Abstract EP64: Creating A Comprehensive Lifestyle Intervention For Stroke Survivors

Abstract

Purpose: Approximately 795,000 people experience a stroke each year, 23% of which are recurrent events. Among stroke survivors, comprehensive lifestyle intervention (CLI) is recommended for secondary stroke prevention, and obesity and glucose management. American Heart Association (AHA) guidelines for CLI recommend that interventions address physical activity and dietary intake through ≥14 sessions delivered over ≥6 months. Few existing programs meet these recommendations. Therefore, the purpose of this project was to create a 6-month, 14-session CLI using stakeholder input that adheres to the AHA recommendations. Methods: The study team, which included individuals with expertise in stroke, nutrition, nursing, and occupational therapy, adapted the content, structure, and format of an existing 1-year, 22-session diabetes prevention program, the Group Lifestyle Balance—CVA (GLB-CVA), to create the CLI. An advisory board of health professionals with expertise in nutrition, exercise science, occupational therapy, and physical therapy then provided feedback on the CLI through 2 focus group meetings. Qualitative data from focus groups were transcribed and used to modify the CLI. Results: Study team adaptions included shortening the GLB-CVA to 14 sessions, tailoring content to accommodate stroke-related disability (e.g., sitting-based and one-handed exercise and cooking recommendations), and including a care-partner. Advisory board modifications included shortening individual sessions, simplifying language, and ensuring physical activity and dietary recommendations were appropriate for stroke survivors. Additional modifications are listed in the table. Conclusions: Evidence-based CLIs for stroke survivors are lacking. Our adapted CLI meets the AHA recommendations for CLI and provides recommendations appropriate for stroke survivors based on expert opinion. Future directions include efficacy testing of the adapted CLI and intervention implementation in clinical and community settings.