Stroke Survivor-caregiver Dyads Research Articles

Abstract 15657: Stroke Survivors’ and Caregivers’ Experience of Using Game-Based Virtual Reality Training Modules Designed for Promoting Social Participation

Introduction: Virtual reality (VR) technology may provide a promising alternative to promote stroke survivors’ social participation. Three innovative social participation-focused, game-based VR training modules for community-dwelling stroke survivors were developed. Aim: This study sought to understand the survivors’ and caregivers’ perceptions of the usefulness of VR-based interventions in supporting post-stroke recovery and their experience of using the specially developed VR modules. Methods: A qualitative study with semi-structured, in-depth, individual interviews was conducted with a convenience sample of 10 stroke survivor-caregiver dyads (n=20). Each survivor and caregiver attended a first interview about their perceptions and expectations of VR-based interventions. They were then invited to experience all games of the VR modules and were interviewed again about their experience and satisfaction with using the VR modules, and suggestions on areas for improvement. All interview data were transcribed verbatim and analyzed thematically. Results: Most of the survivors (mean age=60.80; SD=6.71) were female (70%), had an ischemic stroke (50%), and walked with a stick (70%). The mean years after stroke was 4.80 (SD=4.16). Most of the caregivers were female (80%) and had a mean age of 56.20 years (SD=7.73). All survivors had no prior VR experience. Three themes were identified: A modern strategy instilling enjoyment into the regular physical training; confidence boosting for reengaging into life situations and outdoor activities; and tailored modifications needed for reviewing training progress, supporting more social interactions and controller-free experience. They suggested enabling availability of the modules in survivors’ home or community settings for increasing the convenience to access the modules. Conclusions: The findings showed that the new VR training modules are acceptable to the survivors. Feedback elicited informed refinement of the modules and the usefulness of the modules in improving social participation of survivors will be evaluated in a large-scale randomized controlled trial.

Effectiveness of a smartphone-enabled dyadic self-care programme (SDSCP) for stroke survivors and caregivers: study protocol for a randomised controlled trial

IntroductionThe promotion of self-care has begun to serve as a central response strategy to the rising burden of stroke. In fact, stroke self-care can be recognised to be a dyad...

The dyadic self-care experience of stroke survivors and their caregivers: A qualitative descriptive study.

Promoting self-care is the core response strategy of the global health system to the burden of stroke. Although self-care in stroke represents a dyadic phenomenon, the dyadic self-care experience of stroke survivors and their caregivers is often overlooked in clinical practice. The aim of this study was to explore the dyadic self-care experience of stroke survivors and their caregivers. A descriptive qualitative design was used to conduct the study. The Consolidated Criteria for Reporting Qualitative Research was used for study reporting. A total of 21 stroke survivor-caregiver dyads were recruited for this study between May 2022 and September 2022. Data were collected through semistructured interviews and analyzed using thematic analysis. In this study, four themes were identified: (1)poor relationship quality of the dyads, (2)dyadic incongruence in managing stroke,(3)a slow and tiring dyadic self-care processand (4)happy cooperation in coping with dyadic self-care. Healthcare professionals should give greater consideration to the contradictions and disparities that may arise between stroke survivors and caregivers during the self-care process. It is crucial for them to provide personalized and tailored support and interventions that can assist these individuals in achieving a more optimal balance in their dyadic self-care. Patients were involved in the formulation of interview questions forthis study. No members of the public wereinvolved in this study.

Actor–partner effects of wellbeing, hope and self-esteem on depression in stroke survivor–caregiver dyads: A randomized controlled trial

