Lessons Learned and Future Actions: Implementing a Stroke Specific Self-Management Program Research Study

Abstract

<h3>Research Objectives</h3> To highlight a research study investigating a stroke specific self-management program. We report the implementation process, lessons learned, and strategies developed in response to the barriers encountered. <h3>Design</h3> Hybrid effectiveness implementation trial. <h3>Setting</h3> Community. <h3>Participants</h3> Inclusion criteria: (1) acute stroke, (2) ≥ one chronic condition, (3) independent consent, (4) community dwelling at the start of the intervention, > 3 months post stroke, and (5) > 18 years old. <h3>Interventions</h3> Evidence-based self-management program, pre-adapted for stroke survivors. Six, 2-hour weekly group sessions on topics such as symptom management. <h3>Main Outcome Measures</h3> Information on lessons learned (barriers to implementation) and strategies to address the barrier, reported using the Consolidated Framework for Implementation Research (CFIR) guidelines. <h3>Results</h3> 352 charts screened; 59 people met the inclusion criteria, 25 consented (42% of eligible sample) and five were interested in continuing at the 3-month call. We addressed barriers to implementation continuously. For example, before the group sessions began, the COVID-19 pandemic necessitated changes to the intervention delivery. We adapted the protocol to an online format, via a virtual platform. After making this change, we determined that almost all participants did not have computers or iPads, nor internet. Therefore, our strategy to remove this barrier was to deliver the intervention over the phone and we distributed the study materials via the mail. We classified this information in CFIR under Domain I, Intervention Characteristics and Construct D- Adaptability. <h3>Conclusions</h3> The CFIR was essential to reporting of barriers and strategies. Essentially, we decided to stop implementation due to poor participation and recruit additional participants. Future work will evaluate the strategies developed as well as report the clinical outcomes with the new cohort. <h3>Author(s) Disclosures</h3> No conflicts of interest.