Pilot RCT Examining Satisfaction and Disability Outcomes of a Technology-Supported Self-Management Intervention in Post-Stroke Individuals

Abstract

<h3>Research Objectives</h3> To evaluate the participant satisfaction and the preliminary efficacy of a technology-supported self-management intervention to improve post-stroke disability outcomes. <h3>Design</h3> 12-week, two-arm randomized controlled trial. <h3>Setting</h3> Community. <h3>Participants</h3> Twenty-four participants (intervention = 11; control = 13) with mild to moderate stroke (mean age = 59.4 years [SD = 11.7], male = 58%, black = 38%). <h3>Interventions</h3> Intervention group received the interactive Self-Management Augmented Rehabilitation Technologies (iSMART). It is an adjunctive behavioral intervention technology composed of skills training, coaching, and text messaging for improved self-management of chronic conditions and participation strategies. Control group received stroke education materials and phone calls over the 12-week. <h3>Main Outcome Measures</h3> Satisfaction was measured by the Client Satisfaction Questionnaire (CSQ), and the Healing Encounters & Attitudes Lists – Health Care Environment (HEAL-HCE), Patient-Provider Connection (HEAL-PPC) and Treatment Expectancy (HEAL-TEX). Disability outcomes were measured by the Patient Health Questionnaire-9 (PHQ-9), Stroke Impact Scale (SIS), Activity Card Sort (ACS), and Reintegration to Normal Living Index (RNL). <h3>Results</h3> Two iSMART participants withdrew from the study. The iSMART group reported greater satisfaction than the control group (CSQ: d = 0.387; HEAL-HCE: d = 0.454; HEAL-PPC: d = 0.374; HEAL – TEX: d = 0.328). The iSMART group exhibited moderate but the control group exhibited small effects on SIS's mobility (iSMART: d = 0.521, control: d = 0.069), hand function (d = 0.699, d = 0.222), and recovery (d = 0.545, d = 0.171), and RNL (d = 0.652, d = 0.272) scores. Both groups exhibited small effects on other scores. <h3>Conclusions</h3> The iSMART participants reported higher participant satisfaction and greater treatment effects than the control participants, suggesting that the iSMART may hold promise for post-stroke self-management. <h3>Author(s) Disclosures</h3> None disclosed.