Background Stroke is a disabling, long-term condition that challenges the mental and physical health of stroke-survivors concurrently with their primary family-caregivers (dyad). However, there has been a lack of emphasis on this dyadic need. Thus, this study aims to investigate the impacts of two interventions on hope, self-esteem and hedonic wellbeing on depression among the stroke-survivor–caregiver dyad. Methods This randomized-controlled-trial applied the actor–partner interdependence model to 100 randomly-selected dyads (N = 200) of stroke-survivors, mean (SD) age was 73.63(7.22) and family-caregivers, mean (SD) age was 62.49(14.44) years, recruited from Hong Kong hospitals and rehabilitation centres. The intervention was eight-weekly two-hour narrative therapy group sessions (n = 54 dyads), compared with the current model of psychoeducational group to each dyad as needed. Outcomes were collected via questionnaires and interviews, at four time-points: baseline (T1), during-intervention (T2) (1-month), immediately post-intervention (T3) (2-months) and follow-up (T4) (6-months). Results The results demonstrated that there are actor effects on stroke-survivors (β = −0.353, p < 0.05) and caregivers (β = −0.383, p < 0.05), where higher levels of hedonic wellbeing were associated with fewer depressive symptoms. Partner effects were observed as caregivers’ depressive symptoms were possessing a significant negative relationship with stroke survivors’ wellbeing (β = −0.387, p < 0.05). Those stroke survivors in the intervention group had a significantly higher level of self-esteem associated with lower levels of depression (β = −0.314, p < 0.05). Conclusions Improving hope, self-esteem and wellbeing through narrative therapy significantly mediates depressive symptoms, strengthening the dyadic support of stroke survivors and family caregivers.

Effects of a social participation-focused virtual reality intervention for community-dwelling stroke survivors with physical disabilities: a randomised controlled trial protocol

IntroductionStudies show that stroke survivors encounter physical and psychological limitations that restrict their participation in social and community activities. Systematic reviews have yielded inconclusive evidence regarding the effectiveness of different...

Linkage of Optimism With Depressive Symptoms Among the Stroke Survivor and Caregiver Dyads at 2 Years Post Stroke: Dyadic Mediation Approach.

Depressive symptoms are substantial among stroke survivors and their caregivers in poststroke management. Optimism and social support are known to protect against depressive symptoms. However, little is known about how optimism and social support contribute to depressive symptoms among stroke survivor-caregiver dyads. The study's purpose was to examine actor and partner effects of optimism on depressive symptoms through perceived social support among stroke survivors and caregiver dyads in the chronic stage of rehabilitation. Stroke survivors and caregivers (N = 105 dyads) completed the survey at 2 years of follow-up after the first stroke. Depressive symptoms, optimism, and perceived social support were assessed using the Center for Epidemiologic Studies-Depression, the Life Orientation Test, and the Interpersonal Support Evaluation List. The Actor-Partner Interdependence Model Extended to Mediation analysis was used to test the indirect effect of optimism on depressive symptoms through perceived social support. Higher optimism was significantly associated with lower depressive symptoms for caregivers (direct actor effect, -0.6844; 95% confidence interval [CI], -0.9844 to -0.3844) and stroke survivors (direct partner effect, -0.4189; 95% CI, -0.0789 to -0.0889). Perceived social support availability significantly mediated the association between optimism and depressive symptoms for stroke survivors (indirect effect, -0.1957; 95% CI, -0.3923 to -0.0670). Caregiver perceived social support availability was also a significant mediator between caregivers' optimism and stroke survivors' depressive symptoms (indirect effect, 0.1658; 95% CI, 0.0559-0.3128). Intervention improving dyad members' optimism and social support would be beneficial to improve depressive symptoms of the stroke survivors and caregivers in chronic stroke management.

Tailored Sitting Tai Chi Program for Subacute Stroke Survivors: A Randomized Controlled Trial.

