survivors.
  • Understanding implementation processes from diverse stakeholder perspectives is crucial for program sustainability.

Purpose of the Study:

  • To explore stakeholder experiences during the initial implementation of a group, task-oriented CBEP-HCP for post-stroke individuals.
  • To document associated personnel and travel costs for this novel program.

Main Methods:

  • A descriptive qualitative study was conducted within a pilot randomized controlled trial across three cities.
  • Semi-structured interviews and focus groups were held with healthcare managers, recreation managers, fitness instructors, healthcare partners, and volunteers.
  • Data analysis utilized the Consolidated Framework of Implementation Research and Theoretical Domains Framework; costs were estimated.

Main Results:

  • Managerial decisions to partner and implement were influenced by program quality, packaging, and cost-benefit analyses.
  • Staff decisions to participate were shaped by prior experiences and beliefs in program benefits.
  • Initial role-based challenges for experienced staff resolved during program delivery; organizational capacity impacted program continuation.
  • First-time implementation costs included healthcare partners ($680), fitness personnel ($3,153), and participant transport ($110-$283).

Conclusions:

  • During initial CBEP-HCP implementation, managers focused on program costs and value, whereas frontline staff emphasized role readiness and patient management capabilities.
  • Recommendations for partnership, staffing, training, and delivery were identified.