Content validation of a return-to-work cognitive intervention after stroke

Return-to-work is a key recovery milestone for many stroke survivors. The Train-Your-Brain community-based return-to-work cognitive intervention program was developed to support this transition. As part of a co-design process, content validation was conducted to refine the intervention components and materials through stakeholder consultation.

This study aimed to conduct content validation of the intervention materials with key stakeholders. A secondary aim was to examine whether stakeholder-informed revisions improved material ratings.

Fifteen stakeholders (five stroke survivors, five caregivers, and five healthcare professionals) participated in a two-round content validation process to evaluate the actionability, understandability, and satisfaction of the intervention materials. In the first round, participants completed an online survey and attended focus groups to provide feedback on content and design. Materials were revised over one month and reevaluated in a second round through a follow-up survey and focus group. Feedback from the second round was incorporated to finalize the intervention materials.

Among stroke survivors, positive trends were observed across all domains following revision, with medium-to-large effect sizes for satisfaction and understandability. Caregivers demonstrated significant improvements in actionability (p = .043) and understandability (p = .031). Healthcare professionals reported significant improvements in overall satisfaction (p = .041). Qualitative feedback further informed refinements to improve the materials.

This study demonstrated that a stakeholder-driven content validation process can meaningfully enhance an intervention program as part of a co-design process. Stakeholders' revisions and input resulted in materials that are better aligned with lived experiences and user needs, which strengthened the intervention.