Provision Of Leaflets Research Articles

FP6.13 - A Quality improvement project to reduce the number of readmissions to surgical assessment unit (SAU) in East Sussex hospitals (ESHT) following laparoscopic cholecystectomy

Abstract Aim This is a QI project aiming to reduce the number of readmissions following laparoscopic cholecystectomy in ESHT from the current rate of 8.1% to the UK national average rate of 5%. This proposal followed an audit I conducted previously. About two-thirds of those readmissions occurred on day one following discharge, half of them due to pain, and almost 90% of them discharged without any intervention needing only reassurance, pain control, and analgesia. Methods Problem identified, SMART objectives followed, which means our intervention is: specific, measurable, achievable, relevant, and time specified. Set up a process map showing areas where intervention is desirable/beneficial. These include time allowed for consent, preoperative assessment clinic, and postoperative discharge information. Then a driver diagram is drawn to indicate the primary and secondary drivers we need to tackle in order to achieve our goal. In summary, the proposed changes include allowing more time in clinic for patients to explain procedure and consent, junior doctors and nurses’ education, resources, and provision of leaflets and websites for information. Identification of stakeholders including managers, anaesthetists’ nurses, and patients, and dealing with them according to their influence and interest. PDSA (plan do study and act) cycle, TQM (total quality management), SPC (statistical process control), and lean methodology were implemented. Conclusion This project is aimed primarily at reducing readmissions numbers to SAU following laparoscopic cholecystectomy from 8.1% to 5% within a year. Areas in the process map were identified to achieve this objective, and since about 90% of patients were discharged without any intervention, we believe this should be achievable.

Improving access to patient information leaflets in patients undergoing emergency appendicectomy

Background
 Informed consent is a cornerstone of ethical surgical practise. Patients undergoing emergency surgery have reduced time to consider their options when compared to the elective setting. Therefore, improving informed consent in this setting is critical. We aim to increase the provision of a pre-operative patient information leaflet (PIL) for patients undergoing an emergency appendicectomy by 50% over two audit cycles.
 Methods
 The same methodology were used for both cycles of this audit. Patients were identified through histopathology lists over a two week period. Medical notes were reviewed for documentation of provision of trust approved patient information leaflets. A QR code for an electronic version of the information leaflet was added to emergency clinic rooms, doctors handover rooms and the SHO on call bleep between audit periods.
 Results
 Empirical results from two audit cycles revealed that introduction of a QR code increased uptake from 0% of patients receiving the recommended appendicectomy leaflet, to 58%, achieving our aim.
 Conclusion
 The QR code provided a useful transportable resource, which was utilised by doctors. This provides scope for progression in provision of leaflet for other surgical issues, both in inpatient and outpatient settings, through utilisation of a QR code.

PROMOSI KESEHATAN TENTANG OBAT AMLODIPIN DAN SIMVASTATIN SERTA CARA PENGGUNAANNYA

Medicines can interact with food or drink, chemicals or other drugs. Amlodipine is an antihypertensive that is often given with Simvastatin as an antihyperlipidemic. The interaction of amlodipine and simvastatin at a major level can cause an increase in simvastatin levels. The aim of this activity is to provide education about the use of amlodipine and simvastatin in Sekumpul Village, Martapura District. Health promotion will be carried out on Thursday, May 25 2023, at 10.00-13.00 WITA. The education was accompanied by the provision of leaflets containing the definition of interaction. The activity was attended by 21 participants from the elderly group who had used simvastatin, amlodipine or both. The activity ran well and smoothly and succeeded in increasing the participants' knowledge.

Improving access to patient information leaflets utilising QR codes in patients undergoing emergency appendicectomy.

