Addressing the Needs of Individuals Early After Stroke: An Adaptation of the 14-Weeks to a Healthier You Program

Northwestern University At Chicago, Evanston IL

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Abstract

? DESCRIPTION (provided by applicant): Although mortality due to stroke is decreasing, stroke is a leading cause of serious long-term disability. Participating in active rehabilitation aimed at minimizing impairments and maximizing function can reduce disability caused by stroke. Unfortunately, up to 40% of individuals who have had a stroke are discharged home without rehabilitation services; instead these individuals are discharged home with recommendations to increase physical activity through a home exercise program and/or a community exercise program. Recent evidence suggests that individuals post-stroke do not participate in exercise programs or continue with the home exercise program received at discharge. The overall goal of this F32 postdoctoral fellowship is to develop a resource for individuals post-stroke that facilitates engagement in physical activity after hospital discharge. The objective of this researc training fellowship is twofold: (1) gain patient-centered understanding of the facilitators and barriers to physical activity immediately after hospital discharge and (2) tailor the physical activity components of an Internet-based program to address the needs of individuals post-stroke. The first objective will consist of questionnaires and focus groups. Questionnaires will be administered to individuals post-stroke with chronic disabilities and those recently discharged home. This aims at identifying the unique barriers and facilitators to physical activity immediatel after hospital discharge. Individuals post-stroke, their caregivers, and rehabilitation therapists will participate in focus groups in order to capture all stakeholders' perspectives on factors that impact physical activity after hospital discharge. The second objective consists of adapting an Internet-based physical activity program to address the needs of individuals after stroke, using those facilitators and barriers identified in the first objective. The outcome of this study, a strke-adapted physical activity program, could be used as a resource to bridge the end of rehabilitation with continued home recovery and potentially improve long-term outcomes and quality of life. This research responds to AHRQ's 2014-2018 Strategic Plan Goal 3C: Improve the accessibility and quality of supportive services for people with disabilities and older adults Goal 1C: Emphasize primary and preventive care, linked to community prevention services, and Goal 1E: Ensure access to quality, culturally competent care, including long-term services and support, for vulnerable populations.