The initiation of exercise during rehabilitation at the subacute stage could provide stroke survivors with an approach to recovery that capitalizes on unique physiological conditions and promotes spontaneous recovery. We aimed to examine the effects of a tailored sitting Tai Chi program on recovery outcomes among subacute stroke survivors. We conducted a 12-week assessor-blind randomized controlled trial in China. Subacute stroke survivor-caregiver dyads were recruited and randomly assigned to either the sitting Tai Chi group (n=80) or attention control group (n=80). Outcomes including upper limb function (Fugl-Meyer Assessment Upper Extremity & Wolf Motor Function Test), balance control (Berg Balance Scale), sitting balance control (Trunk Impairment Scale), depressive symptoms (Geriatric Depression Scale Short Form), shoulder range of motion, shoulder pain (ShoulderQ), activities of daily living (Modified Barthel Index), and quality of life (Stroke Specific Quality of Life Scale) were measured at baseline, in-process, immediately post, and 4-week postintervention. Immediately postintervention, the sitting Tai Chi group (n=69) showed significant upper limb function improvement in the primary outcomes including the performance time (regression coefficient of the group-by-time interaction, B=-21.415 [95% CI, -31.000 to -11.831]) and functional ability (B=10.146 [95% CI, 4.886-15.406]) domains of the Wolf Motor Function Test, balance control (B, 4.972 [95% CI, 1.356-8.588]), and sitting balance control (B=4.397 [95% CI, 2.699-6.096]). Compared with the control group (n=65), improvements were also observed in secondary outcomes including depressive symptoms (B=-1.626 [95% CI, -2.304 to -0.948]), shoulder extension (B=4.518 [95% CI, 0.893-8.144]), activities of daily living (B=5.510 [95% CI, 0.450-10.569]), and quality of life (B=15.680 [95% CI, 7.255-24.105]). The results support the effectiveness of a tailored sitting Tai Chi program in improving recovery outcomes among subacute stroke survivors and provide additional knowledge to support the clinical implementation of such a program. URL: https://www. gov; Unique identifier: NCT04138407.

Self-care interventions in stroke survivor–caregiver dyads: a protocol for systematic review and meta-analysis

IntroductionStroke is known as one of the leading causes of mortality and disability worldwide. Self-care plays a significant role in improving the quality of life, self-efficacy and many other outcomes...

Support system diversity among family caregivers of stroke survivors: a qualitative study exploring Asian perspectives

BackgroundCaregiving is a global phenomenon which is bound to increase in tandem with the aging population worldwide. Stroke is a condition common in older people that requires complex caregiving necessitating provision of adequate support to the caregivers. Past literature consists of limited accounts of types and organization of support arrangements needed by different caregivers. We aimed to describe the support system of caregivers of stroke survivors in Singapore, highlighting differences across the different caregiver identities (i.e. spouse, adult-child, etc.).MethodsWe conducted a qualitative descriptive study in the community setting involving 61 purposively sampled and recruited stroke survivors and caregivers. Semi-structured interviews were conducted, and transcripts were analysed using thematic analysis.ResultsOur findings were summarized across the following 4 themes: 1) cultural influence and caregiving; 2) caregiver support system with the following sub-themes: 2.1) dyadic caregiver support type, 2.2) extended caregiver support type, 2.3.) distributed caregiver support type and 2.4) empowering caregiver support type; 3) breaks in care of stroke survivor and 4) complex relationship dynamics. We operationalized the caregiver support system as comprising of type, people and activities that enable the caregiver to participate in caregiving activities sustainably. While spouse caregivers preferred dyadic and extended support systems positioning themselves in a more central caregiving role, adult-child caregivers preferred distributed support system involving family members with paid caregivers playing a more central role.ConclusionsOur findings highlight caregiver identity as a surrogate for the differences in the caregiver support systems. Practical implications include imparting relationship-building skills to the stroke survivor-caregiver dyads to sustain dyadic support system and educating clinicians to include differences in caregiving arrangements of stroke survivors in practising family-centred care.

Protective Role of Caregiver Preparedness on the Relationship Between Depression and Quality of Life in Stroke Dyads.

