Harnessing an Implementation Science Framework and Measures to Develop a Technology-Augmented Self-Management Intervention for Stroke Rehabilitation

Abstract

<h3>Research Objectives</h3> To conduct a pre-implementation study to determine barriers and facilitators of adapting and implementing a technology-augmented self-management intervention in stroke rehabilitation and assess the initial feasibility of this intervention. <h3>Design</h3> We engaged a community advisory board to develop and pretest the intervention. We used the Consolidated Framework for Implementation Research (CFIR) to identify barriers and facilitators of treatment implementation and administered implementation outcome measures to assess the initial acceptability, appropriateness, and feasibility of the intervention. <h3>Setting</h3> Stroke rehabilitation setting. <h3>Participants</h3> Stroke rehabilitation stakeholders (N=6), including a rehabilitation clinic director, a technology development company director, two licensed occupational therapists, a PhD-level nurse researcher with expertise in self-management, and a post-stroke patient advocate. <h3>Interventions</h3> interactive Stroke Management Augmented by Rehabilitation Technologies (iSMART). <h3>Main Outcome Measures</h3> Acceptability of Intervention Measure (AIM), Intervention Appropriateness Measure (IAM), and Feasibility of Intervention Measure (FIM). <h3>Results</h3> We identified a total of 37 barrier codes and 125 facilitator codes across multiple CFIR domains to promote the adaptation and implementation of the iSMART in stroke rehabilitation. The most common barrier domain was intervention characteristic, whereas the most common facilitator domain was characteristics of individuals. We also found high acceptability (mean [SD] = 4.63 [0.38]), appropriateness (mean= 4.63 [0.38]), and feasibility (mean= 4.58 [0.34]) of this program. <h3>Conclusions</h3> Findings provide information about what, where, and why the iSMART works, and its areas for improvement, promoting the effective adaptation and sustainable implementation of this intervention in stroke rehabilitation. This study further provides initial support for the feasibility of a technology-augmented intervention for post-stroke self-management. <h3>Author(s) Disclosures</h3> None disclosed.