Abstract Background Informed consent is a cornerstone of ethical surgical practise. Patients undergoing emergency surgery have reduced time to consider their options when compared to the elective setting. Therefore, improving informed consent in this setting is critical. We aim to increase the provision of a pre-operative patient information leaflet (PIL) for patients undergoing an emergency appendicectomy by 50% over two audit cycles. Methods The same methodology were used for both cycles of this audit. Patients were identified through histopathology lists over a two week period. Medical notes were reviewed for documentation of provision of trust approved patient information leaflets. A QR code for an electronic version of the information leaflet was added to emergency clinic rooms, doctors handover rooms and the SHO on call bleep between audit periods. Results Empirical results from two audit cycles revealed that introduction of a QR code increased uptake from 0% of patients receiving the recommended appendicectomy leaflet, to 58%, achieving our aim. Conclusion The QR code provided a useful transportable resource, which was utilised by doctors. This provides scope for progression in provision of leaflet for other surgical issues, both in inpatient and outpatient settings, through utilisation of a QR code.

Effect of Leaflets and Balanced Menu Videos on Knowledge, Attitudes and Behaviors among Undernourished Toddlers’ Mothers

<p><strong>Background:</strong> Toddlers are a vulnerable group in terms of nutrition and are at a high risk for disease. Toddlers’ nutritional health might be affected by a lack of nutrient intake. The nutritional status of children under the age of five is critical since it is an indicator of their health and nutritional status. Malnutrition continues to increase in Sukodono where there are currently 54 undernourished toddlers. This is due to the mother’s lack of knowledge. Counseling through leaflets and video screenings is one of the media for increasing mothers’ knowledge. This study aimed to analyzed the effect of leaflets and balanced menu videos on the knowledge, attitudes and behavior of malnourished mothers under five in the village of Sukodono Tahunan Jepara, Central Java.</p><p><strong>Methods</strong>: A quantitative research with quasi-experimental approach. The populations of the study were 54 undernourished toddlers at the aged 1 to 5 years. A total of 32 undernourished toddlers’ mothers in Sukodono were included in this study, and divided into 16 subjects from control group (using leaflet) and 16 subjects from intervention group (using video)<strong>. </strong></p><p><strong>Results:</strong> There was an effect of balanced menu leaflet media on the knowledge, attitudes, and behavior of malnourished toddler mothers in the village of Sukodono Tahunan Jepara. There is an effect of balanced menu video media on the knowledge, attitudes, and behavior of malnourished toddler mothers in Sukodono Tahunan village, Jepara. There is no more effective difference between giving leaflets and balanced menu videos on the knowledge, attitudes, and behavior of malnourished toddler mothers in Sukodono Tahunan Jepara village with p values > 0.05 (0.434, 0.067 and 0.131).</p><p><strong>Conclusion:</strong> There is no more effective difference between the provision of leaflets and balanced menu videos on the knowledge, attitudes, and behavior of undernourished toddlers’ mothers in Sukodono Tahunan Jepara with a p value > 0.05 (0.434, 0.067 and 0.131.</p><p> </p>

Prevention and Control of Hypertension through Tera Gymnastics with Guntung Paikat Residents of Banjarbaru

World Health Organization estimates that in 2019 the global prevalence of hypertension is 22%. Based on the 2018 Riskesdas report, the prevalence of hypertension in Indonesia is 34.11% and South Kalimantan ranked first (44.13%). One of the risk factors for hypertension is a sedentary lifestyle. Therefore, it is necessary to empower the community related to lifestyles that affect the occurrence of hypertension. A total of 15 residents of RT.007 RW.005 in Guntung Paikat have participated in exercise to control blood pressure. Seven of them received leaflets to increase knowledge and attitudes related to hypertension. Based on the evaluation results, there was a decrease in the mean systolic (p-value=0.020) and diastolic (p-value=0.011) blood pressure between before and after exercise. The increase in mean knowledge (p-value=0.655) and attitude (p-value=0.436) was not significantly affected by the provision of leaflets.

