Determining whether access to a co-designed website and an online self-management facilitation session improves self-efficacy in survivors of stroke

Prior to this trial, a website (EmpowerMe) has been co-designed with survivors of stroke and carers to enhance self-efficacy after stroke. The website includes a tailoring tool to support users find information relevant to their needs, nine content pages on topics prioritised as most important with regard to self-efficacy by survivors and carers (what is self-efficacy, being involved in decisions about your care and treatment, seeking information you need, advocating for yourself, managing fatigue, managing emotional problems, managing mobility changes, managing speaking difficulties) and a resources bank (fact sheets, internal and external website links, videos). All content pages include video-stories of survivors and carers, text and a downloadable 2-page PDF fact sheet. The website has undergone usability testing and subsequent refinement. Access to the website is password protected and only research participants will have access during the trial period. Survivors of stroke will be stratified according to age (18-64, 65+) and time since stroke (within 12 months, 12 months or more). All recruited participants will receive one individual 60-minute Take Charge session via Zoom, delivered by a research nurse or physiotherapist. All people delivering the intervention will receive training prior to delivering any sessions. The survivor can participate in the session on their own or with support people (family members, friends) present. Delivery of Take Charge will be consistent with delivery described by original investigators (Harwood M, Weatherall M, Talemaitoga A, Barber PA, Gommans J, Taylor W, McPherson K, McNaughton H. Taking charge after stroke: promoting self-directed rehabilitation to improve quality of life - a randomized controlled trial. Clin Rehabil. 2012;26:493-501) although we will deliver sessions online rather than in-person. The research team member will facilitate discussions on the following topics, which are outlined in a take Charge manual, supplied in hard copy to participants: Hopes for next 12 months, Main fears, My “best day”, Physical things, Communication, Emotional issues, Information needs, Financial issues, My support network, Preventing strokes and heart attacks in the future. Participants are supported to identify person-centred goals for each of the discussion topics when relevant. Identified goals are written in the booklet. Participants are encouraged to see this process as ongoing, and something they can do on their own. For the identified goals, participants are supported to identify interim steps, and how these can be achieved. In this way, participants are encouraged to “take charge” of working through what matters most, and how to address the things that matter most to them. On completion of the Take Charge session, participants are provided with the password to access the EmpowerMe website for the following 4 weeks. Frequency and duration of website use will be at the discretion of the participant. Google analytics will be used to monitor access to the website and content within the website. This will measure general, not individual, access to the content and site.