A tailored implementation intervention is successful in sustaining a stroke circuit class in a regional setting

Area of Science:

• Stroke rehabilitation
• Implementation science
• Community health

Background:

• Circuit classes are recommended for improving mobility post-stroke.
• Sustaining these classes in regional settings presents unique challenges.
• A structured implementation approach is needed to address these challenges.

Purpose of the Study:

• To develop, deliver, and evaluate an intervention to sustain a lower limb stroke circuit class in regional Australia.
• To identify and address barriers and facilitators for health professionals delivering stroke circuit classes.
• To assess the impact of the intervention on class sustainability and outcomes.

Main Methods:

• The study utilized the Knowledge to Action framework across four phases.
• Phase 1 involved reviewing current circuit class practices.
• Phase 2 evaluated health professional barriers and facilitators, followed by developing and delivering a tailored implementation intervention (Phase 3).
• Phase 4 assessed sustainability and class outcomes.

Main Results:

• Initial circuit class attendance was low (22/month).
• Health professionals identified lack of training and confidence as key barriers.
• The intervention, including role modeling and training, increased average attendance (32/month during, 33/month post-intervention).
• Health professionals' confidence in others conducting the class significantly increased (43% to 92%).

Conclusions:

• A tailored implementation intervention effectively improved the sustainability of stroke circuit classes in a regional Australian setting.
• The intervention enhanced health professionals' confidence and capacity to deliver these classes.
• This approach offers a model for sustaining specialized rehabilitation programs in underserved areas.