Edukasi Waspada DBD dan Pandai Memilih Jajanan di Sekolah dengan Leaflet

Dengue Hemorrhagic Fever (DHF) is one of the most common diseases in regions such as Southeast Asia. The incidence of DHF infection is estimated to reach 50 to 100 million cases each year. Snacks or street food are usually presented in various colors, shapes, tastes, sizes to make it attractive to buyers. Data analysis by BPOM shows that as much as 40% of snacks are not in accordance with food safety. The two problems above can trigger extraordinary events (KLB), so it is important to do education to prevent this. The health promotion method used is by providing education to participants in the form of lectures and accompanied by the provision of leaflets. The results of the activity show an increase in the knowledge of educational participants based on the post-test results. Health promotion activities (Promkes) about DHF and Pinter choosing snacks at school using effective leaflets to increase participants' knowledge. This increase in knowledge is expected to prevent outbreaks due to DHF and food poisoning.

Self-education Program for Osteoarthritis Reduces Sodium Intake, Knee Joint pain, and Serum Interleukin-17A level in Osteoarthritis Patients

Objectives: As it has been known that sodium may aggravate joint inflammation throuh IL-17A pathway and it can cause joint pain, the purpose of this study was to determine the effect of the Self Education Programs for Osteoarthritis (SEPO) intervention on sodium intake, knee join pain and IL-17A level in patients with knee osteoarthritis.
 Methods: This multicenter study was conducted in orthopedic and internal medicine outpatient wards in three hospitals. This research has received ethical approval. Patients were recruited based on accidental sampling, who met the inclusion criteria. SEPO intervention was carried out for 30 days, followed by provision of leaflets, posters, and handbook about osteoarthritis, daily WhatsApp education chat and/or video. Patients’ demographic, knee joint pain, and sodium intake data was collected during interview, using the Semi Quantitative Food Frequency Questionnaire (SQ_FFQ), and WOMAC (Western Ontario McMaster Osteoarthritis Index) whereas serum IL-17A was determined by using ELISA. The effect of SEPO was analyzed statistically using Mann Whitney tests (p< 0.05).
 Results: Total subjects recruited were 80, namely 30 patients in control group and 50 patients in treatment group. Majority of patients were female (74, 92.5%), age 56-65 yo (32, 40%), obese (54, 67.5%) and senior high school (23, 46%). Statistical results showed that following SEPO intervention daily sodium intake was lower (1289.45±457.98 mg) compared to the control group (2143.94±744.75 mg), p= 0.04. WOMAC score of control group (28±12.41) higher than treatment group (23.88±13.61), p=0.02. Serum IL-17A levels were also lower in the treatment group (3.974±1.06 pg/mL) than the control group (5.542±1.99 pg/ml), p=0.01.
 Discussion: Education as a non-pharmacological therapy is needed to reduce disease progression. Education is provided according to the patient's needs. Educational models can be offline (face to face) or online (digital). SEPO intervention in patients with knee osteoarthritis can reduce sodium intake, knee joint pain, and may impact on reduction of serum IL-17A.

The Role of Peer Counselors in Breast Self-Examination in Increasing Female Teenagers’ Self-Awareness

Background: breast self-examination is a systematic breast self-examination by a woman for the purpose of detecting abnormalities in the breast which is carried out every month. To increase adolescent self-awareness, health education is needed, namely peer counseling which helps peer counselors. In addition to peer activities, the provision of leaflets about breast self-examination also helps counseling in providing informationPurpose: this study was to know the effectivity of peer counselor counseling and leaflets about breast self-examination towards students’ self-awareness.Methods: this study uses a Quasy Experiment approach a pre-test and post-test without control group design. The research sample was 40 respondents. Collecting data used a questionnaire that has been tested by expert on Maternity Nursing. Data analysis used the paired sample t-test in the paired group while the independent sample t-test in the unpaired groupResults: the results that self-awareness before the group was given peer counselor treatment had an average of 67.10 and given after peer counselors about breast self-examination had an average of 100.50 while in the control group self-awareness before being given leaflets an average of 68.50 and after being given leaflets an average of 73.35. There are differences in peer counselors regarding breast self-examination on self-awareness of students with p value = 0.000.Conclusion: follow-up process is still needed to increase self-awareness in carrying out breast self-examination and coordination from the school.