Depression and quality of life (QOL) have an interdependent and transactional nature in stroke survivor-caregiver dyads. While the strong relationship between depression and physical and emotional QOL in stroke survivor-caregiver dyads is well known, it is less clear if this relationship is moderated by caregiver preparedness, which could easily be targeted with interventions. In this study, we examined the moderating role of caregiver preparedness on the association between depression and QOL in stroke survivor-caregiver dyads. We used a longitudinal design with follow-ups every 3 months over a 1-year period. Considering the nonindependent nature of the data (survivors and their caregivers), we used multilevel modeling to analyze data at the dyad level. We implemented 4 longitudinal dyadic moderation models (one for each QOL domain: physical, psychological, social, and environmental) using hierarchical linear modeling. A sample of 222 stroke survivor-caregiver dyads was analyzed. Stroke survivors were older (M=70.8, SD=11.9) than their caregivers (M=52.4, SD=13.1). Stroke survivors predominantly had an ischemic stroke, equally distributed by site. Caregivers were primarily female (66%), with a medium to high educational level (57%). Caregiver preparedness significantly moderated the association between survivor depression and survivor psychological (B=0.56, P<0.01) and environmental (B=0.58, P<0.01) QOL at baseline and social QOL over time (B=0.24, P<0.05). Similarly, caregiver preparedness significantly moderated the association between caregiver depression and caregiver physical (B=0.25, P<0.01) and environmental (B=0.18, P<0.05) QOL over time. Caregiver preparedness has a positive influence on both members of the dyad. Assessment of stroke-caregiver preparedness could be helpful to motivate clinicians to develop and implement interventions for stroke survivor-caregiver dyads.

At the Intersection of Race, Socioeconomics, and Chronic Illness: A Case and Frame Analysis of Two Survivor-Caregiver Dyads in the Aftermath of Stroke

ABSTRACT Although the overall incidence of stroke in the United States has decreased in recent years, the incidence of stroke among Black Americans has not changed. This has resulted in a widening gap between White and Black stroke survivors and their families. A variety of factors contribute to this inequity including social determinants of health (e.g., adverse life events, discrimination, neighborhood deprivation, lack of access to health care). This article uses a “case and frame” approach, through the lens of ecological systems theory, to illustrate how social determinants of health express themselves in two stroke survivor-caregiver dyads living in a large Midwestern city. We draw out implications for practice and policy in social work and related disciplines that focus on recognizing the impact of social determinants of health, developing culturally-specific interventions that mitigate unique stressors but that also leverage unique strengths, and building capacity for cultural competence and cross-cultural health communication within organizations.

Role of caregiver factors in outpatient medical follow-up post-stroke: observational study in Singapore

BackgroundOutpatient medical follow-up post-stroke is not only crucial for secondary prevention but is also associated with a reduced risk of rehospitalization. However, being voluntary and non-urgent, it is potentially determined by both healthcare needs and the socio-demographic context of stroke survivor-caregiver dyads. Therefore, we aimed to examine the role of caregiver factors in outpatient medical follow-up (primary care (PC) and specialist outpatient care (SOC)) post-stroke.MethodStroke survivors and caregivers from the Singapore Stroke Study, a prospective, yearlong, observational study, contributed to the study sample. Participants were interviewed 3-monthly for data collection. Counts of PC and SOC visits were extracted from the National Claims Database. Poisson modelling was used to explore the association of caregiver (and patient) factors with PC/SOC visits over 0–3 months (early) and 4–12 months (late) post-stroke.ResultsFor the current analysis, 256 stroke survivors and caregivers were included. While caregiver-reported memory problems of a stroke survivor (IRR: 0.954; 95% CI: 0.919, 0.990) and caregiver burden (IRR: 0.976; 95% CI: 0.959, 0.993) were significantly associated with lower early post-stroke PC visits, co-residing caregiver (IRR: 1.576; 95% CI: 1.040, 2.389) and negative care management strategies (IRR: 1.033; 95% CI: 1.005, 1.061) were significantly associated with higher late post-stroke SOC visits.ConclusionWe demonstrated that the association of caregiver factors with outpatient medical follow-up varied by the type of service (i.e., PC versus SOC) and temporally. Our results support family-centred care provision by family physicians viewing caregivers not only as facilitators of care in the community but also as active members of the care team and as clients requiring care and regular assessments.

