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Adapting a Poststroke Sedentary Behavior Intervention for Remote Delivery: Lessons from a Formative Descriptive Case
Emily Kringle1, Karli Jahnke1, Amos Badu1
1School of Kinesiology, College of Education and Human Development, University of Minnesota, Minneapolis, Minnesota, USA.
Introduction:
Activating Behavior for Lasting Engagement (ABLE) is a conversation-based intervention designed to reduce poststroke sedentary time. Remote delivery may overcome access barriers but requires adaptations to promote participant engagement and safety. We explored the feasibility of delivering ABLE remotely (teleABLE) using synchronous videoconferencing.
Methods:
Community-dwelling ambulatory stroke survivors (N = 11) were enrolled in this descriptive case series. Pre- and post-test measures of sedentary time (accelerometry), activity engagement (Activity Card Sort 3), and health-related quality of life (EuroQOL-5D-5L) were completed at weeks 0 and 8. Participants completed 12 sessions teleABLE sessions and two semi-structured interviews (mid- and postintervention). Feasibility metrics were documented and assessed against a priori benchmarks. Changes in clinical outcomes were reported descriptively. Framework analysis was applied to interview data to contextualize quantitative findings.
Results:
Most stroke survivors (median age = 56.5 years, median chronicity = 6.2 months poststroke) were retained through postintervention (90.9%). Feasibility benchmarks for safety (0 severe adverse events), participant satisfaction (Client Satisfaction Questionnaire-8 score = 3.7 vs. 3.0), and session frequency (1.7 sessions per week vs. 1.5) were met. Some participants experienced within-person change in sedentary time, activity engagement, and health-related quality of life. Participants characterized teleABLE as a useful planning process that contributed to re-engagement in activities and improved mental health.
Conclusion:
Intervention adaptations focused on structures to support participant engagement and safety during remotely delivered intervention. Clinical outcomes and qualitative data suggest that teleABLE may contribute to psychosocial outcomes such as disability adjustment and mental well-being. Future research is required to determine the efficacy of teleABLE.