The Effectiveness and Value of Written Medicine Information Across Asia and Africa: Systematic Review

Reviews on the role, value, effectiveness and desirable content of written medicine information (WMI) mostly include studies from high-income countries. We reviewed studies from Africa and Asia published between January 2004 and December 2019 to determine (1) the effect of WMI on knowledge and behaviour and (2) whether patients value WMI and their preferences for WMI. We included 16 intervention studies involving almost 3500 participants and 27 surveys of patients/public totalling over 11,000 people. Both the quality of the intervention studies and the reporting quality varied. Surveys were mostly localised, many with inadequate sampling strategies, and hence, were poorly representative of wider populations. However, most included a high proportion of participants with low educational levels. Most of the intervention studies reported significant improvements in knowledge and/or adherence after provision of WMI. Many utilised specially developed WMI in local languages, enhanced by pictograms. Provision of verbal information in addition to WMI showed variable impact. The proportion of people who read WMI, used as an indicator of its value, was reported in 15 surveys, with an overall figure of 74%. The most desirable aspects of WMI reported in 12 studies were indication, side effects, dose/instructions for use, contraindications, precautions and interactions. Nine studies reported local language was desirable. The studies suggest that WMI can improve both knowledge and adherence and is highly valued by people in many countries across Africa and Asia. Mechanisms should be considered by regulatory authorities and manufacturers to facilitate the provision of leaflets in local languages using simple terminology, perhaps enhanced by pictograms.This study is registered with PROSPERO, registration number: CRD42019127001.

Change in maternal intention and perception about postpartum care after provision a leaflet media in Bau Bau City

Postpartum is the riskiest period of the pregnancy process. Treatment at this stage must be carried out until the puerperium is complete. Provision of health education about childbirth care is needed to improve maternal behavior, including through the provision of leaflets. This study aims to assess changes in maternal intentions and perceptions in postpartum care after giving leaflets. This research uses a quasi-experiment with One Group Time Series design. The study population was all pregnant women who examined their pregnancies from September to February 2019, totaling 131 pregnant women. The sample was determined using a purposive sampling method with 26 mothers selected. Data analysis using the Wilcoxon test and paired t-test. Intention and perception of maternal were change after giving leaflets. An increase can see the value of measurements (p=0.019) of intentions and attitudes in pretest 2 to post-test 1. The repeated analysis of the first pretest for the third post-test also shows an increase in the measurement value (p=0.000) toward the intention and perception after giving the leaflet. There was a change in intention and positive perception and lasts a long time in pregnant women before and after the provision of leaflets about postpartum care. Changes in plans and positive opinions are significant in pregnant women with age groups 20-35 years and advanced education level. It is recommended that providers at the health center use leaflets as a companion to the Maternal and Child Health Book to educate pregnant women about postpartum care to improve maternal intentions and perceptions.

Survey of outpatients' use and needs of patient medicine information leaflets in Thailand.

Background Patient information leaflets are important sources of medicine information. Regulations of patient information leaflet provision varies among country. Little is known regarding patients' behavior and expectation on use of patient information leaflets. Objectives To explore patients' use of either package inserts or patient information leaflets and to survey patients' expectations and needs on use of patient information leaflets and their associated factors. Setting Two university hospitals in Thailand. Methods Cross-sectional study using self-administered questionnaires distributed to outpatients over a 3-month period. Participants were selected through systematic random sampling. Logistic regression was used for data analysis. Main outcome measure Patient use of medicine information. Visual Analogue Scale scores for patient needs and their expectation of knowledge gains from using patient information leaflets. Results The response rate was 77.0%. Most respondents had received package inserts (91.3%) with 59.4% reporting that they sometimes read them. While most respondents had not previously known about patient information leaflets (75.9%), 97.3% reported that patient information leaflets would be useful. Respondents scored their needs and expected knowledge gains after reading patient information leaflets as 9.68 ± 0.97 and 9.64 ± 0.99, respectively. Previous experience with package inserts was associated with increased patient need scores (p = 0.002) and higher expected knowledge gains from use of patient information leaflets (p = 0.037). In addition, patients who had not previously known about patient information leaflets had higher expectations of knowledge gains (p = 0.016). Conclusion Overall, patients showed good behavior on reading package inserts. Although many patients were not previously aware of patient information leaflets, they realized the importance. Hence, patient information leaflets should be developed and provided to Thai patients.

