Stroke, Adherence, Patient, Strategy Training
Conditions
Keywords
Rehabilitation, Disability, Mobile Health Technology
Brief summary
Adherence to rehabilitation interventions is associated with functional outcomes (e.g. independence in daily activities, return of motor function) after stroke. Low adherence to rehabilitation home programs is common after stroke. Interventions delivered via mobile health applications demonstrated positive effects on adherence to health behaviors (e.g. medication routines, smoking cessation). The investigators developed the iADAPT mobile application to support adherence to Strategy Training. Strategy Training is an iterative rehabilitation intervention the promotes goal setting, planning, and self-monitoring after stroke. This study examines the effects of the iADAPT mobile health application relative to a workbook on adherence to Strategy Training after stroke.
Interventions
BEHAVIORALStrategy Training
Strategy training is a form of meta-cognitive instruction that trains individuals with stroke-related cognitive impairments to identify and prioritize problematic daily activities, identify the barriers impeding performance, generate and evaluate their own strategies to address barriers, and apply these skills through iterative practice.
Sponsors
University of Pittsburgh
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 105 Years
Healthy volunteers
No
Inclusion criteria
-Diagnosis of Stroke
Exclusion criteria
* prior exposure to Strategy Training * vision impairment that impairs ability to read device screen or worksheet * poor self-awareness (score of ≥2 on Self Awareness of Deficits Inventory item #1 or #2 * current major depressive, bipolar, or psychotic disorder (Patient Health Questionnaire-9, PRIME-MD) * current alcohol or drug abuse (Mini International Neuropsychiatric Interview) * severe aphasia (score ≤1 on Boston Diagnostic Aphasia Examination) * current diagnosis of dementia, neurodegenerative disease, or cancer * anticipated discharge to a skilled nursing facility
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Adherence: Observed client behavior | Baseline to 3 months | Number of completed activity trials in the iADAPT application or Workbook |
| Adherence: Client-reported progress on goals. | Baseline and 3 months | Client rating of independence with self-selected goals (measured using Canadian Occupational Performance Measure) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Adherence: Client perspectives on treatment environment | Baseline and 3 months | Client rating on patient-provider connection and treatment expectancy measured by Healing Encounters and Attitudes Lists |
Countries
United States
Outcome results
None listed