Stroke
Conditions
Keywords
Stroke, Self-Management, Telehealth, Activities of daily living, Community engagement
Brief summary
The overall goal of this proposed study is to evaluate the efficacy of a small-group, stroke-specific, self-management program delivered via telehealth to improve self-efficacy, activity performance, and quality of life in individuals with sub-acute stroke.
Interventions
BEHAVIORALImproving Participation after Stroke Self-Management Program (IPASS)
The IPASS-R program is a group-based self-management intervention that aims to improve problem-solving, action-planning, and resource utilization skills for improved community living and participation. The Activity-Barriers-Changes-Doing-Evaluation (ABCDE) framework is a user friendly problem-solving and goal setting framework that is used repetitively in each session throughout the program. Participants are guided to identify (1) an activity that they want to improve or re-engage in (A); (2) individual and environmental barriers that hinder their engagement (B); (3) changes that they can make to deal with the barriers and improve their engagement (C); and (4) an action plan to pursue (D). After the action plan, participants come back in the next session and evaluate their performance in following through on their plans (E).
The program is facilitated by two trained leaders in small groups in a community setting with individuals who have chronic health problems and will follow the CDSMP protocol. Participants receive education on various health-related topics applicable to a range of chronic conditions, share experiences, and support one another.
Sponsors
University of Missouri-Columbia
University of Washington
National Institutes of Health (NIH)
Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
University of Illinois at Chicago
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Masking description
All outcomes assessors will be blinded to participant study group assignment.
Eligibility
Sex/Gender
ALL
Age
45 Years to 85 Years
Healthy volunteers
No
Inclusion criteria
* less than 6 months post-stroke * age 45-85 years * completed inpatient rehabilitation services (if recommended) * living in the community with or without caregiver support (i.e., not living in a skilled nursing facility) * ability to read, write, and speak English * diagnosis of mild or moderate stroke (National Institutes of Health stroke score \<16) * able to use videoconferencing independently or with caregiver support
Exclusion criteria
* severe depressive symptoms as indicated by a score ≥21 on the Patient Health Questionnaire * dementia symptoms as indicated by a score of \<23 on the Montreal Cognitive Assessment * additional neurological diagnoses (e.g., brain malignancy, previous severe stroke) * (4) moderate or severe aphasia as indicated by a National Institutes of Health Stroke Scale aphasia score of ≥ 2 * inability to provide informed consent * any other condition not otherwise specified that the PI determines would render participation in this study as unsafe for the participant
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Canadian Occupational Performance Measure (COPM) Performance | Pre-intervention (week 0), post-intervention (week 6), and 6-month follow-up (week 32) | Self-report measure of activity performance. Minimum = 1, Maximum = 10. Higher scores mean better performance. |
| Canadian Occupational Performance Measure (COPM) Satisfaction | Pre-intervention (week 0), post-intervention (week 6), and 6-month follow-up (week 32) | Self-report measure of activity performance. Minimum = 1, Maximum = 10. Higher scores mean higher satisfaction. |
| Participation Strategies Self-Efficacy Scale (PS-SES) | Pre-intervention (week 0), post-intervention (week 6), and 6-month follow-up (week 32) | Self-report measure of self-efficacy in using participation strategies. The subject rates confidence across 35 items within six subscales: (1) managing home participation, (2) staying organized, (3) planning and managing community participation, (4) managing work and productivity), (5) managing communication, and (6) advocating for resources. Range of scores from 35-350. Higher scores indicate greater self-efficacy. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| In home activity level as measured by sensor system | Duration of study (from baseline assessment (week 0) to 6-month follow-up assessment) | average hourly percentage of time spent engaged in activity |
| Community engagement as measured by sensor system | Duration of study (from baseline assessment (week 0) to 6-month follow-up assessment) | Time outside the home as measured by time between door sensor activations |
| Stroke Impact Scale participation domain | Pre-intervention (week 0), post-intervention (week 6), and 6-month follow-up (week 32) | Measures perceived stroke recovery/quality of life. Range of scores 0-100. Higher scores indicate higher performance. |
| Assessment of Life Habits (LIFE-H) | Pre-intervention (week 0), post-intervention (week 6), and 6-month follow-up (week 32) | Measures self-reported participation in daily activities by measuring total score across 6 domains. Score range of 0 to 9 with higher scores indicating better performance. |
Countries
United States
Contacts
CONTACTAnna E Boone, PhD, OTR/L
CONTACTJuliana H. Earwood, OTD, OTR/L
PRINCIPAL_INVESTIGATORAnna E Boone, PhD, OTR/L
University of Missouri Occupational Therapy
Outcome results
None listed