Patient-focused medicines information: General practitioners’ and pharmacists’ views on websites and leaflets

Objectives: To determine how often general practitioners (GPs) and pharmacists recommend patients obtain information about their medicines via websites and to explore factors that might improve the delivery of written information about medicines to patients. Design: Cross-sectional surveys. Setting: GPs and community pharmacists in New Zealand primary care. Method: Questionnaires were developed and sent to a sample of pharmacists and GPs. Data were collected using SurveyMonkey® and analysed to examine views about websites and leaflets informing patients about medicines. Results: In total, 143 GPs and 126 pharmacists responded. GPs and pharmacists did not routinely direct patients to medicine information websites. Most commonly, GPs did not provide medicine information leaflets due to time constraints and concerns about possibly confusing information. Both professions thought leaflets might cause patients to worry about side-effects. Pharmacists mainly withheld leaflets because the medicine has been taken previously or because leaflet indications differed to prescribed use. A summary leaflet, if available, would be the preferred option for improving leaflet provision. Conclusion: Providing digital medicine information is uncommon in New Zealand. Summarised, relevant information tailored to patient requirements might facilitate the provision of medicines information at the point of care.

Doctors and pharmacists provision and opinions of medicines information leaflets in New Zealand

Background Providing verbal medicines information to patients may be insufficient. Providing medicine information leaflets could support verbal information, however New Zealand health professionals' opinions or use of leaflets is unknown. Objective To examine self-reported provision and health professionals' views about medicine information leaflets and to determine their support for tailoring patient leaflets. Setting A cross sectional survey of general practitioners (GPs) and community pharmacists in New Zealand primary care. Method GPs and pharmacists completed validated questionnaires. Data was collected using SurveyMonkey® and where applicable, Chi squared analysis was carried out. Main outcome measures Frequency of leaflet provision, how leaflets are used in practice and why, likes and dislikes of available leaflets, and opinions on providing tailored information. Results 143 GPs and 126 pharmacists responded. For new medicines, significantly more pharmacists than GPs reported providing leaflets all or most of the time. For repeat medicines, leaflets were more likely to be given only on request. Leaflets were given to ensure patients are well-informed. Most GPs and pharmacists report discussing sections of leaflets with patients. The likes and dislikes of leaflets were mostly about design and content. Both professions support tailoring leaflets to meet individual's requirements. Conclusions Provision of medicines information needs to be re-evaluated. Relying on verbal communication is inadequate and leaflet provision appears to be suboptimal. Making leaflets more patient-centred and accessible could improve health professionals' perceptions and use of them. Automated creation and provision of tailored summary leaflets would be beneficial. Further advantage could be gained by digital patient access.