Abstract P817: The Mediation Effects of Perceived Social Support on the Association Between Optimism and Depressive Symptoms Among the Stroke Survivors and Caregiver Dyads

Background: Depressive symptoms are a common psychological outcome in post-stroke management among stroke survivors and their caregivers. Optimism and social support are known to protect against depressive symptoms. However, little is know about how optimism and perceived social support contribute to depressive symptoms among stroke survivor-caregiver dyads. The purpose of this study was to examine the mediating effect of perceived social support on the relationship between optimism and depressive symptoms among stroke-survivor and caregiver dyads. Methods: A total of 105 stroke survivor and caregiver dyads completed a survey two years after first stroke. Depressive symptoms, optimism, and perceived social support were assessed using the Center for Epidemiologic Studies-Depression, the Revised Life Orientation Test, and the Interpersonal Support Evaluation List. The dyadic actor-partner interdependence mediation analysis with distinguishable dyads was used to test the mediation effect on dyadic data. Results: Stroke survivors (mean age 58.7 years, 56% male) and their caregivers (mean age 56.7 years, 61% female) reported similar levels of depressive symptoms, optimism, and perceived social support,. Figure 1 presents the results. Individuals with higher levels of optimism had higher levels of perceived social support. Higher levels of optimism in caregivers were significantly associated with lower levels of depressive symptoms of both caregivers and stroke survivors. Perceived social support significantly mediated the relationship between optimism and depressive symptoms for stroke survivors. Caregivers’ perceived social support was also a significant mediator between caregivers’ optimism and stroke survivors’ depressive symptoms. Conclusion: The findings suggest that interventions to improve dyad members’ social support would be beneficial to improve depressive symptoms of dyad members even for those who have lower levels of optimism.

The Association of Spirituality with Anxiety and Depression in Stroke Survivor-Caregiver Dyads: An Actor-Partner Interdependence Model.

Although several authors have analyzed the effects of spirituality on stroke survivors' physical functioning and on their own caregiver's outcomes, such as quality of life, only few authors have explored the interaction between spirituality and anxiety and depression using a dyadic approach. The aim of this study was to analyze the influence of spirituality in the stroke survivor-caregiver dyad and specifically on anxiety and depression in both parties. A total of 217 stroke survivor-caregiver dyads were enrolled at discharge from several rehabilitation hospitals in central and southern Italy. The actor-partner interdependence model was used to analyze the dyadic data. To verify the differences in the effects between survivors and caregivers, comparisons were made between the χ2 values of the model in which actor and partner effects were constrained to be equal. The average age of stroke survivors and their caregivers at baseline was 71.2 and 52.7 years, respectively. Among the stroke survivors, there were slightly more men than women, whereas 65% of the caregivers were women. Most stroke survivors had had an ischemic stroke. Four statistically significant actor effects were identified. Higher survivors' and caregivers' spirituality was associated with higher survivor and caregiver anxiety. The only significant partner effect that was identified was the association between stroke survivor spirituality and caregiver depression. This study highlights the importance of studying spirituality in the population with stroke. Spirituality seems to play an important protective role in both stroke survivors' and caregivers' depression but not in anxiety.

Feasibility of the Hand in Hand Relationship Intervention for Stroke Survivor–Caregiver Dyads: A Randomized Trial

Purpose: A strong interpersonal relationship after stroke is important for the prevention of depression in survivors and family caregivers. This study aimed to test the feasibility of quality of relationship intervention for stroke dyads called Hand in Hand (HiH). Methods: Sixteen dyads were randomized into either the HiH group ( n = 8) or information, support, and referral (ISR) control group ( n = 8). HiH dyads received up to eight sessions, with topics prioritized according to a 17-item screening tool. ISR dyads received up to eight sessions that included information, active listening, and referrals. Feasibility, acceptability, and outcomes data were collected for both groups. Results: The HiH and ISR groups were feasible and acceptable. Caregivers in both groups, as well as survivors in the ISR group, experienced improvements in depressive symptoms and other select outcomes. Conclusions: Findings suggest that HiH is feasible to implement with stroke dyads and that it merits further refinement and testing.

Moderator Role of Mutuality on the Association Between Depression and Quality of Life in Stroke Survivor-Caregiver Dyads.