Preparation, Validation and User-testing of Patient Information Leaflets on Diabetes and Hypertension

A patient information leaflet is an educational material for educating patients regarding a disease, medications and lifestyle modifications for better care. The present study aimed at preparing, validating and user-testing of diabetes and hypertension information leaflets in different languages among patients. The patient information leaflets on diabetes and hypertension were prepared by referring to the primary, secondary and tertiary resources. The content of the leaflet was validated by an expert committee. The readability of leaflets has been assessed by Flesch Reading Ease and Flesch-Kincaid Grade Level scores using MS Office 2007. The patient information leaflets were translated into Kannada and Malayalam languages with the help of language experts. During the user-testing, baseline knowledge was assessed before providing the patient information leaflet followed by provision of leaflets to the patients. After allowing the patients to read the leaflet for a period of 20 min, patients have again been administered with a set of questions to assess their knowledge. The Flesch Reading Ease and Flesch-Kincaid Grade Level readability scores achieved for diabetes leaflets are 70.4 and Flesch-Kincaid Grade Level score achieved is 6.3 and for hypertension leaflets, the Flesch Reading Ease score is 68.3 and Flesch-Kincaid Grade Level score achieved is 6.9. User testing of the patient information leaflets on diabetes and hypertension in different languages have been carried out on 40 each diabetic and hypertensive patients using knowledge based questionnaire. Knowledge assessment after providing patient information leaflet, the mean scores have significantly risen from 44.80 to 87.99 and 63.19 to 90.13 with p<0.0001, respectively in diabetes and hypertensive patients. It showed that patient education added with a well-designed patient information leaflet has a greater impact on knowledge of the patients towards their disease management, so that the medication adherence is improved.

Predictors of outcomes of arthroscopic rotator cuff repair: A pilot study

s / International Journal of Surgery 23 (2015) S15eS134 S88 Teaching Hospital, Dundee were recruited prospectively over a 2month period. Patients with dementia (AMT < 8), visual impairment were excluded. 59 patients recruited in loop-1 were given Likert scale questionnaires assessing knowledge of the hip fracture, treatments and complications. 64 patients recruited in loop-2 were given new information leaflets and completed the same questionnaire. Scores per question and total scores were assessed. Statistically significant improvement (p < 0.0001) was observed in understanding injury, treatment options, complications and prognosis. Total score improved from 11.7 to 18.5 (p < 0.0 001). Conclusion: We observed significant benefit to patients' understanding of hip fracture with new leaflet provision in addition to existing modalities. Further study to elucidate optimal information content and delivery is required. 0917: PREDICTORS OF OUTCOMES OF ARTHROSCOPIC ROTATOR CUFF REPAIR: A PILOT STUDY J. Turnbull , T. Mackenzie , M. Walton , P. Monga , L. Funk . University of Manchester Medical School, UK; Wrightington Hospital & University of

Pengaruh Konseling dan Leaflet terhadap Efikasi Diri, Kepatuhan Minum Obat, dan Tekanan Darah Pasien Hipertensi di Dua Puskesmas Kota Depok

Self-efficacy and low adherence was significant problem on using antihypertension drugs. The study purpose was to evaluate the effectiveness of counseling and provision of leaflets againts self-efficacy and adherence as well as the blood pressure of hypertensive patients at two community health centers in Depok City. The study desain is a quasi-experimental with 37 patients in counseling group and 36 patients in the leaflets group during March to June 2013. The instrument determine self-efficacy is MUSE scale, MMAS-8 scale for adherence and the tensimeter for blood pressure. Data were analyzed uses the Wilcoxon and Kolmogorov-Smirnov test. The results showed that the largest percentage of hypertension patients in community health centers have mild hypertension, has been suffering from hypertension between 1-5 years, received a single drug, mostly captopril, and did not feel any side effects. The counseling and provision of leaflets can increase self-efficacy and medication adherence, and lower systolic blood pressure significantly. Provision of leaflets to patients can increase self-efficacy and adherence, and lowering the systolic and diastolic pressure significantly. There is no significant difference between the effects of counseling and the provision of leaflets to increase self-efficacy and adherence, as well as a decrease in blood pressure in hypertensive patients in community health centers in Depok City.

P241 ‘CURE-CAP’: A Comprehensive Admission &amp; Discharge Pneumonia Care Bundle

Introduction The annual incidence of Community acquired pneumonia (CAP) is 5–11/1000. Between 22% and 42% require admission to hospital. Wide variation exists in the management of CAP despite guidelines issued by the British Thoracic Society (BTS). Care bundles have been shown to improve outcomes through standardisation of care in other diseases as well as in CAP. A BTS/NHS Improvement initiative is due to launch a pneumonia admission bundle. However, it does not address the issue of standards around comprehensive discharge care. Objectives To design and implement a care bundle for the management of CAP, that incorporates admission and discharge standards and to assess improvements post-implementation. Methods We formulated a CAP bundle including a triage tool, with the acronym ‘CURE-CAP’, focussing on seven key standards (Fig. 1). Data was collected retrospectively on consecutive patients admitted to our GP Assessment Unit with a primary diagnosis of CAP with a 3-month period of implementation in between. Compliance to standards before and after implementation of the bundle was then measured. Results The pre-implementation cohort had 43 patients (17 (40%) male; median (range) age 74 (36 –101)) and post–implementation cohort had 30 (8 (27%) male; median (range) age 82 (36–93)). Chest x-ray was performed within 4 hrs in 30/43 (70%) in the pre-implementation cohort, increasing to 30/30 (100%) post-implementation. Time from admission to x-ray improved as well (median (range) 2:49 (0:30–18:27) to 1:00 (0:21–2:42). Urgent oxygen assessment was performed in 100% cases in both cohorts. Recording of the CURB-65 severity score improved from 35/43 (81%) to 28/30 (93%). Early antibiotic administration (within 4 hrs) increased from 12/43 (28%) to 20/30 (68%) with appropriate (severity based) antibiotics selection improving from 29/43 (67%) to 28/30 (93%). The bundle led to total compliance with all discharge standards including appropriate smoking cessation counselling (5/7 (71%) to 4/4 (100%)), patient information leaflet provision (0% to 100%) and appropriate follow-up arranged (16/43 (37%) to 30/30 (100%)). Conclusions We have successfully designed a CAP admission and discharge care bundle and shown improvements across all measured standards post implementation. A further study is planned to measure effects on direct patient outcomes.

Brief intervention content matters

Brief intervention content matters

A multi-centre randomised controlled trial of rehabilitation aimed at improving outdoor mobility for people after stroke: study protocol for a randomised controlled trial.

BackgroundUp to 42% of all stroke patients do not get out of the house as much as they would like. This can impede a person’s quality of life. This study is testing the clinical effectiveness and cost effectiveness of a new outdoor mobility rehabilitation intervention by comparing it to usual care.Methods/designThis is a multi-centre parallel group individually randomised, controlled trial. At least 506 participants will be recruited through 15 primary and secondary care settings and will be eligible if they are over 18 years of age, have had a stroke and wish to get out of the house more often. Participants are being randomly allocated to either the intervention group or the control group. Intervention group participants receive up to 12 rehabilitation outdoor mobility sessions over up to four months. The main component of the intervention is repeated practice of outdoor mobility with a therapist. Control group participants are receiving the usual intervention for outdoor mobility limitations: verbal advice and provision of leaflets provided over one session.Outcome measures are being collected using postal questionnaires, travel calendars and by independent assessors. The primary outcome measure is the Social Function domain of the SF36v2 quality of life assessment six months after recruitment. The secondary outcome measures include: functional ability, mobility, the number of journeys (monthly travel diaries), satisfaction with outdoor mobility, mood, health-related quality of life, resource use of health and social care. Carer mood information is also being collected.The mean Social Function score of the SF-36v2 will be compared between treatment arms using a multiple membership form of mixed effects multiple regression analysis adjusting for centre (as a fixed effect), age and baseline Social Function score as covariates and therapist as a multiple membership random effect. Regression coefficients and 95% confidence intervals will be presented.DiscussionThis study protocol describes a pragmatic randomised controlled trial that will hopefully provide robust evidence of the benefit of outdoor mobility interventions after stroke for clinicians working in the community. The results will be available towards the end of 2012.Trial registrationISRCTN58683841