Authors of previous research have not yet analyzed the role of potential moderators in the relationship between depressive symptoms and quality of life (QOL). The aim of this study was to examine the moderating effect of mutuality between depressive symptoms and QOL in stroke survivor and caregiver dyads. This study used a longitudinal design with 222 stroke survivor-caregiver dyads enrolled at survivor discharge from rehabilitation hospitals. Data collection was performed for 12 months. We examined survivor and caregiver QOL dimensions (physical, psychological, social, and environmental), depression, and mutuality at baseline and every 3 months. Hierarchical linear modeling was used to test 4 longitudinal dyadic moderation models (1 for each QOL domain). Survivors (50% male) and caregivers (65% female) were 70.8 (SD, 11.9) and 52.5 (SD, 13.1) years old, respectively. We observed no significant moderating effects of mutuality for survivors across the 4 dimensions of QOL over time. However, higher survivor mutuality was significantly associated with higher survivor psychological and social QOL at baseline. Regarding caregivers, caregiver mutuality significantly moderated the association between caregiver depressive symptoms and caregiver physical (B = 0.63, P < .05), psychological (B = 0.63, P < .01), and social (B = 0.95, P < .001) QOL at baseline, but not in environmental QOL. Higher caregiver mutuality was significantly associated with less improvement in caregiver physical QOL over time. Mutuality is a positive variable on the association between depression and QOL for both members of the dyad at discharge but may lead to declines in physical health for caregivers over time. Further work is needed to understand the role of mutuality on long-term outcomes and associations with increased care strain.

Effectiveness of dyadic interventions to improve stroke patient-caregiver dyads' outcomes after discharge: A systematic review and meta-analysis study.

Because of the importance of a dyadic approach, it is necessary to conduct a systematic review to identify which dyadic intervention could be implemented for stroke survivor-caregiver dyads after discharge from the rehabilitation hospital to improve outcomes. The aims were to systematically review the evidence to identify which dyadic interventions have been implemented in stroke survivor-caregiver dyads to improve stroke survivor-caregiver dyads' outcomes and to analyse, through a meta-analysis, which intervention was found to be the most effective. A systematic review and meta-analysis were conducted using the following electronic databases: PubMed, CINAHL and PsycInfo. Randomized controlled trials (RCTs) and quasi-RCT studies published within the last 10 years were included. Quantitative data were extracted from papers included in the review using the standardized data extraction tool from JBI-MAStARI. Pooled effects were analysed between the experimental and control groups for each outcome. Sixteen studies involving 2997 stroke survivors (male gender=58%) and 2187 caregivers (male gender=25%) were included in this review. In 16 studies, which were subdivided into three quasi-RCTs and 13 RCTs, the application of dyadic interventions for stroke survivors and caregivers was systematically reviewed, but only a few of these identified a significant improvement in the stroke survivors' and caregivers' outcomes of its intervention group. Dyadic interventions showed a significant effect on stroke survivors' physical functioning (p=0.05), memory (p<0.01) and quality of life (p=0.01) and on caregivers' depression (p=0.05). This study provides moderate support for the use of a dyadic intervention to improve stroke survivors' physical functioning, memory and quality of life and caregiver depression.

Dyadic approach to supervised community rehabilitation participation in an Asian setting post-stroke: exploring the role of caregiver and patient characteristics in a prospective cohort study

ObjectiveTo study the association of caregiver factors and stroke survivor factors with supervised community rehabilitation (SCR) participation over the first 3 months and subsequent 3 to 12 months post-stroke in...

Abstract WP463: Moderator Role of Preparedness on the Association Between Depression and Quality of Life in Stroke Survivor-Caregiver Dyads

Background: Although several studies have clearly shown that depressive symptoms in stroke survivors and caregivers decreases their quality of life (QOL), previous research has not yet analyzed the role of potential moderators in the relationship between the above two variables. Aims: To examine the moderating effect of caregiver preparedness between depressive symptoms and QOL in stroke survivor and caregiver dyads. Methods: Longitudinal design with 222 stroke survivor-caregiver dyads enrolled at survivor discharge from rehabilitation hospitals. Data collection was performed over 12 months. We measured survivor and caregiver QOL dimensions (physical, psychological, social and environmental), depression and preparedness. Hierarchical Linear Modeling was used to test four longitudinal dyadic moderation models (one for each QOL domain). Results: Survivors (50% males) and caregivers (65% females) were 70.8 (SD=11.9) and 52.5 (SD=13.1) years old, respectively. Controlling for baseline covariates, caregiver preparedness significantly moderated the association between survivor depressive symptoms and survivor psychological (B = 0.56, p &lt; .01) and environmental (B = 0.58, p &lt; .01) QOL at baseline and social QOL over time (B = 0.24, p &lt; .05). In each case, higher levels of caregiver preparedness were protective and buffered the influence of survivor depressive symptoms on survivor QOL. Similarly, caregiver preparedness significantly moderated the association between caregiver depressive symptoms and caregiver physical (B = 0.25, p &lt; .01) and environmental (B = 0.18, p &lt; .05) QOL over time. Conclusions: Caregiver preparedness is a positive variable for both members of the dyad and the paper highlights the importance of implementing tailored intervention which could improve caregivers’ preparedness already during the rehabilitation period.

Effect of 5-Minute Movies Shown via a Mobile Phone App on Risk Factors and Mortality After Stroke in a Low- to Middle-Income Country: Randomized Controlled Trial for the Stroke Caregiver Dyad Education Intervention (Movies4Stroke).

BackgroundPakistan is the sixth most populous nation in the world and has an estimated 4 million stroke survivors. Most survivors are taken care of by community-based caregivers, and there are no inpatient rehabilitation facilities.ObjectiveThe objective of this study was to evaluate the effectiveness and safety of locally designed 5-min movies rolled out in order of relevance that are thematically delivered in a 3-month program to deliver poststroke education to stroke survivor and caregiver dyads returning to the community.MethodsThis study was a randomized controlled, outcome assessor–blinded, parallel group, single-center superiority trial in which participants (stroke survivor-caregiver dyads) with first-ever stroke (both ischemic and hemorrhagic) incidence were randomized within 48 hours of their stroke into either the video-based education intervention group or the control group. The video-based education intervention group had health education delivered through short videos that were shown to the participants and their caregivers at the time of admission, before discharge, and the first and third months of follow-up after discharge. The control group had standardized care including predischarge education and counseling according to defined protocols. All participants enrolled in the video education intervention and control groups were followed for 12 months after discharge for outcome assessment in the outpatient stroke clinics. The primary outcome measures were the proportion of participants achieving control of blood pressure, blood sugar, and blood cholesterol in the video intervention versus the control group. Several predefined secondary outcomes were included in this study, of which we report the mortality and functional disability in this paper. Analysis was by performed using the intention-to-treat principle.ResultsA total of 310 stroke survivors and their caregiver dyads (participant dyads) were recruited over a duration of 6 months. In total, 155 participant dyads were randomized into the intervention and control groups, each. The primary outcome of control of three major risk factors revealed that at 12 months, there was a greater percentage of participants with a systolic BP<125 mm Hg (18/54, 33% vs 11/52, 21%; P=.16), diastolic BP<85 mm Hg (44/54, 81% vs 37/52, 71%; P=.21), HbA1c level<7% (36/55, 65% vs 30/40, 75%; P=.32), and low-density lipoprotein level<100 mg/dL (36/51, 70% vs 30/45, 67%; P=.68) in the intervention group than in the control group. The secondary outcome reported is the mortality among the stroke survivors because the number of stroke-related complications was higher in the control group than in the intervention group (13/155, 8.4% vs 2/155, 1.3%), and this difference was statistically significant (P<.001).ConclusionsThe Movies4Stroke trial failed to achieve its primary specified outcome. However, secondary outcomes that directly related to survival skills of stroke survivors demonstrated the effectiveness of the video-based intervention on improving stroke-related mortality and survival without disability.Trial RegistrationClinicalTrials.gov NCT02202330; https://www.clinicaltrials.gov/ct2/show/NCT02202330